Health Care Package Major Provisions Timeline

Discussion in 'The Refreshment Lounge' started by Blake Bowden, Apr 7, 2010.

  1. Blake Bowden

    Blake Bowden Administrator Staff Member

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    Health Care Package Major Provisions Timeline 
(Timeline of Major Provisions in the Current Health Care Package)
    2009
    • 2-year tax credit (total cap of $1B) for new chronic disease therapy investments
    • Medicare cuts to hospitals begin - long-term care (7/1/09) and inpatient and rehabilitation facilities (FY10)

    2010
    • States and Federal officials review premium increases
    • FDA authorized to approve “follow-on†biologics
    • Increase brand name pharmaceutical Medicaid rebate (from 15.1% to 23.1%)
    • Medicare payments to physicians in primarily rural areas increase (2 years)
    • Deny “black liquor†eligibility for cellulosic biofuel producers’ credit
    • Tax credits provided to certain small employers for health care-related expenses
    • Increase adoption tax incentives for 2 years
    • Codify economic substance doctrine and impose penalties for underpayments (transactions on/after 3/23/10)
    • Provide income exclusion for specified Indian tribe health benefits provided after 3/23/10
    • Temporary high-risk pool and high-cost union retiree reinsurance ($5 B each for 3.5 years) (6/23/10)
    • Impose 10% tax on indoor UV tanning (7/1/10)
    • Medicare cuts to inpatient psych hospitals (7/1/10)
    • Prohibits lifetime and annual benefit spending limits (plan years beginning 9/23/10)
    • Prohibits non-group plans from canceling coverage (rescissions) (plan years beginning 9/23/10)
    • Requires plans to cover, at no charge, most preventive care (plan years beginning 9/23/10)
    • Allows dependents to stay on parents’ policies through age 26 (plan years beginning 9/23/10)
    • Provides limited protections to children with pre-existing conditions (plan years beginning 9/23/10)
    • Hospitals in “Frontier States†(ND, MT, WY, SD, UT) receive higher Medicare payments (FY11)
    • Hospitals in “low-cost†areas receive higher Medicare payments for 2 yrs ($400 million, FY11)

    2011
    • Medicare Advantage cuts begin
    • No longer allowed to use FSA, HSA, HRA, Archer MSA distributions for over-the-counter medicines
    • Medicare cuts to home health begin
    • Wealthier seniors ($85k/$170k) begin paying higher Part D premiums (not indexed for inflation in Parts B/D)
    • Medicare reimbursement cuts when seniors use diagnostic imaging like MRIs, CT scans, etc.
    • Medicare cuts begin to ambulance services, ASCs, diagnostic labs, and durable medical equipment
    • Impose new annual tax on brand name pharmaceutical companies
    • Americans begin paying premiums for federal long-term care insurance (CLASS Act)
    • Health plans required to spend a minimum of 80% of premiums on medical claims
    • Physicians in “Frontier States†(ND, MT, WY, SD, UT) receive higher Medicare payments
    • Prohibition on Medicare payments to new physician-owned hospitals
    • Penalties for non-qualified HSA and Archer MSA distributions double (to 20%)
    • Seniors prohibited from purchasing power wheelchairs unless they first rent for 13 months
    • Brand name drug companies begin providing 50% discount in the Part D “donut holeâ€
    • 10% Medicare bonus payment for primary care and general surgery (5 years)
    • Employers required to report value of health benefits on W-2
    • Steps towards health insurance administrative simplification (reduced paperwork, etc) begins (5 yr process)
    • Additional funding for community health centers (5 years)
    • Seniors who hit Part D “donut hole “in 2010 receive $250 check (3/15/11)
    • New Medicare cuts to long-term care hospitals begin (7/1/11)
    • Additional Medicare cuts to hospitals and cuts to nursing homes and inpatient rehab facilities begin (FY12)
    • New tax on all private health insurance policies to pay for comp. eff. research (plan years beginning FY12)

