HEALTH CARE REFORM

January 3rd, 2011 by MorganDowney Leave a reply »

January 21, 2011

As part of health care reform legislation, the Department of Health and Human Services was tasked with reporting to Congress on the status of obesity prevention efforts in Medicaid program. Here is their announcement of sending the report to Congress and a link to the full report. HHS Report to Congress on Availability and Status of Obesity Prevention Programs in Medicaid – Kaiser Health Reform

January 18, 2011

A new federal study estimates 129 million Americans , 1 out of 2, have a pre-existing condition which could disqualify them from obtaining insurance coverage. Obesity is one of the pre-existing conditions. At Risk: Pre-Existing Conditions Could Affect 1 in 2 Americans: | HealthCare.gov The study is part of the debate over repeal of President Obama’s signature health care reform law. The law guarantees health insurance to persons with pre-existing conditions. The vote to repeal, expected in a day or two, is not likely to be approved by the Senate or signed into law by the President.

2011 will be a critical year in implementing the Health Care Reform Legislation, the Affordable Care Act. About the Affordable Care Act | HealthCare.gov  Unless, of course, it is repealed or the courts throw all or part of the milestone legislation out. In any event, how critical pieces of the legislation affecting obesity will be implemented is important and we will follow it here.

Coming, 2011              The Food and Drug Administration isexpected                    to   finalize rules for chain restaurants to provide calorie information on their menu offerings.

January 3, 2011           Medicare beneficiaries will get the “Welcome to Medicare” physical without cost sharing. An annual Wellness visit will be covered with no cost sharing. Physicians or the health team will take height, weight, waist circumference, and blood pressure. A health risk assessment will also be provided. Preventive services of the USPSTF will be covered with no cost sharing. (It is our understanding that Medicare still does not cover intensive behavioral counseling for obesity.)

January 1, 2010           Medicare will boost primary care reimbursement to keep doctors and nurses working in primary care as the expected numbers of persons now with insurance coverage will surely increase.

September 23, 2010    New group and individual plans must cover services recommended by the US Preventive Services Task Force (USPSTF) which includes intensive behavioral counseling of adults on obesity. Screening for Obesity in Adults: Recommendations and Rationale These services must be provided without applying copayments or coinsurance for in-network services. Cost sharing can be applied to out-of-network providers.

Interim final rules are issued to allow children up to age 26 to stay on a parent’s health insurance plan. Dependent Coverage of Children Who Have Not Attained Age 26

 Also, new rules governing appeals of claim denials, including independent reviewers go into effect. Appealing Health Plan Decisions under the Affordable Care Act | HealthCare.gov

July 1, 2020                 Persons without health insurance due to pre-existing conditions can obtain health insurance through their state government or the federal government. Pre-Existing Condition Insurance Plan (PCIP) under the Affordable Care Act | HealthCare.gov

Insurance is in effect until 2014 when state insurance exchanges will be operational.

Follow Health Care Reform implementation at these websites:

Department of Health and Human Services   Home | HealthCare.gov

HHS Office of Consumer Information and Insurance Oversight  Regulations and Guidance

Department of Labor Affordable Care Act

Internal Revenue Service Affordable Care Act Tax Provisions  and Affordable Care Act of 2010: News Releases, Multimedia and Legal Guidance

Other:   Excellent blog on the ACA implementation from Timothy Jost Implementing Health Reform: Little-Noticed But Important Guidances – Health Affairs Blog

1 comment

  1. Thanks for the great read =)

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