PAs and Provisions of Health. What does it Mean to You?

Size: px
Start display at page:

Download "PAs and Provisions of Health. What does it Mean to You?"

Transcription

1 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

2 Agenda Overview of the federal Affordable Care Act Implications for the PA Profession How this impacts state laws pertaining to PA practice What do we do next? And a few more items...

3 AAPA s Principles for Health Care Reform Use of evidence-based medicine Physician-directed teams Optimal utilization of primary care Health promotion and disease prevention Quality, affordable cost-effective health care Comparative-effectiveness information

4

5 Patient Protection and Affordable Care Act Public Law Signed into law March 23, W-111publ148/pdf/PLAW- p 111publ148.pdf

6 The Congressional Budget Office estimates that the combined legislation will cost $938 billion and will reduce the deficit by $143 billion over 10 years. The new law is expected to reduce the number of uninsured Americans by 32 million by 2019.

7 The new law requires that most uninsured individuals purchase health insurance coverage by 2014 through a health benefit exchange established by each state.

8 Implications for PA Practice Order SNF under Medicare 10% Bonus for Primary Care Codes Increased Support through h the National Health Service Corps Increased Funding for PA Education Loan Repayment for PA Faculty Full Integration of PAs in New Models of Care

9 For Patients Team-Based Primary Care Disease Prevention & Health Promotion Care Coordination

10 For Patients effective now Coverage of Adult Children up to 26 Rx Coverage for Seniors High h Risk Pool for Individuals id with Pre- Existing Conditions Cost-free Preventive Services Choice of Primary Care Provider, OB/GYN, pediatrician Use of nearest ER without penalty

11 For patients effective now Insurers can no longer Deny Coverage to Children with Pre- Existing Conditions Impose Lifetime Benefits Cancel a Policy without Proving Fraud Deny Claims without Appeal

12 In 2014 The plan is to be fully operational State Insurance Exchange Programs offering affordable health insurance coverage Tax penalty imposed on uninsured adults without coverage Fee imposed on large employers who do not offer health insurance coverage.

13 Special implications for rural communities Incentives to Attract Health Care Professionals to Rural Communities Increased Opportunities for PAs in Rural Areas.

14 Accountable Care Organizations Local or regional organizations consisting of health care professionals, typically one or more hospitals and related health care entities that have a formal or informal relationship Jointly responsible (or accountable) for achieving measurable improvements in the quality and cost of health h care delivered d within a given community.

15 Accountable Care Organizations Health care professionals and organizations financial success will be based on patient care outcomes instead of number of services delivered ACOs will have a strong base of primary care professionals, but may also provide a wide range of specialty & ancillary care services.

16 Accountable Care Organizations Expectation is that ACO participants will share information and better coordinate patient t care activities PAs must work to assure that t ACOs use appropriate interdisciplinary models, that recognize the efficiencies of the team approach For the first time, many health care professionals will have to understand and deal with the managing financial risk.

17 Insurance Exchanges Goal is to establish insurance plan options for uninsured individuals Provide a competitive (cost-effective) effective), simplified array of insurance plans for purchase for those who lack health insurance.

18 Insurance Exchanges Fully operational by 2014 Federal government is granting up to $1 million in seed money to each state to start/implement insurance exchanges.

19 Insurance Exchanges What Will Be Covered? US Department of Health & Human Services (HHS) have defined an essential benefit package Released in December 2011 (regs released in 2012) Includes the following services: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance use disorder services, including behavioral health treatment Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management, and Pediatric services, including oral and vision care

20 Electric Health Record Incentive - Medicare Only physicians qualify for the Medicare EHR incentive $44,000 over 5 years to implement EHR system Must meet meaningful use criteria.

21 EHR Incentive - Medicaid Maximum payment is $63,750 over 6 years (max. of $21,250 in the first year) Special concerns in states where Medicaid does not enroll PAs Office of the National Coordinator will issue a list O ce o t e at o a Coo d ato ssue a st of certified EHR systems.

