New Year, New Provisions of the Affordable Care Act Effective

January 1, 2013 at 8:20 pm 2 comments

Now that we are officially in 2013, new provisions of the Affordable Care Act (health care reform) become effective. As I wrote last year, there are many provisions in the Affordable Care Act that are extremely important for IBD patients, like eradicating the preexisting condition exclusions. While that doesn’t go into effect for another year, there are some important aspects of the law that go into effect this year.

Below is a list of those provisions and what they entail. All information was obtained from the timeline on www.healthcare.gov.

Effective Immediately

  • Improving Preventive Health Coverage: To improve coverage and affordability, new funding will be allocated to state Medicaid programs that cover preventive services for patients at little or no cost.
  • Increasing Medicaid Payments for Primary Care Doctors: In preparation of covering more patients next year, the Affordable Care Act requires states pay primary care physicians no less than 100 percent of Medicare payment rates this year and next year for primary care services. This increase in payment is fully funded by the federal government.
  • Expanded Authority to Bundle Payments: Effective no later than today, the Affordable Care Act established a national pilot program encouraging hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care through payment “bundling.” Essentially, hospitals, doctors and other providers are paid a flat rate for an episode of care rather than the currently method where each procedure or test is billed separately to Medicare. Bundling is supposed to provide incentives to deliver health care services more efficiently while, at the same time, maintaining or improving quality of care. The savings are shared between providers and the Medicare program.

Effective This Year

  • Additional Funding for the Children’s Health Insurance Program (CHIP): Effective on October 1, 2013, states will receive two more years of funding for the State Children’s Health Insurance Program which enables them to continue coverage not eligible for Medicaid but whose family cannot afford to buy insurance. To be eligible for CHIP, children must be 19 or younger in families with incomes up to $45,000 per year (for a family of four). Pregnant women may be eligible for CHIP coverage as well. Lastly, CHIP covers U.S. citizens and certain legal immigrants.

I will continue to post updates on the Affordable Care Act and any information important to IBD patients as the year goes on.

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2 Comments Add your own

  • 1. Levi  |  January 2, 2013 at 9:23 pm

    Thanks for the summary. I am definitely one that enjoys reading the cliff notes versus the extended version. Any preventative treatment for people not on medicaid?

    Reply
    • 2. caringforcrohns  |  January 3, 2013 at 7:18 pm

      Hi Levi,

      Thanks for checking my blog out!

      I’m actually working on a post that summarizes the whole legislation so if you can sit tight, I will be talking about that soon!

      Rebecca

      Reply

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