Affordable Care Act: January 2011 Provisions
The Patient Protection and Affordable Care Act is a long, complicated document that will cause real changes in the way that you and your family access and pay for health insurance. Texas Impact is committed to helping you understand the bill and making sure that you get the benefits available to you. Below is a list of PPACA provisions that go into effect in January, 2011.
Prescription Drug Discounts
Starting January 1, 2011, Seniors under Medicare Part D coverage will receive a 50 percent discount when purchasing Medicare covered brand-name prescription drugs. In 2020, the Medicare coverage gap will be closed, but until then, savings for seniors will slowly be phased in.
The Medicare office has a new document explaining new provisions in detail.
Free Preventive Care for Seniors
The Affordable Care Act already requires all new health plans to cover preventive services, but effective January 1, 2011, seniors already on Medicare will also be eligible to receive free preventive services, such as annual check-ups.
Center for Medicare and Medicaid Innovation This new center was established in November 2010, in order to explore methods of healthcare delivery and payment that would improve quality of patient care to Medicare and Medicaid enrollees. By January 1, 2011, the US Department of Health and Human Services will issue a National Health Care Quality Strategy and Plan that includes Medicare, Medicaid, and CHIP. The HHS sought public input and comment in developing this strategic plan, and has held several listening sessions and calls on the topic. Community Care Transitions Program Beginning January 1, 2011, a 5-year grant will fund this Community Care Transitions Program, which aims to cut down on unnecessary hospital readmissions for senior Medicare recipients who are at high risk due to illness. Medical Loss Ratio Effective January 1, 2011, Insurance companies will be required to show that their expenditure for administrative costs and overhead reflects a certain ratio expended for patient care and quality care. According to Healthcare.gov, the Affordable Care Act will require that at least 85% of all premium dollars collected by insurance companies for large employer plans are spent on health care services and health care quality improvement, and 80% of premium dollars in small employer and individual plans must be directed to the same purpose. Insurance companies that do not reach this medical loss ratio standard will be required to provide rebates to their customers. Strengthening Medicare Advantage and ending Overpayment To Insurance Companies Beginning January 1, 2011, provisions of the Affordable Care Act will gradually eliminate the difference between Traditional Medicare and Medicare Advantage. This will end Medicare Advantage overpayment to insurance companies, for which current rates average $1,000 more per person than Traditional Medicare. The Affordable Care Act provides bonus payments to Medicare Advantage plans that provide high quality health care. The Medicare office has developed a new document explaining the provision in detail.
