cmonfils | January 13, 2012
Streamlining electronic funds transfers in health care will bring total savings to
more than $16 billion over 10 years
New standards for electronic funds transfers in health care, required by the Affordable Care Act, will reduce up to $4.5 billion off administrative costs for doctors and hospitals, private health plans, states, and other government health plans, over the next ten years, according to estimates included in new rules published today by the U.S. Department of Health and Human Services (HHS). The standards build upon regulations published earlier this year that set industry-wide standards for how health providers use electronic systems to quickly and easily determine a patient’s eligibility for health coverage and check on the status of a health claim.
Category: Health Care Legislation, HHS |
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cmonfils | January 12, 2012
Health reform had a big year in 2010, when it passed Congress and a slew of consumer-friendly provisions came online. And it’ll have another big year in 2014. That’s when the individual mandate kicks in, pre-existing conditions end and Medicaid expands to cover 16 million more Americans. But 2012 won’t be all quiet on the health-care front: The Obama administration is laying a policy foundation for 2014, while health reform opponents try to stop the law altogether. Here are five key dates to mark on your health reform calendar (you do have one of those, don’t you?):
Category: Health Care Legislation |
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cmonfils | January 12, 2012
WASHINGTON—Internal Revenue Service guidance released last week resolves additional questions employers have raised about a health care reform law requirement that they report the cost of health care coverage on employees’ W-2 wage and income statements.
Under the requirement, health care cost information must be reported on 2012 W-2s, which will be issued in 2013. Under previous IRS guidance, smaller employers—those that distribute fewer than 250 W-2s in 2011—are exempt from this requirement until at least 2014 and possibly longer.
http://www.businessinsurance.com/article/20120108/NEWS03/301089986#crit=Health
Category: Health Care Legislation |
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cmonfils | January 10, 2012
The Obama administration surprised supporters and critics when it decided to let states define the “essential health benefits” that must be provided to their citizens under health care reform. The move could lessen opposition in Republican-led states and increase the chances that they will move ahead on building new health insurance exchanges to comply with the reform law.
Category: Health Care Legislation |
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cmonfils | January 10, 2012
The Patient Protection and Affordable Care Act (the Act) enacted a series of insurance market reforms that impose new rules on health insurance issuers and group health plans. Commencing in 2014, the Act requires that polices of health insurance offered in the individual and small group markets as well as Medicaid benchmark plans offer a comprehensive package of items and services known as “essential health benefits” (EHB). Essential health benefits must include items and services within at least the following 10 categories: (1) ambulatory patient services, (2) emergency services (3) hospitalization, (4) maternity and newborn care, (5) mental health and substance use disorder services, including behavioral health treatment, (6) prescription drugs, (7) rehabilitative and habilitative services and devices, (8) laboratory services, (9) preventive and wellness services and chronic disease management, and (10) pediatric services, including oral and vision care. Self-insured group health plans, health insurance coverage offered in the large group market, and grandfathered health plans are not required to provide essential health benefits.
Category: Health Care Legislation, Health Insurance, HHS, PPACA |
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cmonfils | January 8, 2012
www.myhealthguide.com
MyHealthGuide Source: Chris Dimick, American Health Information Management Association (AHIMA), 1/4/2012, AHIMA Field Guide
CHICAGO — The healthcare industry has been inundated with change in recent years and health information management (HIM) professionals are being challenged to re-evaluate and prioritize initiatives that will have the most impact on the profession. Seven of the nation’s top initiatives will be monitored throughout the year by AHIMA’s HIM experts and are discussed in this month’s Journal of AHIMA cover story, “Field Guide: Seeing the Trees Through the Forest in 2012.” (more…)
Category: Accountable Care Organizations, Health Care Legislation, HIPAA |
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cmonfils | January 8, 2012
Last time, we discussed how the demands of health care reform are getting HR and finance to work together in closer collaboration.
Now, let’s take a look at why health care reform-related decision making will require cross-functional input and discussion. Remember, the health insurance exchanges are coming on line and companies must make the so called “pay-or-play” decision in just 24 months. Is it better for the company to continue to offer its employees health insurance (play)? Or is it more advantageous to eliminated health benefits and pay the resulting penalties (pay)?
Category: Health Care Legislation |
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cmonfils | January 8, 2012
As CPAs gear up for tax season, they’ll find the Form 1040 series for 2011 looking much the same as that of the previous year, but only because of Congress’ 11th-hour compromise late in 2010 to keep it so. Nonetheless, a number of new features affecting individuals and businesses, such as new information reporting forms, are debuting, so return preparers should be aware of developments in the past year that will affect 2011 tax returns.
Category: Health Care Legislation, PPACA |
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cmonfils | January 8, 2012
This year’s crop of healthcare buzzwords and catchphrases includes a handful of terms that are really oxymorons. By oxymoron, of course, we mean one of the words or phrases in the expression contradicts the rest. But if you think about it, that’s the very theme of health reform today.