22 EHR Incentive - Medicaid NPs qualify in all practice settings under Medicaid PAs qualify under Medicaid only in Rural Health Clinics and FQHCs AAPA has had legislation introduced (Rep. Karen Bass, D-CA) in an attempt broaden PA eligibility under Medicaid 30% f ti t i t b M di id b fi i i t 30% of patient mix must be Medicaid beneficiaries to qualify for Medicaid incentive

23 Implications for the PA Profession Recognition Incentive and Momentum to Remove Federal and State Barriers to the Quality Care Provided by PAs Success Generates Success on Capitol Hill

24 It All Starts and Ends with Advocacy If You re Not at the Table, You re on the Menu!

25 PAs are key to implementation, But Only If Increase Support for PA Education to Grow the PA Workforce Eliminate Barriers to Care Existing in Federal Law and Regulations Fully Integrate t PAs in New Models of Care State Laws allow full utilization of PAs Reimbursement systems cover PAs

26 Some PA Fast Facts There are 81,000 PAs currently in clinical practice with nearly 6,000 entering the workforce each year PAs account for: more than 307+ million patient visits per year more than 264+ million prescriptions i per year hundreds of millions of recommendations for OTC products Source: AAPA 2010 Annual Conference Survey & 2008 Census

27 Health Care Reform Implication for the PAP Profession As more and more health care consumers or patients enter our health care system, there will be an even greater acknowledgement of the role of PAs and a greater incentive to remove current barriers to care provided by PAs in federal and state legislation. This creates real opportunity.

28 State Advocacy Agenda The Six Key Elements of a Modern PA Law Full prescriptive authority Licensure as the regulatory term Scope of practice determined d at the practice No ratio restriction No co-signature requirement in law Adaptable supervision requirements

29 Number of Key Elements Included in State PA Law January 2013 RI DE DC One Key Element Two Key Elements Three Key Elements Four Key Elements Five Key Elements Six Key Elements

30 States Making Improvements in the Six Key Elements Since May 2009 RI DE DC No Improvements to 6KEs since May 2009 Made a definitive improvement to at least one 9/11 of the Six Key Elements since May 2009

31 States Making Improvements to PA Laws & Regulations Since May 2009 RI DE DC No legislative or regulatory improvement since May 2009 Made one or more definitive improvements to PA laws or 9/11 regulations since May 2009

32 Where does SD Stack Up? South Dakota meets 5 of the six key elements: Key not met: Licensure Scope of Practice Distance Limitations Co-Signature Supervision Ratio

33 Ratio Law 36-4A Modification of method and frequency of supervision-- Number of physician assistants--application. A supervising physician may apply ppy to the board for permission to supervise more than one physician assistant. The board shall establish the number of physician assistants, up to four FTE, to be supervised by a supervising physician based upon its finding that adequate supervision will exist under the arrangement proposed by the supervising physician.

34 How is South Dakota Doing? In 2010, a study was conducted which reviewed the number of the Six Key Elements of a Modern PA Practice Law in comparison to the number of practicing i PAs in a state SD was ranked #2 in the number of PAs per 10, individuals (by population) 4.9 PAs per 10,000 Ranked 20 th in the nation of the percentage of counties lacking a PA (15.2%) *source: JAAPA September 2010

35 What does this tell us? PAs educated in South Dakota stay here While laws and regulations governing PA practice are good to great, SD PAs must remain vigilant, il looking outside the practice act to assure laws are allowing PAs to fully participate i t in care.

36 In addition Nominate PAs to State Health Commission, State Health Workforce Commission Look for opportunities to support PA Education Review legislation for opportunities to promote PAs Remove state law practice barriers Review the exchange products for inclusion of PAs and reimbursement of care provided by PAs Ensure full integration of PAs in new models of care.

37 It All Starts and Ends with Advocacy Our professional organizations are the voice, but we are the megaphone. Stephane VanderMeulan, MPAS, PA-C

38 Federal Advocacy Update

39 112 th Congress Approx. 220 laws were passed by the 112 th Congress vs. over 700 laws passed by the 100 th Congress. Must-pass legislation, (farm bill, postal reform, hurricane relief, cyber security protections) failed to make it out of the 112 th Congress.

40 PA Issues in 112 th Congress Stalled : bipartisan bills designed to increase access to and continuity of the quality medical care provided by PAs - PA Hospice, Ordering Home Health Care, Federal Workers Compensation, Medicaid Coverage, and EHR Incentive Payments, etc. Passed: one year patch to Medicare s SGR, averting a 27.5 percent decrease in Medicare reimbursements.

