In 2010, through President Barrack Obama’s advocacy, the United States enacted the Patient Protection and Affordable Care Act (“PPACA”) in an effort to ensure that all Americans have access to health coverage. As part of the PPACA Congress directed the Secretary of the U.S. Department of Health and Human Services (“HHS”) to develop and implement a Medicare Self –Referral Disclosure Protocol. The SRDP is intended to foster the resolution of potential or actual violations of Stark. This Section will give an in depth look at disclosures prior to SRDP, its enactment and the important developments in its brief existence. 1. Disclosures Prior to the SRDP Prior to this enactment providers had the option to make unsolicited or voluntary refunds to Medicare administrative contractors who process claims and issue payments on behalf of CMS. Generally, these refunds are in the form of adjustment bills or checks. The Medicare contractors process the refunds and review the circumstances surrounding the overpayment and take appropriate steps to resolve the issue. Entities could also request an advisory opinion from CMS to resolve violations. For CMS to consider an advisory opinion the requester must be a party to the existing agreement and is the only individual or entity that may rely on that opinion. Also, entities could make disclosures through the Office of Inspector General (“OIG”) under its Self-Disclosure Protocol (“SDP”). Today a Stark violation may still be
In order to more fully delve into this issue, this literature review will be focusing on three main areas of study as it applies to the topic of Medicare/Medicaid reimbursement and its relation to the Affordable Care Act. These areas of focus will include
The Patient Protection and Affordable Care Act (PPACA) of 2010, also known as the Affordable Care Act (ACA), is a legislation designed to extend coverage to the uninsured, eliminate practices that include rescission and denial of coverage due to pre-existing conditions, and lower health care costs. Moreover, the PPACA provides incentives to businesses to offer health insurance or impose penalties on business that do not provide coverage, and require individuals without health insurance to purchase reasonably priced polices through health insurance exchanges (Martocchio, 2014, p. 143). This health reform legislation was taken into effect in 2010, and is expected to complete implementation over the next few years.
In March of 2010, President Barack Obama signed into effect the Patient Protection and Affordable Care Act, or widely known as “Obamacare.” The changes that the act is making with all of health care will slowly be implemented throughout the years, and should be completed by 2022 (Obamacare Facts: Dispelling the Myths). In the Affordable Care Act it changes or alters almost all programs that we have today and creates new programs to assist people and properly state what type if care is expected and required of health care professionals. The Patient Protection and Affordable Care Act includes all of the following departments of health care, Affordable Health Care for America Act, the Patient Protection Act, the Health Care and Education Reconciliation Act, the Student Aid and Fiscal Responsibility Act, and effects the Food, Drug and Cosmetics Act and the Health and Public Services Act (Obamacare Facts: Dispelling the Myths). The Affordable Care Act will make many changes, but some of the big changes that will occur involve the patients quality of care, the benefits that all of America will receive with the prevention measures it will be taking, the total availability and access of health care for all Americans, and how all Americans health care finances will be altered.
This paper explores the flaws within the healthcare system in America that was passed as the Affordable Care Act and Patient Protection Act (PPACA); although, the intent behind the act was meant to do no harm, it seems as if the Affordable Care Act did more harm than good within the majority of the population. There are many sides to any issue, especially concerning the healthcare system within the United States, but based off of research, statistics, and articles one can obviously perceive it to be a good effort upon the American government. Questions arise upon efficiency from a physical/quality perspective of the American people, and also the monetary aspect. As stated, the issue of the Affordable Care Act is somewhat controversial and the politics of the subject are rarely black and white, but an objective view upon the issue is necessary to fully appreciate the act and constructively analyze the issue at hand, and the concerns that arose due to the act. Signed into the law on March 23rd, 2010 by President Barack Obama were the Patient Protection and Affordable Care Act (ACA). The ACA was expected to revolutionize American healthcare insurance security by expanding healthcare coverage, lowering insurance costs, improving the quality of medical care, etc., but it seemed to have done just the opposite. One can surely assume that the intent behind the healthcare innovation was completely genuine; however, one certainty can observe the issues following the ACA and Patient
When president Obama was a candidate in the 2008 election he promised wide scale health care reform that would increase the availability and affordability of medical insurance for a large portion of the American population. At the time of his campaign, millions of low-income Americans were stuck in the Medicaid gap – where they could not afford health insurance, but also were not eligible for the joint state and federal government Medicaid program. This promise eventually became the bill later named the Patient Protection and Affordable Care Act that was passed by the senate on December 24, 2010. The bill’s policy seeks to expand health care coverage to low-income families
The Patient Protection and Affordable Care Act (ACA) is legislation signed into law by the Obama Administration in 2010 and is gradually becoming implemented over several years. As of 2014 the ACA is requiring nearly every American to have an approved level of health insurance or pay a penalty. The required insurance coverage includes nearly 34 million Americans who are currently or were previously uninsured and is subsidized mainly through Medicaid and Health Insurance Exchanges that will completely or partially pay for coverage. The ACA goes beyond requirements for the individual by including extensive requirements on the health insurance industry and several regulations on the practice of medicine.
