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Medicare Blog | Medicare News | Medicare Information

What the PP&AC Act Means to Your Clients

Posted by Richard Ybarra on Fri, Mar 26, 2010 @ 11:18 AM

On March 23, 2010, President Barack Obama signed into law the Patient Protection and Affordable Care Act.  The new law brings much change to our health care system, and with that you will likely encounter many questions from your clients.  The following is a list of major provisions in the law that will impact many of your clients directly:

The Medicare “doughnut hole” will be closed
- the approximately 4 million Medicare beneficiaries who hit the so-called “doughnut hole” in the program’s drug plan will get a $250 rebate this year.

No more co-pays for preventative screenings
– to encourage earlier detection of health issues and treat them at a lower cost.

Extending the life of the Medicare Trust Fund - Health insurance reform will extend the life of the Medicare Trust Fund by an additional four to five years – and delivery system reforms included in health insurance reform have the potential to keep the Trust Fund solvent even longer into the future.

The Physician Payments Sunshine Act – requires disclosure of payments and gifts provided to doctors from pharmaceutical, biologic, and medical device companies.  This law aims to reduce medical costs for consumers by preventing conflicts of interest created by such financial incentives.

Medicare Payment Improvement Act of 2009 – health care providers will be compensated for their services based on the quality, not the quantity, of care they provide.  States that achieve higher quality-to-cost ratios will receive an increased reimbursement from Medicare.

The Nursing Home Transparency and Improvement Act – consumers will have more access to information regarding nursing homes’ historical record of care.  This increased level of transparency is meant to encourage nursing homes to maintain the highest quality of care by their own initiative.

The Patient Safety and Abuse Prevention Act – prevents individuals with violent or criminal histories from working at organizations that provide care to senior citizens.  This will be accomplished through a new system of nationwide background checks.

Retooling the Healthcare Workforce for an Aging America Act of 2009 - expands, trains, and supports all sectors of the health care workforce to care for the growing population of older individuals in the United States.

The Home and Community Balanced Incentives Act – provides states with financials support and incentives to encourage restructuring of Medicaid programs to allow for more individuals to receive home and community-based services (HCBS).

According to Joe Baker, the president of the Medicare Rights Center, the PP&AC Act will be especially beneficial to those on Medicare.  “People with Medicare will save hundreds of dollars each year as the coverage gap in the Medicare drug benefit is phased out. They will have better access to preventive services and primary care. Hospitals and doctors will have new incentives to provide high-quality, coordinated care that will help people with Medicare manage chronic conditions. Medicare's finances will be stronger and the budget deficit will be reduced.”

For a high-level overview of all the changes that the PP&AC  Act introduces see this document (note: Medicare specific information starts on page 23): http://www.kff.org/healthreform/upload/housesenatebill_final.pdf

Another good source of information regarding health insurance reform and Medicare can be found here: http://www.healthreform.gov/reports/medicare/index.html

Sources: healthreform.gov, seniorjournal.com, kff.org

Tags: senior market blog, senior market news, Medicare Advantage, Medicare, Medicare Supplement, Medicare Discussion, Medicare News, senior insurance market news, health insurance news, health insurance industry

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