Healthcare Reform Industry Advocacy, Stakeholder Impacts & Outlook
|
|
- Catherine Parrish
- 7 years ago
- Views:
Transcription
1 Healthcare Reform Industry Advocacy, Stakeholder Impacts & Outlook APPENDIX M: GLOSSARY OF KEY HEALTHCARE REFORM TERMS N: DETAILED IMPLEMENTATION TIMELINE JULY 2010
2 The material provided is excerpted from authoritative sources and is believed to be current through the date set forth below. While every effort has been made to ensure the accuracy of this material, readers should obtain appropriate advice from qualified staff, consultants and professionals and should rely on official documents when making any decision that may have significant financial consequences. The material is offered for the information and convenience of the readers and should not be construed as advice. The Healthcare Reform: Industry Advocacy, Stakeholder Impacts & Outlook Appendix: M: Glossary of Key Healthcare Reform Terms, N: Comprehensive Implementation Timeline is published by the Health Industry Distributors Association, copyright All rights reserved. The contents of this publication may not be reproduced by any means, in whole or in part, without prior written consent of the publisher. For more information about HIDA membership, products, or services, please contact HIDA at (703) Health Industry Distributors Association (HIDA) 310 Montgomery Street Alexandria, Virginia Phone: (703) Fax: (703) Printed 7/2010
3 . APPENDIX VIII M. Glossary of Key Healthcare Reform Terms * Accountable Care Organization (ACO) An organization of healthcare providers (e.g., physicians, nurse practitioners, hospitals, etc.) that agrees to work together to meet quality measurements and share in any achieved Medicare cost savings through coordinating patient care. The primary concept of ACOs is to integrate care to slow the growth of healthcare costs while improving the quality of care delivered. Bundled Payments A single, fixed payment to healthcare providers to cover all services associated with a patient s condition and treatments over an episode of care. The single payment could span multiple providers in a variety of settings, motivating providers to reduce costs and the volume of services. Cadillac Insurance Plan A high-cost insurance policy defined by the total cost of premiums, rather than what the insurance plan covers or how much the patient must pay out-of-pocket for a doctor or hospital visit. Healthcare reform legislation defines high-cost health plans as anything valued above $10,200 for an individual or $27,500 for a family annually; including worker and employer contributions to flexible spending or health savings accounts. Community First Choice Program An optional state-based program to provide community-based attendant services and support to disabled individuals who would otherwise require care in a hospital, nursing facility, or intermediate care facility. Community Health Centers Federally qualified health clinics that provide comprehensive primary care services to patients regardless of the individual s income or insurance status. Federal law requires that the health centers be located in or targeted to serve medically underserved communities, provide a variety of primary care services, establish sliding fee scales based on a patient s ability to pay for care, and have community boards. Community Living Assistance Services and Supports (CLASS) Act Included in healthcare reform, the CLASS Act establishes a voluntary, self-funded long-term care insurance program to provide functionally disabled individuals with lifetime cash benefits for non-medical expenses. Comparative Effectiveness Research (CER) Research designed to inform healthcare decisions by providing evidence on the effectiveness, benefits, and harms of different treatment options. The evidence is generated from research studies that compare drugs, medical devices, tests, surgeries, and/or ways to deliver health care. * All sources are listed on the inside back cover. 3
4 Congressional Budget Office (CBO) A non-partisan congressional agency established to develop budgetary and economic information independent of the executive branch of the federal government. The CBO issues studies and reports on the federal cost of legislation, as well as the impact on state and local governments and the private sector. Disproportionate Share Hospital (DSH) Payments A funding adjustment that provides federal compensation to hospitals that serve a significantly higher number of lowincome Medicaid and/or Medicare patients. FDA Class I Medical Devices Devices that present minimal potential harm to the patient, and are not life-supporting or life-sustaining (e.g., tongue depressors, bedpans, or examination gloves). These medical devices are simpler in design than Class II and III devices and are only subject to general federal controls that are deemed sufficient to provide reasonable assurance of the safety and effectiveness of the device. FDA Class II Medical Devices Devices that are held to a higher level of assurance that they will perform as indicated and will not cause injury or harm to the patient (e.g., x-ray machines, surgical needles, or suture materials). Class II devices are subject to special controls, in addition to the general controls of Class I devices, which may include labeling requirements, mandatory performance standards, and post-market surveillance. FDA Class III Medical Devices Devices for which insufficient information exists to assure safety and effectiveness solely through the general or special controls applied to Class I or Class II devices (e.g., replacement heart valves, implanted cerebral stimulators, or implantable pacemaker pulse generators). Class III devices require pre-market approval. Federal Poverty Level (FPL) Also known as federal poverty guidelines, the measure is primarily used to determine an individual s financial eligibility for certain federal programs. The guidelines are updated annually. Currently, the poverty guideline for a single person is $10,830, and for a family of four it is $22,050. Fee-for-Service (FFS) A healthcare payment method based upon a fee schedule that specifies rates for each service provided to a patient over the course of care. Health Information Technology (Health IT; HIT) The electronic management and exchange of comprehensive medical information between healthcare providers and patients. 4