Category: Health Care Legislation, News |
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cmonfils | January 5, 2012
New data show 1.2 million more children nationwide have health insurance since the reauthorization of CHIP in 2009
More than $296 million was awarded to states for ensuring more children have health coverage, HHS Secretary Kathleen Sebelius announced today.
The performance bonus payments are funded under the Children’s Health Insurance Program Reauthorization Act, one of the first pieces of legislation signed into law by President Obama in 2009. To qualify for these bonus payments, states must surpass a specified Medicaid enrollment target. They also must adopt procedures that improve access to Medicaid and the Children’s Health Insurance Program (CHIP), making it easier for eligible children to enroll and retain coverage.
Category: Health Care Legislation, HHS |
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cmonfils | January 3, 2012
Employer’s Guide to Self-Insuring Health Benefits December 2011 | Vol. 19, No.3
The recently proposed summary of benefits and coverage (SBC), while still a work in progress, will fill a currently unmet need for a tool enabling plan participants to comparison-shop for coverage, federal regulators told a recent conference. They sought to allay plan sponsors’ concerns that the SBC is redundant, confusing or even regressive. (more…)
Category: DOL, ERISA, Health Care Legislation, HHS, HIPAA |
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cmonfils | January 3, 2012
Employer’s Guide to Self-Insuring Health Benefits December 2011 | Vol. 19, No.3
The U.S. Supreme Court definitively announced on Nov. 14 it will decide the question of whether Congress exceeded its powers to regulate commerce when it decided to require people to buy health insurance (that is, whether the individual mandate is allowed under the U.S. Constitution). The court will hear National Federation of Independent Business v. Sebelius; and Florida v. HHS. The High Court will hear oral arguments in February and March 2012; it said it will issue a ruling in June 2012. It will also cover the question of “severability;” that is, the issue of whether the entire law must fall in the event that the individual mandate is stricken. The National Federation of Independent Business expressed hope that the Court would overturn the law, saying that it was putting a damper on business growth and job creation. (more…)
Category: 11th, 4th, Health Care Legislation, HHS, PPACA, Supreme Court, Washington D.C. |
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cmonfils | January 3, 2012
Employer’s Guide to Self-Insuring Health Benefits December 2011 | Vol. 19, No.3
Health plans outside of health reform’s system of state-run insurance exchanges are not required to observe the health reform law’s essential benefits package (EBP), so self-insured plans will have an option of carving out benefits in the interest of affordability. Individual and small-group policies offered through exchanges must cover the package, which includes outpatient services, emergency services, hospitalization, maternity/newborn care, mental health/substance abuse services, prescription drugs and four other categories. The EBP takes effect in March 2014. (more…)
Category: Health Care Legislation, HHS, Self-Funding |
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cmonfils | January 1, 2012
On December 16, 2011, the Department of Health and Human Services’ Center for Consumer Information and Insurance Oversight (CCIIO) released an essential health benefits bulletin (pdf) that describes a proposed regulatory approach that the HHS will use to define essential health benefits (EHB) under the Affordable Care Act. The health care reform law requires that, beginning in 2014, health plans offered in the individual and small group markets, including those to be offered in the future health insurance exchanges, provide a package of benefits and services considered “essential.” While the Act does not specify the EHBs that must be covered by each plan, it does state that as of January 1, 2014, non-grandfathered plans in the individual and small group market and those in the exchanges must provide coverage of benefits or services in the following 10 categories: ambulatory patient services; emergency services; hospitalization; maternity and newborn care; mental health and substance use disorder services, including behavioral health treatment; prescription drugs; rehabilitative and habilitative services and devices; laboratory services; preventive and wellness services and chronic disease management; and pediatric services, including oral and vision care. In addition, the Act mandates that the scope of EHBs must be equal to the scope of benefits provided under a “typical” employer plan.
Category: Health Care Legislation, HHS, PPACA |
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cmonfils | January 1, 2012
WASHINGTON — Chief Justice John Roberts said Saturday that he has “complete confidence” in his colleagues’ ability to step away from cases where their personal interests are at stake, and noted that judges should not be swayed by “partisan demands.”
The comment, included in Roberts’ year-end report, comes after lawmakers demanded that two Justices recuse themselves from the high court’s review of President Barack Obama’s health care law aimed at extending coverage to more than 30 million people. Republicans want Justice Elena Kagan off the case because of her work in the Obama administration as solicitor general, whereas Democrats say Justice Clarence Thomas should back away because of his wife’s work with groups that opposed changes to the law.
http://www.localwireless.com/wap/news/text.jsp?sid=254&nid=792177481&cid=10009&scid=-1&ith=3&title=National+News&headtitle=National+News%22
Category: Health Care Legislation, Supreme Court |
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