The Department of Health and Human Services has been entrusted with the responsibility for implementing many major provisions of the historic health reform bill, the Patient Protection and Affordable Care Act (hereafter “Affordable Care Act”), which the President signed into law on March 23, 2010. This bill was further improved by the Health Care and Education Affordability Reconciliation Act of 2010, which the President signed into law on March 30, 2010. Additional information on the implementation of the Affordable Care Act can be found on the Regulations and Guidance page of the Office of Consumer Information and Insurance Oversight (OCIIO).
Preventative Care for Better Health
Eliminates deductibles, copayments, and other cost-sharing for preventative care in Medicare, and provides free annual wellness check-ups starting in 2011. Today, seniors must pay 20 percent of the cost of many preventative services and office visits.
If you have any questions as to how these new changes pertain to your health or you would like to make an appointment, please contact North Shore Medical Clinic or use the listing on the NSMC home page for the clinic in your area.
Quality, Affordable Health Care for Seniors
Thousands in Savings by Closing the Medicare “Donut Hole”
More than 8 million seniors in 2007 hit the “donut hole,” which is the gap in prescription drug coverage in Medicare Part D. this year, beneficiaries who hit the donut hole will receive a $250 rebate. Beginning in 2011, the Act institutes a 50 percent discount on brand name drugs in the donut hole, and the Act will completely close the donut hole for all prescription drugs by 2020.
Reduces Unwarranted Subsidies to Insurance Companies
Puts Medicare Advantage plan payments more in line with the costs for the Medicare program. Provides new incentives for health plans that improve quality and enrollee satisfaction. Medicare’s guaranteed benefits are not affected, and reducing these unwarranted subsidies will save Medicare more than $150 billion over 10 years.
Strengthens the Financial Health of Medicare
Invests in fighting waste, fraud, and abuse. Reforms payments to reduce harmful unnecessary hospital admissions and health care acquired infections. Together, these proposals will extend the financial health of Medicare by 9 years. Not a penny of Medicare taxes or trust funds will be used for health reform.
Affordable Long-Term Care
Creates a voluntary long-term care insurance program, which will provide a cash benefit to help seniors and people with disabilities obtain services and supports that will help them to remain in their homes and communities.
Control Chronic Disease
Invests in innovations that improve the quality of care that seniors receive such as medical homes and care coordination and improve the delivery of care for beneficiaries with one or more chronic conditions.
Promote Better Care After a Hospital Discharge
Links payments between hospitals and other care facilities to promote more effective transitional care following discharge from the hospital and encourage investments in hospital discharge planning.
Improve Quality of Care
Invests in developing and reporting quality of care measures across all providers to help beneficiaries make more informed choices among providers for the care they may need.
Creates incentives to reward providers that meet quality goals or show significant progress in improving patient outcomes. This focus on quality improvement will move our health system toward one that rewards better care rather than more care.
Protecting Seniors for Abuse and Neglect
Elder Justice Act
Includes the bipartisan Elder Justice Act which will help prevent and eliminate elder abuse, neglect, and exploitation. Specifically, the law requires the Secretary of HHS in consultation with the Departments of Justice and Labor, to award grants and carry out activities that provide greater protection to those individuals in facilities that provide long-term services and supports and provide greater incentives for individuals to train and seek employment at such facilities. It also requires the immediate reporting of suspected crimes to law enforcement officials.
Improving Quality of Care in Nursing Homes
Standardized Complaint Form
Creates a standardized complaint form for use by residents (or a person acting on a resident’s behalf) in filing complaints with a State survey and certification agency and a State long-term care ombudsman program. The Act also requires States to establish resolution processes.
Ensuring Staffing Accountability
Develops a program for facilities to report staffing information in a uniform format.
Criminal Background Checks for Employees in Nursing Homes
Establishes a nationwide program for national and State background checks for employees that have direct access to patients in long term care facilities.