5 Health Professional Shortage Area (HPSA) An area designated by the Department of Health and Human Services that lacks a sufficient number of healthcare providers and services to meet the primary care needs of the residents. The classification allows the federal government to direct supplemental funding and resources to these areas to support and strengthen healthcare services. Independent Payment Advisory Board (IPAB) A 15-member independent panel charged with enforcing a limit on annual Medicare spending growth. Beginning in 2015, Medicare spending will be limited to a fixed growth rate, initially set at a mix of general inflation in the economy and inflation in the health sector. By 2018, the spending ceiling limit will be set permanently at per capita gross domestic product growth plus one percentage point. IPAB recommendations will automatically become law unless Congress reverses them with a majority vote and presidential approval. Insurance Exchange A state-based entity designed to offer enrollees private health insurance plan options. An exchange is intended to provide consumers with transparent information about plan provisions such as premium costs and covered benefits, as well as a plan s performance in encouraging wellness, managing chronic illnesses, and improving consumer satisfaction. Meaningful Use Criteria developed by the Centers for Medicare & Medicaid Services (CMS) that demonstrate that the electronic health record technology utilized by healthcare providers is connected in a manner that provides for the electronic exchange of health information in accordance with all applicable laws and standards that govern the exchange of information to improve the quality of healthcare (e.g., coordinated care). Providers must meet the requirements outlined by the criteria in order to qualify for federal health IT incentive payments; providers must pay monetary penalties in 2015 if meaningful use is not achieved. Medical Home A team-based model of care led by a personal physician who provides continuous and coordinated care throughout a patient s lifetime. Also known as a patient centered medical home, it is responsible for providing for all of a patient s healthcare needs or appropriately arranging care with other qualified professionals. Medicare Payment Advisory Commission (MedPAC) An independent congressional agency established to advise the U.S. Congress on issues affecting the Medicare program, such as payments to providers, access to care, quality of care, and other issues affecting Medicare. Medicare Shared Savings Program A new program that allows for accountable care organizations to form and share a percentage of any savings should the actual per capita expenditures of their assigned Medicare beneficiaries fall below their specified benchmark amount. 5
6 Minimum Data Set 3.0 (MDS 3.0) A comprehensive screening and assessment tool used to measure the functional capacity for all residents of Medicare or Medicaid certified nursing homes. Not only does MDS standardize communication regarding resident problems and conditions, it is also tied to reimbursement groupings and is used to monitor and assess the quality of care provided to nursing home residents. Part D Coverage Gap ( Doughnut Hole ) Prior to healthcare reform, Medicare Part D beneficiaries were required to pay 100% of their total prescription drug costs after their spending exceeded the initial coverage limit and before reaching the catastrophic coverage limit that would trigger public assistance. Physician Quality Reporting Initiative (PQRI) A Medicare program that incentivizes physicians to report data on quality measures by providing bonus payments to participants. In 2015, physicians face a penalty if they do not participate. Recovery Audit Contractor (RAC) A Medicare program established to identify improper Medicare payments both overpayments and underpayments made to healthcare providers that may not have been detected through existing program integrity efforts. Resource Utilization Groups (RUGs) A Medicare Part A prospective payment system that categorizes nursing home residents into a payment group based upon his or her care and resource needs. Sustainable Growth Rate (SGR) A cost-containment formula that aims to control spending for physicians services provided under Medicare Part B. The formula sets an overall Medicare spending threshold and triggers automatic offsets (e.g., physician payment reductions) to the Medicare physician fee schedule when expenditures exceed the spending threshold. Tort Reform The process of changing the current medical liability and litigation system for resolving disputes over injuries caused by a healthcare provider, with the goals of improving patient safety, reducing medical errors, encouraging the efficient resolution of disputes, and improving access to liability insurance for healthcare providers. Value-based Purchasing (VBP) Purchasing practices aimed at improving the value of healthcare services, where value is a function of both quality and cost; as opposed to the fee-for-service model that bases provider reimbursements on volume of care. 6
7 N. Detailed Implementation Timeline Insurance Reforms Establishes a high-risk coverage pool for individuals with pre-existing medical conditions (effective until January 1, 2014) Extends health insurance eligibility for dependents to age 26 Requires qualified plans to offer coverage for preventive services rated A or B by the U.S. Preventive Services Task Force, recommended immunizations, and additional preventive care and screenings for women, infants, children, and adolescents Establishes a temporary reinsurance program to reimburse employers that provide health insurance to non-medicare eligible retirees over the age of 55 Prohibits health plans from having lifetime coverage limits, restricts annual coverage limits, and prohibits canceling coverage for individuals who get sick Implements the first phase of a small business tax credit program for contributions to purchase health insurance for employees Medicaid Allows state Medicaid plans to offer coverage to childless adults Increases the Medicaid drug rebate percentage to 23.1% for brand name drugs (except the rebate for clotting factors and drugs approved exclusively for pediatric use increases to 17.1%); increases the Medicaid rebate for non-innovator, multiple-source drugs to 13% of the average manufacturer price 2010 Medicare Gives senior citizens who reach the Medicare Part D coverage gap a $250 rebate; begins to shrink the donut hole Reduces annual market basket updates for inpatient, outpatient, and long term care hospital services, inpatient rehabilitation facilities, and psychiatric facilities Prohibits physician-owned hospitals without a Medicare provider agreement by December 31, 2010, from participating in the program; restricts growth among grandfathered facilities Extends the Physician Quality Reporting Initiative Quality Improvement Establishes non-profit Patient-Centered Outcomes Research Institute to conduct comparative effectiveness research Tax Changes Imposes several new requirements on 501(c)(3) tax-exempt hospitals to maintain their tax-exempt status Workforce Strengthens student loan and scholarship programs for the healthcare workforce Other Changes Authorizes the FDA to approve generic drugs and grants manufacturers of biologics a 12-year exclusive use period before generics can be developed 7
8 Insurance Reforms Establishes the Community Living Services and Supports program, a voluntary, national long-term care insurance program Prevention and Wellness Eliminates Medicare beneficiary out-of-pocket cost sharing for most preventive services covered by Medicare Provides access to a comprehensive health risk assessment and a personalized prevention plan for Medicare beneficiaries Encourages small employers to establish wellness programs with grants for up to five years Medicaid Prohibits federal Medicaid payments for services related to certain healthcare acquired conditions Establishes the State Balancing Incentive program to enhance federal matching payments to the states to increase noninstitutionally based long-term care services Creates the state-based Community First Choice program for disabled individuals to have home and community based services Medicare 2011 Requires pharmaceutical manufacturers to begin offering a 50% discount on brand-name drugs to senior citizens in the Medicare Part D coverage gap; begins system of federal subsidies for generic prescriptions filled in coverage gap Freezes Medicare