41 AAPA Priorities: 113 th Congress Reintroduction of PA bills from 112 th: - Allowing PAs to provide care to patients who elect to receive Hospice through Medicare. - Allowing PAs to order home health care for Medicare patients - Including PAs in the Medicaid financial incentive program for Electronic Health Records. - Including PAs as providers in the Federal Employees Compensation Act. Appropriations: Preserve funding for PA Programs through Title VII Health Professions Grants

42 Increasing Medicare Transparency Through legislative and regulatory efforts, AAPA aims to: Fully enroll PAs in Medicare and Medicaid Change the current culture of billing PA care through physician Improve ability to track and compare the effectiveness, quality, and value of PA practice and prescriptive patterns Update Medicare payment policy to treat PA reimbursement the same as other medical providers, allowing PA-owned clinics to be assigned an NPI number.

43 Improving Care in Rural Communities AAPA supports the Strengthening Rural Access to Emergency Services Act (S. 328), introduced by Sen. John Thune (R- SD), to improve access to emergency services in rural and medically underserved areas.

44 We re From the Academy and dw We re Here to Help

Health 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 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 information

THE AFFORDABLE CARE ACT IMPACT ON YOUR MEDICAL PRACTICE

THE AFFORDABLE CARE ACT IMPACT ON YOUR MEDICAL PRACTICE THE AFFORDABLE CARE ACT IMPACT ON YOUR MEDICAL PRACTICE Dennis Olmstead, MPA Vice President Practice Economics & Payer Relations Pennsylvania Medical Society Kaiser Health Tracking Poll Poll (March 2013)

More information

Summary of the Major Provisions in the Patient Protection and Affordable Health Care Act

Summary 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 information

ANA s Belief. Quality, affordable health care is not a privilege, but a basic human right. 9/22/2011

ANA 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 information

HEALTH REFORM and VACCINES: Review of Federal Legislation

HEALTH 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 information

Strengthening Community Health Centers. Provides funds to build new and expand existing community health centers. Effective Fiscal Year 2011.

Strengthening 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 information

WHAT S IN THE WIND AT THE STATE EDUCATORS AND FEDERAL LEVEL FOR DIABETES PRESENTED BY: JAMES E. SPECKER, MBA MIS

WHAT S IN THE WIND AT THE STATE EDUCATORS AND FEDERAL LEVEL FOR DIABETES PRESENTED BY: JAMES E. SPECKER, MBA MIS WHAT S IN THE WIND AT THE STATE AND FEDERAL LEVEL FOR DIABETES EDUCATORS PRESENTED BY: JAMES E. SPECKER, MBA MIS STRENGTHENING THE IMPACT OF AADE MEMBERS AND DIABETES SELF-MANAGEMENT EDUCATION IN IDAHO

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department The Affordable Care Act What Happens Now? Kansas Society of CPAs June 5, 2013 Linda J. Sheppard, Special Counsel & Director of Health Care Policy and Analysis 2010 Affordable

More information

Health Care Reform and Its Impact on Nursing Practice

Health 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 information

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform.

It goes by many names: Patient Protection and Affordable Care Act (PPACA) or ACA or Obama Care or simply Healthcare Reform. WHAT IS HEALTHCARE REFORM? Healthcare Reform (HCR) is a law passed by Congress that provides many different requirements. A very important aspect of the law is that it is designed to provide individuals

More information

An Internist s Practical Guide to Understanding Health System Reform

An 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 information

The 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 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 information

Fact Sheet. AARP Public Policy Institute. Health Reform Changes Insurance Rules

Fact 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 information

Health Care Reform Update

Health Care Reform Update Small Businesses No Financial Requirements for Small Businesses: The ACA imposes no financial requirements for small businesses to contribute to their employees health insurance. However, beginning in

More information

How Health Reform Will Affect Health Care Quality and the Delivery of Services

How 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 information

Timeline of New Health Care Law and Its Impact on American Businesses

Timeline 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 information

You CAN have Health Care

You CAN have Health Care You CAN have Health Care Presentation will cover 1. Key aspects of the ACA 2. Impact in California 3. Current coverage programs 4. Remaining uninsured What is Healthcare Reform? ~ March 23, 2010 ~ President

More information

The Vermont Health Benefit Exchange: An Update

The Vermont Health Benefit Exchange: An Update The Vermont Health Benefit Exchange: An Update Today s Discussion Health Reform Goals & Timeline Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like? Plan Design Enrollment

More information

Community Health Centers and Health Reform: Issues and Ideas for States

Community Health Centers and Health Reform: Issues and Ideas for States Community Health Centers and Health Reform: Issues and Ideas for States Ann S. Torregrossa, Esq. Deputy Director & Director of Policy Governor s Office of Health Care Reform Commonwealth of Pennsylvania

More information

ANA ISSUE BRIEF Information and analysis on topics affecting nurses, the profession and health care.

