14 Feb Compliance Alert: Health Care Reform – What You Need To Know
Keeping You Compliant With The Latest Government Regulations!
Prestige is working diligently in 2013 to ensure our clients stay in compliance with all the new laws and regulations affecting small to medium size businesses.
GOVERNMENT REGULATION
Affordable Care Act
When President Obama signed the Affordable Care Act (ACA) in 2010 it put in place comprehensive health insurance reforms. Some have already gone into effect while others will continue to roll out over the next few years. The ACA, the most significant change to the health care delivery system since the formation of Medicare and Medicaid is intended to cover approximately 30 million uninsured.
Employers of all sizes are facing historical compliance challenges as they find themselves subjected to new rules, regulations and penalties regarding health care benefit plans and administration.
- The Patient Protection & Affordable Care Act (PPACA) is transforming the provision of small group and individual health insurance. The PPACA’s impact began immediately in 2010 with the elimination of pre-existing conditions for children and expansion of dependent coverage to age 26.
- Keeping on top of these regulatory changes is essential to navigate through the new health insurance landscape
PRESTIGE SOLUTION
What Prestige Is Doing To Keep You Compliant!
Health Care Reform will remain a moving target for the foreseeable future and Prestige is committed to keeping you up-to-date on all matters affecting group health plans, and communicating changes to employees, to ensure compliance. Prestige is staying on top of all the new Health Care laws and summarized some of the changes below:
Below are just some of the many changes that have taken place over the last three years:
2010
- A new Patient’s Bill of Rights went into effect, protecting consumers from the worst abuses of the insurance industry, and cost-free preventive services began for many Americans.
- New rules permitted young adults to stay on their parents’ plan until they turn 26 years old and prevented insurance companies from denying coverage to children under the age of 19 due to a pre-existing condition.
- Insurance companies were also prohibited from rescinding coverage and imposing lifetime dollar limits on essential benefits.
- Access to insurance is afforded for uninsured Americans with pre-existing conditions.
- A $5 billion program was created to provide needed financial help for employment-based plans to continue to provide valuable coverage to people who retire between the ages of 55 and 65, as well as their spouses and dependents.
- As many as four million small businesses became eligible for tax credits to help them provide insurance benefits to their workers.
2011
- Insurers are required to spend at least 85% of all premium dollars collected on health care services and health care quality improvement, or provide rebates to consumers
- People with Medicare are able to get key preventive services for free, and also receive a 50% discount on brand-name drugs in the Medicare “donut hole.”
- Uniform coverage documents and standard definitions were developed by HHS.
2012
- Accountable Care Organizations and other programs helped doctors and health care providers work together to deliver better care, and establish a hospital Value-Based Purchasing program (VBP) linking payment to quality outcomes.
- A series of changes were instituted to reduce paperwork and administrative costs.
More Regulations Ahead
The government will be issuing new rules and regulations on the Affordable Care Act and, most likely, changing the rules it has already made, based on employers’ and insurers’ comments. As always, Prestige will be at the forefront of the debate, ensuring your interests are well represented. Prestige is committed to keeping our clients compliant in 2013 and will continue to send compliance alerts.