Advantage at 2010 rates and begins process of aligning payments to traditional Medicare rates Begins to provide $400 million in Medicare payments to qualifying hospitals in counties with the lowest quartile of Medicare spending (across only) Creates the Center for Medicare & Medicaid Innovation to test new payment methods and service delivery models Quality Improvement Establishes the Community-based Collaborative Care Network program to coordinate care services for low-income populations within healthcare consortiums comprised of safety net hospitals, community health centers, and other safety net providers Strengthens emergency and trauma center capacity with the creation of a new trauma center program to fund research on emergency medicine and develop demonstration programs to test new emergency care models Begins to provide funds for community health centers to build and expand services ($11 billion across ) Establishes programs to support school-based and nurse-managed health centers Tax Changes Restricts health reimbursement accounts and health flexible spending accounts from reimbursing non-prescription overthe-counter (OTC) drugs; restricts health savings accounts and Archer Medical Savings Accounts from reimbursing OTC products on a tax-free basis unless they are doctor prescribed Increases the tax penalty from 10% to 20% for non-qualified medical expenses from a health savings account or an Archer Medical Savings Account Implements new annual fees on pharmaceutical manufacturers Workforce Provides a 10% Medicare pay bonus through 2015 for certain services performed in health professional shortage areas Expands funding for scholarships and loan repayment for primary care doctors working in medically underserved areas Redistributes unused graduate medical education training slots to ease primary care physician shortages 8
9 Medicaid Creates a Medicaid demonstration project to make bundled payments to hospitals (effective ) Creates a Medicaid demonstration project to make global capitated payments (fixed-dollar payments for the care that patients may receive in a given time period, such as a month or year) to safety net hospital systems (effective ) Creates a Medicaid demonstration program to allow pediatric medical providers organized as ACOs to share in Medicaid cost savings (effective ) 2012 Medicare Allows accountable care organizations (ACOs) that achieve targeted quality improvements to share in the Medicare cost savings Reduces Medicare payments to hospitals who have high rates of preventable readmissions Reduces market basket updates for home health agencies, skilled nursing facilities, hospices, and other Medicare providers Creates the Medicare Independence at Home demonstration program to test the use of home-based primary care teams for certain chronically ill patients Establishes a hospital value-based purchasing program; the Department of Health and Human Services (HHS) is also tasked with submitting a plan to Congress on establishing value-based purchasing programs for home health agencies, skilled nursing facilities, and ambulatory surgical centers Medicaid Increases Medicaid payments to primary care physicians to 100% of Medicare rates for two years, across Medicare Begins phasing-in federal subsidies for brand-name prescription drugs for Medicare beneficiaries in the Part D coverage gap (to 25% in 2020, in addition to the 50% manufacturer brand-name discount) Establishes a national Medicare pilot program for bundled payments for acute, inpatient hospital services, physician services, outpatient hospital services, and post-acute care services by January 1, 2013; expands the program, if appropriate, by January 1, Quality Improvement Requires pharmaceutical, biological, medical device manufacturers, and group purchasing organizations (GPOs) to report payments and gifts to physicians and teaching hospitals Tax Changes Increases the threshold for claiming itemized deduction for medical expenses from 7.5% to 10 percent Increases the hospital insurance tax rate by 0.9% on individuals earning more than $200,000 ($250,000 for married and filing jointly) Imposes limits on flexible spending account contributions to $2,500 per year (amount will increase annually based on cost of living adjustments) Imposes 2.3% medical device tax on manufacturers and importers first sale Eliminates deduction for 28% business tax subsidy for employers that provide prescription coverage for retirees 9
10 Individual and Employer Requirements Requires individuals to have a minimum level of health insurance coverage or pay tax penalties Requires large employers (50+ FTEs) to provide health insurance for employees or pay a penalty of $2,000 per FTE (excluding the first 30 employees) Requires large employers (50+ FTEs) that offer coverage, but have at least one FTE receiving a premium tax credit, to pay a penalty of the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each FTE (excluding the first 30 employees) Requires employers with more than 200 employees to automatically enroll employees into health insurance plans; employees may opt-out Insurance Reforms 2014 Creates state-based health insurance exchanges through which individuals and businesses (up to 100 employees) can purchase coverage Limits deductibles to $2,000 for individuals or $4,000 for families for health plans in the small group market Expands Medicaid eligibility to 133% of the federal poverty level (FPL) Prohibits health plans from denying coverage based on preexisting conditions or because an individual participates in a clinical trial Subsidizes coverage in the insurance exchanges for low-income individuals and families (between 133% and 400% of FPL) Medicaid Expands Medicaid eligibility for individuals under the age of 65 with incomes up to 133% of the federal poverty level who are not eligible for Medicare Reduces state payments to Medicaid Disproportionate Share Hospitals Medicare Establishes the Independent Payment Advisory Board (IPAB) to develop Medicare payment policies to reduce Medicare spending Reduces payments to Medicare Disproportionate Share Hospitals initially by 75% and later increases payments based on the percent of the population uninsured and the amount of uncompensated care provided Prevention and Wellness Allows employers to incentivize employee participation in wellness programs and meeting health-related standards with rewards in the form of premium discounts or benefits that otherwise would not be provided of up to 30% of the cost of coverage (increasing to 50% if appropriate); establishes pilot programs in 10 states allowing a similar reward system in the individual insurance market Tax Changes Imposes fees on health insurance companies Insurance Reforms 2015 AND LATER Permits states to form health care choice compacts, allowing insurers to sell policies in all states involved in the compact (2016) Medicare Reduces Medicare payments to hospitals by 1% for certain hospital-acquired conditions (2015) Creates a physician value-based purchasing program (2015) Tax Changes Imposes a tax on employer-sponsored Cadillac health plans with aggregate values exceeding $10,200 for individual coverage or $27,500 for family coverage (2018) 10