ANA ISSUE BRIEF Information and analysis on topics affecting nurses, the profession and health care. ANA ISSUE BRIEF Information and analysis on topics affecting nurses, the profession and health care. Health System Reform: Nursing s Goal of High Quality, Affordable Care for All Key Points Nursing has

More information

Health Care Reform Overview How Will People with Hepatitis Benefit?

Health 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 information

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014

Health Insurance Marketplace. vhealth insurance exchanges. What to expect in 2014. What to expect in 2014 vhealth insurance exchanges Health Insurance Marketplace What to expect in 2014 What to expect in 2014 The basics of exchanges As part of the Affordable Care Act (ACA or health care reform law), starting

More information

The Affordable Care Act and People with Disabilities

The Affordable Care Act and People with Disabilities The Affordable Care Act and People with Disabilities The Arc of Texas envisions a world where people with disabilities are included in their communities and neighborhoods and where quality supports and

More information

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers

Health Care Reform Frequently Asked Questions (FAQ) Consumers Employers This page provides answers to frequently asked questions (FAQ) regarding The Patient Protection and Affordable Care Act (PPACA; P.L. 111-148) and the Health Care and Education Reconciliation Act of 2010

More information

Affordable Care Act Opportunities for the Aging Network

Affordable Care Act Opportunities for the Aging Network Affordable Care Act Opportunities for the Aging Network The Affordable Care Act (ACA) offers many opportunities for the Aging Network to be full partners in health system reform. These include demonstration

More information

Regulatory and Legislative Action Since the September 2010 Membership Meeting:

Regulatory and Legislative Action Since the September 2010 Membership Meeting: MEMBERSHIP MEETING January 19, 2011 Delivery System Reform: Healthcare Workforce Issue: The passage of health reform will bring millions of newly insured individuals into the system and drive patients

More information

What s in the Healthcare Law for you and your Business

What s in the Healthcare Law for you and your Business What s in the Healthcare Law for you and your Business How the new law impacts your bottom line Marcia Dávalos Disneyland Hotel - Anaheim, CA October 17, 2013 About Small Business Majority Small business

More information

Senate-Passed Bill (Patient Protection and Affordable Care Act H.R. 3590)**

Senate-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 information

Health Insurance Reform at a Glance Implementation Timeline

Health 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 information

Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin

Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin Washington State Health Care Authority Comments: Department of Health and Human Services Essential Health Benefit Bulletin The Washington State Health Care Authority (HCA) is pleased to submit comments

More information

Nebraska Health Insurance Exchange Update

Nebraska Health Insurance Exchange Update Nebraska Health Insurance Exchange Update State of Nebraska s Health Insurance Exchange A Presentation to Advocacy Groups August 2012 TODAY'S AGENDA Section 1: Overview of Health Insurance Exchanges Section

More information

Ohio Health Benefits LLC. Your health insurance partner!!

Ohio 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 information

Can the Affordable Care Act and the Prepaid Health Care Act Co- Exist?

Can the Affordable Care Act and the Prepaid Health Care Act Co- Exist? Can the Affordable Care Act and the Prepaid Health Care Act Co- Exist? HAZEL G. BEH PROFESSOR OF LAW, DIRECTOR HEALTH LAW POLICY CENTER WM. S. RICHARDSON SCHOOL OF LAW Health Reform PHCA An employer-mandate

More information

Workforce Series: Physician Assistants

Workforce Series: Physician Assistants National Rural Health Association Policy Position Workforce Series: Physician Assistants Recruitment and Retention of Quality Health Workforce in Rural Areas: A Series of Policy Papers on the Rural Health

More information

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association

Tobacco Cessation and the Affordable Care Act. Jennifer Singleterry Director, National Health Policy American Lung Association Tobacco Cessation and the Affordable Care Act Jennifer Singleterry Director, National Health Policy American Lung Association Background on ACA Acronyms ACA = Affordable Care Act (healthcare reform) HHS

More information

Health Care Law Implementation: What Nonprofits Need to Know WELCOME!