The Patient Protection and Affordable Care Act offers many healthcare benefits to a diverse group of American citizens. However, there are a few downsides as well. The major portions of the act deal with four primary issues:
After numerous failed attempts by previous legislations, President Obama was the first to implement federal health care reform. The Patient Protection and Affordable Care Act (ACA), otherwise known as Obamacare, was signed into law on March 23, 2010, in efforts to abate healthcare costs and provide health insurance to all United States citizens and legal residents. The intent of Obamacare revolves around providing universal access to healthcare regardless of a pre-existing condition, setting reasonable prices for health care insurance, and providing government subsidies to those who cannot afford health insurance on their own (up to 400% of the federal poverty level). The law entails many essential provisions, some of which include an
History was made as the President of the United States signed the Patient Protection and Affordable Care Act into law on March 23, 2010. The Patient Protection and Affordable Care Act (PPACA) delivers access to quality, affordable health care to all Americans. The breakthrough legislation, passed in March of 2010, represents the most significant government expansion and regulatory overhaul of the country’s healthcare system since the passage of Medicare and Medicaid in 1965 (Dix, 2013). The PPACA promises to reduce health disparities, improve access to preventative services, improve health outcomes and reduce healthcare spending. As stated by the Congressional Budget Office (CBO), the PPACA will provide coverage to more than 94 percent of
The Patient Protection and Affordable Care Act was signed into law in March of 2010 after years of struggling to create health reform policy that both sides could agree upon. Prior to the passing of the ACA, the democratic party had attempted for nearly 75 years to create healthcare policy that would benefit all Americans, but it was not until Nancy Pelosi presented the act in July of 2009 to the Senate that progress was seen (History of the Affordable Care ). The act that was created contained nearly 11,000 pages of requirements including ten title sections to group the regulations together. While overwhelming for many Americans to sit down and read, the items included in this legislation that would impact them directly were communicated and discussed in almost all media outlets with support and protest. One of the requirements of the ACA that has impacted all Americans is the Shared Responsibility of Health Care Title I- Subsection F. This ultimately has become known as the requirement for all Americans to have insurance coverage and for many businesses to offer health insurance to their full-time employees.
This means in the long run that all uninsured Americans will still have the option to buy health insurance through the state or federal exchanges.
Signed into law by President Barack Obama on March 23, 2010, the Patient Protection and Affordable Care Act (PPACA), or Affordable Care Act (ACA), ushered in a new era in the way Americans get their medical care (coverage). Guaranteeing new consumer protections and creating insurance exchanges to facilitate greater access and affordability by reducing premiums and costs for tens of millions of Americans. When passed, the ACA allowed for states to expand access to Medicaid to those previously ineligible, including some people above the Federal Poverty Level (FPL), and in its five years since passage the law has faced challenges to its component pieces, its legality, and constitutionality all together. A Supreme Court decision in 2012 ruled a key element of the ACA, the expansion of Medicaid, to be optional for the states. From that decision, 24 states and the District of Columbia have chosen the expansion option and seen success, while opposition in other states has led to efforts to block expansion, invoking a sophistic response where those living above the FPL receive federal subsidies and the most in need are left without coverage. The success of the ACA in non-expansion states – Georgia, in particular, here - depends on the state governance to make available the expansion of Medicaid for the population of their states, including opening doors for patient navigators to reach into local communities and raise awareness.
On March 23, 2010, President Barack Obama signed the Patient Protection and Affordable Care Act in Law. The health reform law establishes a national, voluntary insurance program for purchasing community living services supports known as the Community Living Assistance Services and Supports Program (CLASS ACT). The CLASS program is designed to expand options for people who become functionally disabled and require long-term services and supports, including home care, adult day care, or a stay in a nursing home. In exchange for paying premiums during their healthy, working years, people would get a daily cash benefit to help defray the costs of these forms of assistance. The CLASS program was made effective on January 1,
With the current implementation of the Patient Protection and Affordable Care Act (PPACA) and Medicare’s performance-based payment incentives, a streamlined model to help improve patient outcomes and decrease healthcare costs must be developed for the perioperative setting (Berwick et al 2012). Established in 2010 by the PPACA, Accountable Care Organizations (ACOs) hold multiple providers accountable for achieving high quality of care and reducing the cost per capita when they are directly involved in providing services for a designated patient population within an integrated system (Kash et al 2014; Ferrari et al 2015). In order to comply with these ACO requirements, the anesthesiologist must be involved in the coordination of the
In 2011, the Agency for Healthcare Research and Quality recorded that Americans made nearly 40 million hospital stays (Pfuntner). Each of these stays in each of the 4,000 hospitals and medical centers across the nation produced, at the very least, one medical record. Every healthcare provider needs to process and maintain these records with haste and accuracy. Failure to do so can result in a multitude of repercussions, ranging from the mistreatment of patients to errors in reporting to insurance that create a cycle of rising costs for both patients and healthcare providers. ERP systems, or Electronic Medical Records system as it has come to be known in the healthcare industry aim to serve a field with an exponentially growing need for