11 Sources American Association of Homes & Services for the Aging American Clinical Laboratory Association American College of Cardiology American College of Physicians American Hospital Association American Health Care Association American Medical Association American Society of Clinical Oncology Business Roundtable Centers for Medicare & Medicaid Services Congressional Budget Office Congressional Research Service CQ Today Inside Health Policy Kaiser Family Foundation MedPac National Association of Community Health Centers National Association of Public Hospitals and Health Systems National Journal National Public Radio New York Times PricewaterhouseCoopers The New England Journal of Medicine U.S. Congress, House Committee on Energy and Commerce U.S. Congress, House Committee on Rules U.S. Congress, House Committee on Ways and Means U.S. Congress, Joint Committee on Taxation U.S. Congress, Senate Committee on Finance U.S. Department of Health and Human Services U.S. Government Accountability Office Wall Street Journal Washington Post About HIDA The Health Industry Distributors Association (HIDA) is the premier trade association representing medical products distributors. Since 1902, HIDA has provided leadership in the healthcare distribution industry. HIDA also works closely with the manufacturing community through the HIDA Educational Foundation. This outreach serves to build strong manufacturer/distributor relationships as well as to communicate the value of distribution in the healthcare supply chain. For more information on HIDA membership, products or services, call (800) 549-HIDA (4432) or visit Business Tools & Information Consultative Selling Tools Market Research Acute Care Extended Care Physician Diagnostic Testing Distribution Home Care Influenza Vaccine Production & Distribution Ambulatory Surgery Centers Group Purchasing Organizations HIDA Daily Clips Physician Office Set-Up Guide Series HIDA Distributor Financial Performance Survey Disease State Guides Education & Training ADVANCE Sales Training Accredited in Medical Sales (AMS) Certification HIDA MedSurg Conference & Expo HIDA Educational Foundation Executive Conference HIDA Educational Foundation Manufacturers Seminar Distributor Education Network featuring video training Healthcare Distribution Summit Customer Tool Series Legislative & Regulatory Resources Members-only Information from HIDA Government Affairs (GA) Advocacy State Issues Tracking Pedigree Influenza Gift Disclosure Wholesale Licensure Issue-based Resource Centers on HIDA s Web site: Additional GA Reports Industry Initiatives NEW!
12 310 Montgomery Street Alexandria VA Ph: (703) Fax: (703)
How To Improve Health Care For All
TIMELINE FOR IMPLEMENTATION OF THE AFFORDABLE CARE ACT 2010: NEW CONSUMER PROTECTIONS Eliminated pre-existing coverage exclusions for children: under age 19. Prohibited insurers from dropping coverage:
More informationStrengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.
Implementation Timeline Reflecting the Affordable Care Act 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationThe Patient Protection and Affordable Care Act. Implementation Timeline
The Patient Protection and Affordable Care Act Implementation Timeline 2009 Credit to Encourage Investment in New Therapies: A two year temporary credit subject to an overall cap of $1 billion to encourage
More informationHealth Insurance Reform at a Glance Implementation Timeline
Health Insurance Reform at a Glance Implementation Timeline 2010 Access to Insurance for Uninsured Americans with a Pre-Existing Condition. Provides uninsured Americans with pre-existing conditions access
More informationTimeline for Health Care Reform
Patient Protection and Affordable Care Act (H.R. 3590) and the Reconciliation Bill (H.R. 4872) March 24, 2010 Color Code: Hospitals Insurance Coverage Other/Workforce Delivery System 2010 Expands the RAC
More informationHealth Reform. Health Reform
FOCUS on on HEALTH REFORM IMPLEMENTATION TIMELINE On March 23, 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The following timeline
More informationAffordable Care Act at 3: Strengthening Medicare
Affordable Care Act at 3: Strengthening Medicare ISSUE BRIEF Fifth in a series May 22, 2013 Kyle Brown Senior Health Policy Analyst 789 Sherman St. Suite 300 Denver, CO 80203 www.cclponline.org 303-573-5669
More informationImplementation Timeline Reflecting the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act
Implementation Timeline Reflecting the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act 2010 Immediate Access to Insurance for Uninsured Individuals with
More informationSummary of Major Provisions in Final House Reform Package
SPECIAL BULLETIN Monday, March 22, 2010 This summary is five pages. Summary of Major Provisions in Final House Reform Package The U.S. House of Representatives late yesterday voted to pass landmark health
More informationTimeline: Key Feature Implementations of the Affordable Care Act
Timeline: Key Feature Implementations of the Affordable Care Act The Affordable Care Act, signed on March 23, 2010, puts in place health insurance reforms that will roll out incrementally over the next
More informationHealth Reform and the AAP: What the New Law Means for Children and Pediatricians
Health Reform and the AAP: What the New Law Means for Children and Pediatricians Throughout the health reform process, the American Academy of Pediatrics has focused on three fundamental priorities for
More informationAffordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion
Affordable Care Act (ACA) Health Insurance Exchanges and Medicaid Expansion Table of Contents Expanded Coverage... 2 Health Insurance Exchanges... 3 Medicaid Expansion... 8 Novartis Pharmaceuticals Corporation
More informationKey Features of the Affordable Care Act, By Year
Page 1 of 10 Key Features of the Affordable Care Act, By Year On March 23, 2010, President Obama signed the Affordable Care Act. The law puts in place comprehensive health insurance reforms that will roll
More informationSummary of the Major Provisions in the Patient Protection and Affordable Health Care Act
Summary of the Major Provisions in the Patient Protection and Affordable Care Act Updated 10/22/10 On March 23, 2010, President Barack Obama signed into law comprehensive health care reform legislation,
More informationAn Internist s Practical Guide to Understanding Health System Reform
An Internist s Practical Guide to Understanding Health System Reform Prepared by: ACP s Division of Governmental Affairs and Public Policy Updated October 2013 How to cite this guide: American College
More informationThe Patient Protection & Affordable Care Act: Next Steps in Maine. February 8, 2013 1
The Patient Protection & Affordable Care Act: Next Steps in Maine February 8, 2013 1 Maine Medical Association Voluntary membership association of over 3,600 Maine physicians, residents, and medical students
More informationThe Potential Impact of Health Care Reform in Los Angeles County
The Potential Impact of Health Care Reform in Los Angeles County Beyond Health Care Reform: A Vision of the Future SEIU Local 721, September 25, 2010 Dylan H. Roby, PhD Assistant Professor & Associate
More informationHealth Care Reform Frequently Asked Questions
Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation
More informationHealth Care Reform Legislation and You
(Customizable space for CPA Firm Logo to go here) Health Care Reform Legislation and You Timelines and Implications of the New Law for Individuals Updated as of January 2011 The Health Care Reform Legislation
More informationMarch 19, 2009. 820 First Street NE, Suite 510 Washington, DC 20002. Tel: 202-408-1080 Fax: 202-408-1056. center@cbpp.org www.cbpp.