Health Care Law Implementation: What Nonprofits Need to Know WELCOME! Health Care Law Implementation: What Nonprofits Need to Know WELCOME! Health Care Law Implementation: What Nonprofits Need to Know (PPACA) Health Care Law Implementation: What Nonprofits Need to Know Heather

More information

Successes and Challenges in the Affordable Care Act: Beyond Access

Successes and Challenges in the Affordable Care Act: Beyond Access Successes and Challenges in the Affordable Care Act: Beyond Access Robert Greenwald Clinical Professor of Law, Harvard Law School Director, Center for Health Law and Policy Innovation/Treatment Access

More information

Affordable Care Act: Key Provisions for People with MS

Affordable Care Act: Key Provisions for People with MS Affordable Care Act: Key Provisions for People with MS October 2013 Why reform healthcare? By 2008, 15% of the U.S. population, or approximately 47 million Americans, lacked health insurance Documented

More information

Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director

Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director Update: Embracing Change March 23, 2013 Jerry A. Johnson, M.D. Executive Medical Director National Healthcare Reform State of Michigan Regulatory Reform Autism Mandate Direct Pay Initiative Medical Policy:

More information

The Vermont Health Benefit Exchange: An Update for Small Business Owners

The Vermont Health Benefit Exchange: An Update for Small Business Owners The Vermont Health Benefit Exchange: An Update for Small Business Owners Today s Presentation Health Reform Goals Overview of Health Care Reform What is the Exchange? What Does the Exchange Look Like?

More information

Health Insurance Exchange & Network Management Solutions

Health Insurance Exchange & Network Management Solutions Health Insurance Exchange & Network Management Solutions Mike Flanagan AVP, Product Management June 19, 2013 Today s Presenter Mike Flanagan Associate Vice President of Product Management McKesson Health

More information

ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO)

ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) ACP Analysis of the Essential Health Benefits Bulletin, Issued by the HHS Center for Consumer Information and Insurance Oversight (CCIIO) Introduction and background: Summarizes the essential benefit package

More information

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges

Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Patient Protection and Affordable Care Act of 2009: Health Insurance Exchanges Provision Notes Standards SUBTITLE D AVAILABLE COVERAGE CHOICES FOR ALL AMERICANS PART I Establishment of Qualified Health

More information

Workforce Policy Updates

Workforce Policy Updates Workforce Policy Updates Jon Villasurda, MPH Policy Consultant www.mpca.net June 12, 2014 Agenda The Need for Workforce Policy Workforce Policy Updates State Federal MPCA Workforce Policy Priority The

More information

Healthcare Reform: The Top 10 Issues for Employers

Healthcare Reform: The Top 10 Issues for Employers Healthcare Reform: The Top 10 Issues for Employers By Thomas A. Walker Winthrop & Weinstine, P.A. Healthcare reform became reality this spring when President Obama signed the Patient Protection and Affordable

More information

STAYING AHEAD OF THE PACK: EMERGING TRENDS & ISSUES HEALTH CARE REFORM A POTENTIAL PLAYGROUND FOR FRAUD

STAYING AHEAD OF THE PACK: EMERGING TRENDS & ISSUES HEALTH CARE REFORM A POTENTIAL PLAYGROUND FOR FRAUD STAYING AHEAD OF THE PACK: EMERGING TRENDS & ISSUES HEALTH CARE REFORM A POTENTIAL PLAYGROUND FOR FRAUD With the upcoming Health Care Reform Act, health care fraudsters will be using new tactics to defraud

More information

Find health care options that meet your needs and fit your budget. ctober 2014

Find health care options that meet your needs and fit your budget. ctober 2014 O Health Insurance Find health care options that meet your needs and fit your budget. ctober 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law generally requiring

More information

While health care reform has its foundation and framework at

While health care reform has its foundation and framework at CENTER FOR HEALTHCARE RESEARCH & TRANSFORMATION Policy Brief June 2010 The Patient Protection and Affordable Care Act at the State and Local Level While health care reform has its foundation and framework

More information

The Impact of Health Care Reform on Community Health Centers in Colorado. Kristen Pieper Policy Manager Colorado Community Health Network

The Impact of Health Care Reform on Community Health Centers in Colorado. Kristen Pieper Policy Manager Colorado Community Health Network The Impact of Health Care Reform on Community Health Centers in Colorado Kristen Pieper Policy Manager Colorado Community Health Network Presentation Topics Background information on CCHN, Colorado CHCs,

More information

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE

Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE Laurus Strategies Legislative Brief: COMPREHENSIVE HEALTH COVERAGE ESSENTIAL HEALTH BENEFITS PACKAGE The Affordable Care Act (ACA) requires non grandfathered health insurance plans in the individual and

