FEATURE EDITORIAL


Heritage Publishing, Inc. © 2012


AT A GLANCE: PATIENT PROTECTION & AFFORDABLE CARE ACT


- $250 rebate check for all Medicare Part D enrollees who hit the “donut hole”


- Incorporation of new screening procedures for health care providers to reduce health care fraud


- Insurance companies responsible for explaining significant rise in rates before receiving grants


- Incentives to increase availability of primary care doctors, nurses and physician assistants


January - Health insurance tax credits available for small businesses


April - Federal fund matching for states that expand Medicaid coverage


June - Temporary reinsurance program to cover early retirees


July - Access to insurance for those uninsured with pre-existing conditions


- Healthcare.gov established for consumers to easily


- Prevention and Public Health Fund invests in programs to prevent disease and illnesses


- Expansion of community health centers


- Increased payment for rural health care providers


January - Incentives for physicians to form Accountable Care Organizations


January - Increased funding to state Medicaid programs who cover preventive services for little or no cost


January - Individuals can purchase insurance directly from Affordable Insurance Exchanges


- All individuals will be responsible for having basic health insurance, unless exempt


- Physician compensation based on quality of care, not quantity of patient visits


January - 50 percent discount on brand name prescription drugs


- Seniors on Medicare receive free preventive care services


- A certain percentage of premium dollars collected by insurance agencies must be used


March - Federal health programs must collect patient information and provide it to the U.S.


-The federal government funds an increase in Medicaid payment for primary care physicians


- Competitive marketplaces allow individuals and small businesses to buy qualified health benefit plans


- All individuals who earn less than 133 percent of the poverty level can enroll in Medicaid


understand and compare insurance rates


September - Health care coverage for dependants extended to 26 years of age


- Full coverage of preventive care services on new insurance plans


- Prohibiting rescissions from insurance companies as a means to not pay when an individual becomes ill


- Establishment of a system that allows the insured to appeal insurance company decisions


toward health care services and health care quality improvement


- Strengthening of Medicare Advantage


- Center for Medicare and Medicaid Innovation established to test ways to improve quality of care and keep health care costs down for


Department of Health and Human Services to help work toward reducing health disparities


- Bundle payment programs begin


October - Two additional years of funding for the Children’s


- Individuals between 100 percent and 400 percent of the poverty line will be eligible for tax credits in an effort to make health care more affordable


- Insurance companies may not drop or limit


coverage because a patient is involved in a clinical trial


- Insurance plans can not put annual dollar amount caps on the coverage a patient may receive


- Insurers may not deny coverage because of pre- existing conditions


- Increase in health insurance tax credits available for small businesses


Medicare, Medicaid and the Children’s Health Insurance Program


- Instituting the Community Care Transitions Program to coordinate care and help keep seniors healthy after a hospital stay


October - The Independent


October -


Implementation of


standard billing and electronic medical records begins


Health Insurance Program (CHIP)


Payment Advisory Board assembles to find ways to extend the life of the Medicare Trust Fund


- The new Community First Choice Option offers all states the option to have home and community-based services for disabled people through Medicaid


- Value-based purchasing program begins


- Prohibiting insurance companies from establishing lifetime limits on the dollar value of essential benefits


- Regulating annual limits on insurance coverage


- Insurers may not deny children (under 19 years of age) coverage because of pre-existing conditions


October - States can receive federal grants to be used for customer assistance programs pertaining to health care


2012-2013 The Greater Daytona Healthcare GuideTM


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