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org March 19, 2009 HEALTH REFORM PACKAGE REPRESENTS HISTORIC CHANCE TO EXPAND COVERAGE,
More informationWhen Reform Will Affect You
When Reform Will Affect You N AV I G AT I N G T H R O U G H T H E N E W F E D E R A L H E A LT H C A R E L A W Dear Colleague, In March, the Patient Protection and Affordable Care Act (PPACA) was signed
More informationPHYSICIANS. 202.420.7896 888 16 th St. NW, Suite 800, Washington DC 20006 www.npalliance.org
N A T I O N A L PHYSICIANS A L L I A N C E My name is Dr. Valerie Arkoosh. I am an Anesthesiologist at the University of Pennsylvania School of Medicine and the President of the National Physicians Alliance.
More informationFederal Health Care Reform: Implications for Hospital and Physician partnerships. Walter Kopp Medical Management Services
Federal Health Care Reform: Implications for Hospital and Physician partnerships Walter Kopp Medical Management Services Outline Overview of federal health reform legislation Implications for Care delivery
More informationWhat is Healthcare Reform? Get a view of the future health care system in the US; learn. success factors for healthcare administrators?
What is Healthcare Reform? Get a view of the future health care system in the US; learn about primary resources and tools for the healthcare administrator, and what are the success factors for healthcare
More informationHealth Care Implementation Timeline
Health Care Implementation Timeline The massive healthcare (H.R. 3590) and its companion reconciliation bill (H.R. 4872) passed by the Senate and House in early 2010 will go into effect over several years.
More informationThe Affordable Care Act
The Affordable Care Act What does it mean for internists? Joshua Becker MD 10/14/2015 VII. 2015 Reforms and Beyond Payment Penalties under Medicare s Pay-for-Reporting Program Value-Based Payment Modifier
More informationOhio Health Benefits LLC. Your health insurance partner!!
December 16, 2014 Presented by Steve Clark & Scott Prior Patient Protection and Affordable Care Act of 2010 Obamacare or ACA or PPACA or Health Care Reform (HCR) Signed in to law on March 23, 2010 The
More informationRonald Riner, MD. The Riner Group, Inc. 5811 Pelican Bay Blvd., Suite 210 Naples, FL 34108 800.965.8485 www.rinergroup.com
Impact of Healthcare Reform on Small Business January 12, 2011 Ronald Riner, MD The Riner Group, Inc. 5811 Pelican Bay Blvd., Suite 210 Naples, FL 34108 800.965.8485 www.rinergroup.com Healthcare Reform
More informationPublic comments on these options will be due May 26, 2009 to the following address: Health_Reform@finance-dem.senate.gov
Summary of Policy Options Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options Senate Finance Committee May 20, 2009 Public comments on these options will be due
More informationBasics of Health Care Reform. What You Should Know
Basics of Health Care Reform What You Should Know The Affordable Care Act (ACA) has resulted in major across the U.S. health care system. This brochure provides an overview and timeline of the that have
More informationInSight. A Littler Mendelson Report. Health Care Reform: Are You Prepared? A Timeline for Employers to Follow
A Littler Mendelson Report InSight An Analysis of Recent Developments & Trends In This Issue: April 2010 The Patient Protection and Affordable Care Act was signed into law on March 23, 2010. Amendments
More informationHealth Care Reform: What s in the Law
Health Care Reform: What s in the Law Professor Sidney D. Watson March 2013 On June 28, 2012, the United States Supreme Court upheld the Affordable Care Act, also known as ObamaCare. The Supreme Court
More informationSummary of Medicare Provisions in the President s Budget for Fiscal Year 2016
Summary of Medicare Provisions in the President s Budget for Fiscal Year 2016 Gretchen Jacobson, Cristina Boccuti, Juliette Cubanski, Christina Swoope, and Tricia Neuman On February 2, 2015, the Office
More informationNational Healthcare Reform: Implications for Nursing Education and Practice
National Healthcare Reform: Implications for Nursing Education and Practice UMass Graduate School of Nursing Alumni Association Program June 4, 2010 Katharine London 2 Goals for Today s Presentation Explain
More informationProgram Objectives 9/2/2014. Affordable Care Act: Smooth or White Waters Ahead? History of Healthcare Reform
Affordable Care Act: Smooth or White Waters Ahead? Kathleen Bradbury-Golas, DNP, RN, NP-C, ACNS-BC Assistant Professor, Felician College Family Nurse Practitioner, Virtua Atlantic Shore Family Practice
More informationPresentation for Licensed Producers The Affordable Care Act
Presentation for Licensed Producers The Affordable Care Act Bruce Donaldson, CHC Producer & Stakeholder Specialist Arkansas Insurance Department Affordable Care Act The ACA was passed by Congress and signed
More informationANA s Belief. Quality, affordable health care is not a privilege, but a basic human right. 9/22/2011
Health Care Reform Yesterday, Today and Tomorrow The Nursing Perspective ANA s Belief Quality, affordable health care is not a privilege, but a basic human right. ANA s Four Pillars of Health Care Reform
More informationHealth Care Reform Legislation and You
Health Care Reform Legislation and You Timelines and Implications of the New Law for Individuals Updated as of May 2011 Health Care Reform Legislation and You The Patient Protection and Affordable Care
More informationTimeline of New Health Care Law and Its Impact on American Businesses
Timeline of New Health Care Law and Its Impact on American Businesses Summaries of the Patient Protection and Affordable Health Care Act (Public Law 111-148) Health Care and Education Reconciliation Act
More informationSummary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals
Summary of Federal SCHIP Reauthorization, Economic Stimulus, and Health Care Reform Bills and Proposals I. Children s Health Insurance Program (CHIP) Reauthorization Act of 2009 A. Funding for CHIP. The
More informationPPACA, COMPLIANCE & THE USA MARKET
PPACA, COMPLIANCE & THE USA MARKET INTRODUCTION The USA healthcare market is the largest in the world followed by Switzerland and Germany It consists of broad services offered by various hospitals, physicians,
More informationMedicare Part D. MMA establishes a standard Part D drug benefit, which consists of four components or phases.