More information

An Overview of Children s Health Issues in Michigan

An Overview of Children s Health Issues in Michigan An Overview of Children s Health Issues in Michigan Sponsors Michigan Chapter American Academy of Pediatrics Michigan Council for Maternal and Child Health School - Community Health Alliance of Michigan

More information

Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session. August 16, 2012

Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session. August 16, 2012 Nebraska s Health Insurance Exchange Overview of the Essential Health Benefits Public Session August 16, 2012 TODAY'S AGENDA Section 1: Review of Health Insurance Exchanges Section 2: Overview of Essential

More information

The Health Insurance Marketplace 101

The Health Insurance Marketplace 101 The Health Insurance Marketplace 101 National Newspaper Association 127th Annual Convention & Trade Show September 13, 2013 Office of the Regional Director Community Resource California-Based Arizona,

More information

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014.

Effective dates for provisions of the PPACA are spread out from 2010 through 2018. This document focuses on 2013 and 2014. As part of our ongoing initiative to provide added value to our customers, this health care reform summary is being provided on an information only basis. This is NOT a legal document and is not intended

More information

Nursing and Health Reform

Nursing 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 information

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013

Affordable Care Act HEALTHCARE.GOV. Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 HEALTHCARE.GOV Affordable Care Act Marketplace Implementation Briefing Virginia Organizing Marketplace Public Forum August 20, 2013 Joanne Corte Grossi, MIPP Regional Director U.S. Department of Health

More information

Community Clinics and Health Centers under the Patient Protection and Affordable Care Act

Community Clinics and Health Centers under the Patient Protection and Affordable Care Act Community Clinics and Health Centers under the Patient Protection and Affordable Care Act Background On March 23, 2010, President Barack Obama signed into law a comprehensive health care reform bill, the

More information

Timeline: Key Feature Implementations of the Affordable Care Act

Timeline: 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 information

Washington Health Benefit Exchange. Leading Age 2014 Annual Conference. Phil Dyer Board Member

Washington Health Benefit Exchange. Leading Age 2014 Annual Conference. Phil Dyer Board Member Washington Health Benefit Exchange Leading Age 2014 Annual Conference Phil Dyer Board Member DISCLAIMER; The views and information expressed are my personal opinions and perspectives and do not represent

More information

Key Features of the Affordable Care Act, By Year

Key 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 information

THE AFFORDABLE CARE ACT AND DENTAL COVERAGE IN ILLINOIS

THE AFFORDABLE CARE ACT AND DENTAL COVERAGE IN ILLINOIS THE AFFORDABLE CARE ACT AND DENTAL COVERAGE IN ILLINOIS Stephanie F. Altman Health & Disability Advocates www.hdadvocates.org www.illinoishealthmatters.org Health & Disability Advocates Based in Chicago

More information

Affordable Care Act (ACA) Frequently Asked Questions

Affordable Care Act (ACA) Frequently Asked Questions Grandfathered policies Q1: What is grandfathered health plan coverage? A: The interim final rule on grandfathering under ACA generally defines grandfathered health plan coverage as coverage provided by

More information

PHYSICIANS. 202.420.7896 888 16 th St. NW, Suite 800, Washington DC 20006 www.npalliance.org

PHYSICIANS. 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 information

Repeal the Sustainable Growth Rate (SGR), avoiding annual double digit payment cuts;

Repeal the Sustainable Growth Rate (SGR), avoiding annual double digit payment cuts; Background Summary of H.R. 2: The Medicare Access and CHIP Reauthorization Act of 2015 SGR Reform Law Enacts Payment Reforms to Improve Quality, Outcomes, and Cost On April 16, 2015, the President signed

More information

Understanding Self-Funded Concepts In Light of Health Care Reform

Understanding Self-Funded Concepts In Light of Health Care Reform Understanding Self-Funded Concepts In Light of Health Care Reform Benefit Advisors Network August 21, 2013 Stacy H. Barrow sbarrow@proskauer.com Agenda Overview Differences between self-funded and fully

More information

Health Matters. A Guide for Pre-65 Health Care Options. Important health plan information enclosed.

Health Matters. A Guide for Pre-65 Health Care Options. Important health plan information enclosed. Health Matters A Guide for Pre-65 Health Care Options Important health plan information enclosed. Why am I receiving this booklet? Understanding your health care coverage options is more complex than ever.

