Archive for the ‘National Health Care Reform Legislation’ Category

Medicaid Wellness Programs

HHS to offer grants to states to provide incentives to Medicaid beneficiaries to enlist in comprehensive and proven wellness programs. Initial report due not later than January 1, 2014; final report due not later than July 1, 2016. Source: The Common Wealth Fund
July 9th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, Uncategorized | Read More

Evaluate Wellness Programs

 Require the Centers for Disease Control and Prevention (CDC) to study, evaluate, and provide technical assistance to small businesses to implement effective employer-sponsored wellness programs. Must issue a study within two years of enactment. Source: The Common Wealth Fund
July 9th, 2010 | Uncategorized | Read More

Conformed Definition of Medical Expenses

Conformed Definition of Medical Expenses—Tax Years Beginning 2011 or Later. In 2011, the definition of medical expenses for the itemized medical expenses deduction will be extended to apply to health savings accounts, Archer Medical Savings Accounts (MSAs), health flexible spending arrangements, and...
July 9th, 2010 | National Health Care Reform Legislation, tax changes, Uncategorized | Read More

Annual Review of Premium Increases

In 2010, effective immeadiately, the HHS secretary and states will establish a process for annual review of unreasonable premium increases. Health insurers will be required to submit to the secretary and the relevant state a justification for an unreasonable increase prior to implementation of the increase....
July 9th, 2010 | National Health Care Reform Legislation, requirements, Uncategorized | Read More

Limits on Share of Private Premiums Insurers Spend on Non-Medical Costs

New limits will be set for the percent of premiums that insurers can spend on non-medical costs. Beginning in 2010, health plans are required to report the proportion of premiums spent on items other than medical care. Beginning in 2011, health plans in the large group market that spend less than 85...
July 9th, 2010 | National Health Care Reform Legislation, requirements, Uncategorized | Read More

State Option to Expand Medicaid Eligibility

States are given the option to cover parents and childless adults up to 133 percent of poverty and receive curent federal matching contributions. Source: The Common Wealth Fund
July 9th, 2010 | National Health Care Reform Legislation, new programs, Uncategorized | Read More

Prohibition Against Rescissions

Group health plans or insurance companies providing group or individual market coverage are prohibited from rescinding coverage once an enrolled is covered under a plan, except in the case of an individual who has performed an act or practice that constitutes fraud or makes an intentional misrepresentation...
July 9th, 2010 | National Health Care Reform Legislation, requirements, Uncategorized | Read More

Prohibition on Preexisting Condition Exclusions for children

 Insurers are prohibited from excluding coverage of preexisting conditions for children in the individual market, effective six months after enactment. Source: The Common Wealth Fund
July 9th, 2010 | insurance, National Health Care Reform Legislation, requirements, Uncategorized | Read More

Encouraging Integrated Health Systems

 Implement physician payment reforms that enhance payment for primary care services and encourage physicians to join together to form “accountable care organizations” to gain efficiencies and improve quality of care. Allow providers organized as accountable care organizations (ACOs) that...
July 8th, 2010 | National Health Care Reform Legislation, new programs | Read More

Quality Payment Modifier

Require HHS to apply physician payment modifier to Medicare fee-for-service payment to pay physicians differentially based on quality and costs of care. Publish measures in 2012; phase in modifier from 2015 to 2017. Source: The Common Wealth Fund
July 8th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, Uncategorized | Read More

Protect Patient Privacy

Authorize release of Medicare claims data to measure performance of providers and suppliers in a way that protects patient privacy. Effective January 1, 2012. Source: The Common Wealth Fund
July 8th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, Uncategorized | Read More

Impose new tax on insurers with high value plans

Impose an excise tax on insurers of employer-sponsored health plans with aggregate values that exceed $10,200 for individual coverage and $27,500 for family coverage. (Effective January 1, 2018) Source: Kaiser Family Foundation
July 7th, 2010 | National Health Care Reform Legislation, tax changes, Uncategorized | Read More

Reduce Medicare payments to certain hospitals for hospital-acquired conditions by 1%.

Reduce Medicare payments to certain hospitals for hospital-acquired conditions by 1%. (Effective fiscal year 2015) Source: Kaiser Family Foundation
July 7th, 2010 | National Health Care Reform Legislation, new programs, Uncategorized | Read More

Allow states to form healthcare choice compacts

Permit states to form health care choice compacts and allow insurers to sell policies in any state participating in the compact. (Compacts may not take effect before January 1, 2016) Source: Kaiser Family Foundation
July 7th, 2010 | National Health Care Reform Legislation, new programs, Uncategorized | Read More

Large groups allowed to purchase coverage

States may choose to allow large groups (over 100) to purchase coverage through the exchanges. Source: NAHU
July 7th, 2010 | insurance, National Health Care Reform Legislation, new programs, Uncategorized | Read More

Slide-scale premium assistance for non-Medicaid

Creates sliding-scale premium assistance tax credits for non-Medicaid eligible individuals with incomes up to 400% of FPL to buy coverage through the exchange. Beginning in 2019, a fail-safe mechanism would be applied that reduces overall premium subsidies if the aggregate amount exceeds 0.504 percent...
July 7th, 2010 | Medicare/Medicaid, National Health Care Reform Legislation, new programs, Uncategorized | Read More
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