Medicare Part D The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added voluntary prescription drug coverage to Medicare, the federal health insurance program for seniors
More informationHEALTH REFORM and VACCINES: Review of Federal Legislation
HEALTH REFORM and VACCINES: Review of Federal Legislation The Patient Protection and Affordable Care Act (PPACA) And The Health Care and Education Reconciliation Act Alexandra Stewart June 2, 2012 1 Presentation
More informationFact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules
Fact Sheet Health Reform Changes Insurance Rules The Affordable Care Act (ACA) will greatly increase the availability of health insurance and broadly impact the delivery of health care in America. This
More informationHealth Care Reform and Its Impact on Nursing Practice
Health Care Reform and Its Impact on Nursing Practice UNAC-UHCP Convention Las Vegas, NV November 9, 2010 Katherine Cox AFSCME International What Have Your Heard? What Do You Think? How do you think the
More informationSelected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010
Selected Employer Provisions in the Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act of 2010 This chart outlines, in depth, selected provisions in the Patient
More informationHow To Get Health Care Reform For The United States
Federal Health Care Reform: Implications for New York Division of Coverage and Enrollment Office of Health Insurance Programs Health Bureau Insurance Department June 2010 Federal Health Care Reform: Where
More informationHealth Care Reform Update. Spring 2014
Health Care Reform Update Spring 2014 Quincy Quinlan Texas Association of Counties 512 478 8753 quincyq@county.org http://www.county.org Today s Agenda Timeline Fees/Taxes Individual Mandate Marketplace
More informationA Healthy Florida Works Program. Policy Proposal. The smart choice for individuals and businesses in Florida
A Healthy Florida Works Program Policy Proposal The smart choice for individuals and businesses in Florida TABLE OF CONTENTS Introduction Executive Summary Program Description 3 5 6 Coverage Population
More informationAccountable Care Organization Workgroup Glossary
Accountable Care Organization Workgroup Glossary Accountable care organization (ACO) a group of coordinated health care providers that care for all or some of the health care needs of a defined population.
More informationHealth Care Reform Frequently Asked Questions
Health Care Reform Frequently Asked Questions On March 23, 2010, President Obama signed federal health care reform into law, also known as the Patient Protection and Affordability Act. A second, or reconciliation
More informationHow Max Missed the Mark on Healthcare
A NATIONWIDE PUBLIC INTEREST RELIGIOUS CIVIL LIBERTIES LAW FIRM 1055 Maitland Center Cmns. Second Floor Maitland, Florida 32751 Tel: 800 671 1776 Fax: 407 875 0770 www.lc.org 1015 Fifteenth St. N.W. Suite
More informationHow the New Health Care Law Benefits You
How the New Health Care Law Benefits You Congress enacted a new health care law which brings a number of benefits to all Americans, including people over 50. Some of these changes you will see this year.
More informationThis glossary provides simple and straightforward definitions of key terms that are part of the health reform law.
This glossary provides simple and straightforward definitions of key terms that are part of the health reform law. A Affordable Care Act Also known as the ACA. A law that creates new options for people
More informationHow Health Reform Will Help Children with Mental Health Needs
How Health Reform Will Help Children with Mental Health Needs The new health care reform law, called the Affordable Care Act (or ACA), will give children who have mental health needs better access to the
More informationAffordable Care Act: What The Health Care Law Means for Small Businesses
Affordable Care Act: What The Health Care Law Means for Small Businesses August 2013 Indian Country Business Summit These materials are provided for informational purposes only and are not intended as
More informationHealth care reform at-a-glance. December 2013
December 2013 Employer mandate Play or pay penalty for failing to offer coverage to at least 95% of all full-time employees (FTE) and children if any FTE gets subsidy in exchange $2,000 (indexed) times
More informationBaucus Framework Senate HELP Bill House Tri-Committee Bill President Obama
SJR 35: HEALTH CARE Comparison of Selected Elements of the Major Federal Health Care Reform Proposals Prepared for the Children, Families, Health, and Human Services Interim Committee Sept. 11, 2009 Baucus
More informationAffordable Care Act Policy and Implementation Briefing
HEALTHCARE.GOV Affordable Care Act Policy and Implementation Briefing Family Planning Council s Reproductive Health Conference April 27, 2012 Joanne Corte Grossi,, MIPP Regional Director U.S. Department
More informationThe meeting was called to order at 5:27 by the Chairman of the Executive Committee, Joseph Szot, M.D.