More information

HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS)

HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS) HEALTH PROFESSIONAL WORKFORCE (SECTION-BY-SECTION ANALYSIS) (Information compiled from the Democratic Policy Committee (DPC) Report on The Patient Protection and Affordable Care Act and the Health Care

More information

Health Information Technology (IT) Simplified

Health Information Technology (IT) Simplified Health Information Technology (IT) Simplified A glossary of all things Health IT Accountable Care Organizations (ACO) - A group of health care providers who give coordinated care, chronic disease management,

More information

Health Care Reform: Policy Implications for the Future

Health Care Reform: Policy Implications for the Future Health Care Reform: Policy Implications for the Future Michigan Primary Care Association Douglas M. Paterson, MPA Director of State Policy Promoting, supporting, and developing comprehensive, accessible,

More information

(http://www.regulations.gov/#!documentdetail;d=cms-2013-0155-10181) File # CMS-2013-0155-10181

(http://www.regulations.gov/#!documentdetail;d=cms-2013-0155-10181) File # CMS-2013-0155-10181 January 27, 2014 Marilyn Tavenner, Administrator Centers for Medicare & Medicaid Services Department of Health and Human Services Attention: CMS-4159-P P.O. Box 8013 Baltimore, MD 21244-8013 Re: Final

More information

#21 - Should You Provide Health Insurance in 2014?

#21 - Should You Provide Health Insurance in 2014? #21 - Should You Provide Health Insurance in 2014? Yes, for all size groups, but only if you can afford it and it serves other purposes (such as controlling competition for employees or you don t want

More information

Narrative Description Physician Assistants

Narrative Description Physician Assistants Narrative Description Physician Assistant Utilization: Meeting Healthcare Workforce Needs Dawn Ludwig, PhD, PA-C Utilization of physician assistants (Pas) has been a growing workforce issue for Minnesota,

More information

The Affordable Care Act: Overview & Impact on Adult Immunizations

The Affordable Care Act: Overview & Impact on Adult Immunizations The Affordable Care Act: Overview & Impact on Adult Immunizations Adult Immunization Leadership Summit February 1, 2013 Barbara Flye, Senior Health Policy Advisor Office of the Insurance Commissioner 1

More information

Review of H.R. 3200, America s Affordable Health Choices Act

Review of H.R. 3200, America s Affordable Health Choices Act Review of H.R. 3200, America s Affordable Health Choices Act Below is a review of those measures contained in the America s Affordable Health Choices Act of 2009 that correspond to issues contained in

More information

Impact and Opportunities for Integrated Medical and Dental Care Management under the Affordable Care Act

Impact and Opportunities for Integrated Medical and Dental Care Management under the Affordable Care Act Impact and Opportunities for Integrated Medical and Dental Care Management under the Affordable Care Act A Federal Perspective David Williams, Ph.D. Objective of this presentation: To share the Federal

More information

The Patient Protection and Affordable Care Act. Implementation Timeline

The 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 information

State of Alabama. Medicaid Dental Review

State of Alabama. Medicaid Dental Review State of Alabama Medicaid Dental Review October 2010 Executive Summary The Centers for Medicare & Medicaid Services (CMS) is committed to improving pediatric dental care in the Medicaid program reflecting

More information

The Healthcare Law April 19, 2010

The Healthcare Law April 19, 2010 The Healthcare Law April 19, 2010 This healthcare bill, recently made law, is a comprehensive overhaul that increases coverage to 94% of Americans and makes sweeping changes to our current healthcare system.

More information

Presentation for Licensed Producers The Affordable Care Act

Presentation 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 information

The grants that have been awarded to State agencies are listed in the following table:

The grants that have been awarded to State agencies are listed in the following table: Title: Grants and Funding Opportunities under the Affordable Care Act Summary of Several Sections State Options Overview: This document provides background information on grants and other funding opportunities

More information

Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth

Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth Affordable Care Act Health Insurance Exchanges Jim Wotring & Gary Macbeth National Technical Assistance Center for Children s Mental Health, Georgetown University What We Are Talking About Today Exchanges

More information

Community Health Centers: Workforce and Access Issues

Community Health Centers: Workforce and Access Issues Community Health Centers: Workforce and Access Issues Local Perspective Family Health Centers, Inc. Louisville, KY Federally Qualified Health Center 20 FQHC grantees in Kentucky (4 urban) 1200 FQHCs Nationally

More information

Affordable Care Act and Adolescents and Young Adults

Affordable Care Act and Adolescents and Young Adults Affordable Care Act and Adolescents and Young Adults Overview of Summit Welcome and Introductions Affordable Care Act 101 Affordable Care Act and Impact on Adolescents and Young Adults Federal Update on

More information

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers?

