Health care reform
By St. Joseph News-Press
The following components of the Affordable Care Act are authorized to begin today:
Medicare Part D “doughnut hole”: Pharmaceutical companies will offer a 50 percent discount on brand-name prescription drugs that fall within the Medicare Part D coverage gap. Federal subsidies for generic prescriptions in the coverage gap also begin.
Medicare preventive screening: Costs will be relieved for preventive screening services. Medicare will also cover a comprehensive health-risk assessment.
Medicare payments for primary care: Primary care services will receive a 10 percent Medicare bonus payment, as will general surgeons who practice in health-care shortage regions.
Medicare premiums for higher-income patients: Medicare Part B income-related thresholds will freeze at 2010 levels, and Medicare will reduce Part D premium subsidies to those individuals who make more than $85,000 a year and couples who make more than $170,000.
Medicare Advantage payment changes: Medicare payments to Medicare Advantage plans will stay at 2010 levels and decrease for fee-for-service procedures. It also puts a cap on Medicare Advantage plans from increasing cost-sharing requirements for certain fee-for-service covered benefits.
Medicaid health homes: The state option will reimburse Medicaid health home providers for 90 percent of related services for two years.
Chronic disease prevention in Medicaid: States will receive three-year grants for programs to address chronic conditions, such as smoking and high cholesterol, in Medicaid patients.
Center for Medicare and Medicaid Innovation: The organization will assess new Medicare and Medicaid models that cut cost and improve quality.
Medical loss ratios: Health insurance companies must supply rebates to consumers if the proportion of premium money used for medical services is less than 85 percent for large group markets and less than 80 percent for small group or individual markets.
CLASS: The program supplies insurance for community living assistance services.
Health care quality: The Secretary of the Department of Health and Human Services will develop an annual health care quality improvement strategy.
Tax-free health savings accounts: Limits health reimbursement accounts or health flexible spending accounts’ use to prescription medications only, and raises the tax on unused savings to 20 percent of the amount spent.