Minutes Carver College of Medicine Fall Faculty Forum: Health Care Reform Legislation - Its Implementation and Impact on UI Health Care Tuesday, October 26, 2010 Presenters: Vice-President Jean Robillard,
More informationAnswers For Families And Small Business
http://healthreform.gov/about/answers.html Answers For Families And Small Business Q: What is the small business tax credit and how do I know if I am eligible? A: Effective January 1, 2010, tax credits
More informationPWC Self-Insurance Health Fund
PWC Self-Insurance Health Fund Finance Department Human Resources November 23, 2010 0 0 Background 1992 1992-2002 2002 2006 Today Managed Care decade begins Ten years of moderate rate increases for County
More informationHow To Pass The Health Care Bill
Timeline/Summary of Tax s in the Health Reform Laws Effective Date Retrospective to Enactment Health professionals State loan repayment tax relief. Excludes from gross income payments made under any State
More informationMedicare: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590
Medicare: Changes Made by the Reconciliation Act of 2010 to Senate-Passed H.R. 3590 Patricia A. Davis, Coordinator Paulette C. Morgan Holly Stockdale Analyst in Health Care Financing Sibyl Tilson Jim Hahn
More informationFAQ New Health Insurance Law
FAQ New Health Insurance Law (Enacted on March 21, signed into law on March 23, and amended on March 25) On March 23, 2010 President Barack Obama signed the Patient Protection & Affordable Care Act (H.R.
More informationEffective January 1, 2014, expansion to cover all non-elderly individuals at or below 133% FPL. o
Federal Health Care Reform side-by-side with Vermont Implications Draft Reflects known changes as of 10/22/09 [Note: Most of the bill information comes from the NGA side-by-side as of 10/13/09) * Red Reflects
More informationTHE FUTURE OF EMPLOYER BASED HEALTH INSURANCE FOLLOWING HEALTH REFORM
THE FUTURE OF EMPLOYER BASED HEALTH INSURANCE FOLLOWING HEALTH REFORM National Congress on Health Insurance Reform Washington, D.C., January 20, 2011 Elise Gould, PhD Health Policy Research Director Economic
More informationHealth-Care Reform. Begley Insurance Group, Inc. Mary Angelo 5225 Old Orchard Rd. Skokie, IL 60077 800-867-7074
Begley Insurance Group, Inc. Mary Angelo 5225 Old Orchard Rd. Skokie, IL 60077 800-867-7074 Health-Care Reform August 14, 2012 Page 1 of 8, see disclaimer on final page One primary goal of the Patient
More informationHealth Care Reform Overview How Will People with Hepatitis Benefit?
Health Care Reform Overview How Will People with Hepatitis Benefit? A N N E D O N N E L L Y, H E A L T H C A R E P O L I C Y, P R O J E C T I N F O R M R A C H E L M C L E A N, A D U L T V I R A L H E
More informationMedicare Cost Sharing and Supplemental Coverage
Medicare Cost Sharing and Supplemental Coverage Topics to be Discussed Medicare costs to beneficiaries Review Medicare premiums and cost sharing Background on Medicare beneficiary income Current role of
More informationImpact of Health Reform on Prescription Drugs
Impact of Health Reform on Prescription Drugs 1 Indirect Effects Increased Rx Volume = More Prescriptions! Page 2 Retiree Drug Subsidy (RDS) Before HCR Tax-Free Subsidy RDS as taxdeductible income After
More informationQuick Information about Federal Health Reform 3 23 2010
Quick Information about Federal Health Reform 3 23 2010 For detailed information about health reform, go to http://healthreform.kff.or g / A description of federal health reform s impact on the health
More informationHealth care reform at-a-glance. August 2014
Health care reform at-a-glance August 2014 Employer mandate Shared responsibility payment for failing to offer coverage to at least 95%* of all fulltime employees (FTE) and children if any FTE gets subsidy
More informationCoinsurance A percentage of a health care provider's charge for which the patient is financially responsible under the terms of the policy.