The Affordable Care Act: The Health Insurance Marketplace -- What Does It Mean for Individuals, Families, and Employers? The Patient Protection and Affordable Care Act (ACA) includes provisions that will have significant implications for individuals, families and employers in 2014. These provisions include: The creation

More information

SOME ASSEMBLY REQUIRED HEALTH REFORM AND COLORADO"

SOME 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 information

OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION

OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION OUTLINE OF HEALTH CARE OVERHAUL LEGISLATION PREPARED FOR AOA MEMBERS BY THE WASHINGTON OFFICE, MARCH 2010 More than 16 months after a far-reaching overhaul of the nation s health care system became the

More information

Health Insurance Marketplace 101 1

Health Insurance Marketplace 101 1 Affordable Care Act Coverage Accomplishments May 2013 3.1 million young adults have gained insurance through their parents plans 6.1 million people with Medicare through 2012 received $5.7 billion in prescription

More information

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget.

Health Insurance Marketplace 101. Find health care options that meet your needs and fit your budget. Health Insurance Marketplace 101 Find health care options that meet your needs and fit your budget. March 2014 The Health Care Law In March 2010, President Obama signed the Affordable Care Act into law

More information

The Affordable Care Act in New Hampshire

The Affordable Care Act in New Hampshire The State of New Hampshire Insurance Department 21 South Fruit Street, Suite 14 Concord, NH 03301 (603) 271-2261 Fax (603) 271-1406 TDD Access: Relay NH 1-800-735-2964 The Affordable Care Act in New Hampshire

More information

SURVIVAL GUIDE FOR SMALL BUSINESS

SURVIVAL GUIDE FOR SMALL BUSINESS HEALTH INSURANCE MARKETPLACE SURVIVAL GUIDE FOR SMALL BUSINESS Vermont edition NAVIGATING NEXT STEPS IN HEALTH CARE REFORM There s a constant stream of changes and updates related to health care reform,

More information

Nursing Workforce. Primary Care Workforce

Nursing Workforce. Primary Care Workforce Key Provisions Related to Nursing: The Patient Protection and Affordable Care Act (Public Law 111-148) clearly represents a movement toward much-needed, comprehensive and meaningful reform for our nation

More information

Affordable Care Act Policy and Implementation Briefing

Affordable 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 information

State and Federal Health Care Reform Update. Universal Health Care Foundation of Connecticut

State and Federal Health Care Reform Update. Universal Health Care Foundation of Connecticut State and Federal Health Care Reform Update Universal Health Care Foundation of Connecticut Linda Dahlmeyer, CPA Vice President for Finance and Administration ldahlmeyer@universalhealthct.org Jill Zorn,

More information

HHealth HEALTH INSURANCE EXCHANGE FAQs

HHealth HEALTH INSURANCE EXCHANGE FAQs HHealth HEALTH INSURANCE EXCHANGE FAQs Page 1 TABLE OF CONTENTS Introduction... 3 Background... 3 Health Insurance Exchange FAQs... 4 What is the Patient Protection and Affordable Care Act (PPACA)?...

More information

PPACA, COMPLIANCE & THE USA MARKET

PPACA, 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 information

Ben G. Raimer, MD, MA, FAAP Chairman Statewide Health Coordinating Council

Ben G. Raimer, MD, MA, FAAP Chairman Statewide Health Coordinating Council Health Professions Workforce Part II - Recommendations Ben G. Raimer, MD, MA, FAAP Chairman Statewide Health Coordinating Council Workforce Issues Data Needs Assessment and Planning Shortages and Maldistribution

More information

Federal 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 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 information

Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms

Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms Minimum Creditable Coverage, Minimum Essential Coverage and ACA Insurance Market Reforms Kaitlyn Kenney Director of Policy & Research and National Health Reform Coordinator Board of Directors Meeting October

More information

Health Care Reform, What s in It?

Health Care Reform, What s in It? Health Care Reform, What s in It? Rural Communities and Rural Medical Care No. 9 July 2010 Jon M. Bailey Center for Rural Affairs A critical component of the Patient Protection and Affordable Care Act

More information

Kansas Insurance Department

Kansas Insurance Department Kansas Insurance Department A Kansas Guide to Health Insurance Changes Public Policy Session Panel Discussion KAMU Annual Conference Sept. 26, 2013 Sandy Praeger, Commissioner of Insurance 2014 Affordable

More information