    2012
    • Medicare cuts to dialysis treatment begins
    • Require information reporting on payments to corporations
    • Medicare to reduce spending by using an HMO-like coordinated care model (Accountable Care Organizations)
    • Medicare Advantage plans with a 4 or 5 star rating receive a quality bonus payment
    • New Medicare cuts to inpatient psych hospitals (7/1/12)
    • Hospital pay-for-quality program begins (FY13)
    • Medicare cuts to hospitals with high readmission rates begin (FY13)
    • Medicare cuts to hospice begin (FY13)

    2013
    • Impose $2,500 annual cap on FSA contributions (indexed to CPI)
    • Increase Medicare wage tax by 0.9% and impose a new 3.8% tax on unearned , non-active business income for those earning over $200k/$250k (not indexed to inflation)
    • Generally increases (7.5% to 10%) threshold at which medical expenses, as a % of income, can be deductible
    • Eliminate deduction for Part D retiree drug subsidy employers receive
    • Impose 2.3% excise tax on medical devices
    • Medicare cuts to hospitals who treat low-income seniors begin
    • Post-acute pay for quality reporting begins
    • CO-OP Program: Secretary awards loans and grants for establishing nonprofit health insurers
    • $500,000 deduction cap on compensation paid to insurance company employees and officers
    • Part D “donut hole†reduction begins, reaching a 25% reduction by 2020

    2014
    • Individuals without government-approved coverage are subject to a tax of the greater of $695 or 2.5% of income
    • Employers who fail to offer “affordable†coverage would pay a $3,000 penalty for every employee that receives a subsidy through the Exchange
    • Employers who do not offer insurance must pay a tax penalty of $2,000 for every full-time employee
    • More Medicare cuts to home health begin
    • States must have established Exchanges
    • Employers with more than 200 employees can auto-enroll employees in health coverage, with opt-out
    • All non-grandfathered and Exchange health plans required to meet federally-mandated levels of coverage
    • States must cover parents /childless adults up to 138% of poverty on Medicaid, receive increased FMAP
    • Tax credits available for Exchange-based coverage, amount varies by income up to 400% of poverty
    • Insurers cannot impose any coverage restrictions on pre-existing conditions (guaranteed issue/renewability)
    • Modified community rating: individual or family coverage; geography; 3:1 ratio for age; 1.5 :1 for smoking
    • Insurers must offer coverage to anyone wanting a policy and every policy has to be renewed
    • Limits out-of-pocket cost-sharing (tied to limits in HSAs, currently $5,950/$11,900 indexed to COLA)
    • Insurance plans must include government-defined “essential benefits †and coverage levels
    • OPM must offer at least two multi-state plans in every state
    • Employers can offer some employees free choice vouchers for health insurance in the Exchange
    • Government board (IPAB) begins submitting proposals to cut Medicare
    • Impose tax on nearly all private health insurance plans
    • Medicare payment cuts for hospital-acquired infections begin (FY15)

    2015
    • More Medicare cuts to home health begin

    2016
    • States can form interstate insurance compacts if the coverage with HHS approval (2016)

    2017
    • Physician pay-for-quality program begins for all physicians
    • States may allow large employers and ulti-employer health plans to purchase coverage in the Exchange.
    • States may apply to the Secretary for a limited waiver from certain federal requirements

    2018
    • Impose “Cadillac tax on “high cost†plans, 40% tax on the benefit value above a certain threshold: ($10,200 individual coverage, $27,500 family or self-only union multi-employer coverage)

     
  2. JTM

    JTM "Just in case" Premium Member

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    i don't think there's anything in here i approve of.
     
  3. owls84

    owls84 Moderator Premium Member

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    The way I see it....Health Care is a BFD.
     
  4. JTM

    JTM "Just in case" Premium Member

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    Base flood depth?

    Bulk file distribution?






    ohhhhhh, i get it.

    :)
     

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