Glossary of Health Insurance Terms On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act (PPACA) into law. When making decisions about health coverage, consumers should
More informationMedicare Design Part A: Inpatient care, hospice, and some home health care Part B: Physician services + outpatient care Part C ( Medicare Advantage
Medicare Design Part A: Inpatient care, hospice, and some home health care Part B: Physician services + outpatient care Part C ( Medicare Advantage ): Private plan alternative to Parts A and B Part D:
More informationGAO PATIENT PROTECTION AND AFFORDABLE CARE ACT. Effect on Long-Term Federal Budget Outlook Largely Depends on Whether Cost Containment Sustained
GAO United States Government Accountability Office Report to the Ranking Member, Committee on the Budget, U.S. Senate January 2013 PATIENT PROTECTION AND AFFORDABLE CARE ACT Effect on Long-Term Federal
More informationObama Administration Record on Health Care
Obama Administration Record on Health Care Today, two years after we passed health care reform, more young adults have insurance, more seniors are saving money on their prescription drugs, and more Americans
More informationMEDICARE PART B DRUGS. Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals
United States Government Accountability Office Report to Congressional Requesters June 2015 MEDICARE PART B DRUGS Action Needed to Reduce Financial Incentives to Prescribe 340B Drugs at Participating Hospitals
More informationS e c t i o n 4 - P S E R S P o s t e m p l o y m e n t H e a l t h c a r e P r o g r a m s
S e c t i o n 4 - P S E R S P o s t e m p l o y m e n t H e a l t h c a r e P r o g r a m s Health Options Program... Tab 17 Premium Assistance Program... Tab 18 This page intentionally left blank Pursuant
More informationHealth care reform for large businesses
FOR PRODUCERS AND EMPLOYERS Health care reform for large businesses A guide to what you need to know now DECEMBER 2013 CONTENTS 2 Introduction Since 2010 when the Affordable Care Act (ACA) was signed into
More informationHow Health Reform Will Affect Health Care Quality and the Delivery of Services
Fact Sheet AARP Public Policy Institute How Health Reform Will Affect Health Care Quality and the Delivery of Services The recently enacted Affordable Care Act contains provisions to improve health care
More informationAmerican Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA)
American Health Benefit Exchanges Fact Sheet A Provision of the Patient Protection and Affordable Care Act (PPACA) This Fact Sheet reflects the Final Ruling published by the Department of Health and Human
More informationHealth Care Timeline by Subject
Health Care Timeline by Subject Preliminary Review of Enacted Law as Modified by Reconciliation Note: The Whip s Office will continue to update this document as warranted based on further review of the
More informationPatient Protection and Affordable Care Act (H.R. 3590)
on Health Reform Passing comprehensive health care reform has been a priority of the President and Congress. The U.S. House of Representatives passed the Affordable Health Care for America Act on November
More informationNursing and Health Reform
Nursing and Health Reform The Patient Protection and Affordable Care Act (PPACA) was signed into law by President Obama on March 23, 2010. This law will enact sweeping changes to almost every facet of
More informationHealth care reform is once again
Marjorie M. Glover and Rachel M. Kurth Employee Benefit Plan Review Reprinted from April 2010 Health Care Reform: How It May Impact Employers, Employees, and Benefit Plans Health care reform is once again
More informationHow To Compare The Health Care Reform Plan To The Health Insurance Reform Plan From The Health Plan Of A Medicare Plan
A Comparison of Medicare Proposals: The Affordable Care Act and the Romney/ October 2012 Prepared by: Area Agency on Aging 1-B A Comparison of Medicare Proposals: Affordable Care Act and the Romney/ Background
More informationPACIFIC ISLANDERS AND HEALTH CARE REFORM: ACCESS AND COVERAGE FEBRUARY 14/15, 2011
PACIFIC ISLANDERS AND HEALTH CARE REFORM: ACCESS AND COVERAGE FEBRUARY 14/15, 2011 Welcome Dr. Garth Graham Deputy Assistant Secretary Office of Minority Health Herb Schultz Region IX Director James Mason
More informationthe Affordable Care Act: What Colorado Businesses Need to Know
22 About questions the Affordable Care Act: What Colorado Businesses Need to Know 1 What is the Affordable Care Act? Who is impacted (small, large businesses and self-insured)? The Patient Protection and
More informationPAs and Provisions of Health. What does it Mean to You?
PAs and Provisions of Health Reform What does it Mean to You? Presentation to the South Dakota Academy of Physician Assistants March 7, 2013 Liz Roe, Director, Constituent t Organization Outreach and Advocacy
More informationTHE EVOLUTION OF CMS PAYMENT MODELS
THE EVOLUTION OF CMS PAYMENT MODELS December 3, 2015 Dayton Benway, Principal AGENDA Legislative Background Payment Model Categories Life Cycle The Models LEGISLATIVE BACKGROUND Medicare Modernization
More informationSOME ASSEMBLY REQUIRED HEALTH REFORM AND COLORADO"
SOME ASSEMBLY REQUIRED HEALTH REFORM AND COLORADO" Colorado Consumer Health Initiative! www.cohealthinitiative.org! Barrier-free access to quality, affordable, health care" Making sense of Health Reform!
More informationHospitals and the Affordable Care Act (ACA)
Hospitals and the Affordable Care Act (ACA) General Housekeeping If you experience any technical difficulties during the webinar, please contact GoToMeeting.com Corporate Account Customer Support at: 1-888-259-8414
More informationSupreme Court upholds the Affordable Care Act in its entirety:
Supreme Court upholds the Affordable Care Act in its entirety: What does this mean for Seniors? The Supreme Court s decision to uphold the Affordable Care Act (ACA) in its entirety is a huge victory for
More informationSustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation
Sustainable Growth Rate (SGR) Repeal and Replace: Comparison of 2014 and 2015 Legislation Proposal 113 th Congress - - H.R.4015/S.2000 114 th Congress - - H.R.1470 SGR Repeal and Annual Updates General
More informationSetting the Record Straight about Medicare
Fact Sheet Setting the Record Straight about Medicare Keith D. Lind, JD, MS As the nation considers the future of Medicare, it is important to separate the facts from misconceptions about Medicare coverage,
More informationUpdated November 23, 2009
820 First Street NE, Suite 510 Washington, DC 20002 Tel: 202-408-1080 Fax: 202-408-1056 center@cbpp.org www.cbpp.org Updated November 23, 2009 HOUSE HEALTH REFORM BILL EXPANDS COVERAGE AND LOWERS HEALTH
More information340B Drug Discount Program Overview and Emerging Issues
340B Drug Discount Program Overview and Emerging Issues I. APPLICABLE STATUTE AND OTHER LEGAL AUTHORITIES Section 340B of the Public Health Service Act (42 U.S.C. 256b) requires pharmaceutical manufacturers,
More informationSenate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**
Prevention and Screening Services Cost-sharing Eliminates cost sharing requirements for requirements for all preventive services (including prevention and colorectal cancer screening) that have a screening
More informationOhio Health Plans. Maximizing best practices & leading reform efforts. Search. Ohio Association of Health Plans
Ohio Association of Health Plans File Edit View History Bookmarks Tools Window Help http://www.oahp.com Ohio Health Plans Search Maximizing best practices & leading reform efforts HELPING OHIOANS GET NEEDED
More information