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Federal Update
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Health Reform: Big Changes Coming in 2014
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Over the last three years, Americans have been hearing a lot about the changes coming under the Affordable Care Act (ACA). And while many of the law’s provisions have been implemented, some of the more significant changes are coming in 2014.
Coverage Expansion
The Individual Mandate
Starting in 2014, most Americans will be required to obtain “minimum essential coverage,” or pay a penalty. Minimum essential coverage includes: public coverage (e.g. Medicare, Medicaid, etc.), insurance obtained through an employer, or insurance that an individual purchases on their own (as long as it meets certain requirements). To learn more about the individual mandate, including how penalties for noncompliance will work, a one page fact sheet called “Do I Have to Purchase Insurance?” can be accessed here.
Insurance Marketplaces
In 2014, Health Insurance Marketplaces will become available in all states, including Indiana. Open enrollment is expected to begin in October 2013.
Marketplaces will offer a range of health insurance options, comprehensive plan information and general assistance. Additionally, Marketplaces will help individuals determine whether or not they qualify for tax credits to help them purchase private insurance through the Marketplace, or find out if they are eligible for public health coverage programs.
Learn More:
Medicaid Expansion
In 2014, the ACA provides states with funding to expand their Medicaid programs to cover ALL legal residents with individual incomes below approximately $15,000 (133% of the federal poverty level) with no other eligibility restrictions or requirements. Under the law, the federal government will fund 100 percent of the cost of covering newly eligible individuals through 2016. After that, the government’s share of funding gradually drops to 90 percent by 2020. While the ACA would have mandated expansion of all state Medicaid programs, the Supreme Court ruling in June made expansion optional.
Indiana legislators have left Medicaid expansion up to Governor Pence to negotiate a waiver to the Healthy Indiana Program (HIP) with the federal government. If this waiver can be negotiated, HIP could potentially be used as a model for expansion. Unfortunately, we will not know about a waiver approval until probably late in the summer. The budget bill did appropriate some funds that could be used for expansion.
Learn More:
Insurance Reforms
Elimination of Annual and Lifetime Caps on Insurance Coverage
Under the ACA, lifetime caps on insurance benefits are already prohibited. In 2014, both lifetime, as well as annual caps, will be completely eliminated. Additional information on these changes can be found here.
Discrimination Based on Pre-Existing Conditions
Under the ACA, health insurers are no longer allowed to deny or exclude coverage to any child under age 19 based on a pre-existing condition. In 2014, this provision will take effect for all Americans.
Small Businesses
Increased Tax Credits
In 2014, the next phase of the small business tax credit will take effect. In “phase 2,” the existing tax credit will increase to up to 50% of the employer’s contribution to health insurance provided to employees. Small non-profit organizations will receive a tax credit up to 35%.
Learn More:
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CMS Releases Simplified Insurance Applications
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The Centers for Medicare & Medicaid Services (CMS) has released a shortened, more simplified application for individuals and families planning to apply for health care coverage through Health Insurance Marketplaces. Consumers will be able to apply for insurance online, by phone or on paper. A copy of CMS’ press release regarding the revised insurance applications can be found here.
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CMS Proposes Increase to Hospice Payments
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The Centers for Medicare & Medicaid Services (CMS) has issued a proposed rule that would increase payments to hospices by 1.1 percent ($180 million) in fiscal year (FY) 2014. Additionally, the rule would implement a provision included in the Affordable Care Act (ACA) that requires marketbasket updates to hospices that do not meet requirements for quality reporting to be reduced by two percentage points. A copy of the proposed rule is available here.
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May 15 Deadline to Submit Flu Data
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Hospitals submitting data on health care personnel flu vaccinations as part of the inpatient quality reporting program have until May 15 to do so. Failure to meet the deadline will result in exclusion from the Value Based Purchasing program and a two percent reduction in Medicare inpatient payments for fiscal year (FY) 2015. For more details on data submission, click here.
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ACT2020: Provide Feedback and Suggestions
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ACT2020.org contains a number of tools and resources that individuals can use to learn more about the current issues that impact the hospital system, our associates, and the people we serve. Do you have suggestions for other topics or issues that you would like to see covered in the future? If so, please contact us by clicking here. |
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Share Your Story!
Do you have a story to share with our nation's leaders to show why it is imperative that they work to improve health care? If so, please contact us. In your email, please include your name, ministry and role within the organization.
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Contact Us:
Do you have a question for Government Relations? If so, please don't hesitate to contact us. In your email, please include your name, ministry and role within the organization.
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