Archive on Health Care Reform Information

Information presented on the ANA\C Web site 2011-2012.

Patient-Centered Outcomes Research Institute (PCORI):
The non-profit organization was created from the ACA and its purpose is to conduct research to provide information about the best available evidence to help patients and their healthcare providers make more informed decisions. The research is intended to give patients a better understanding of the prevention, treatment, and care options available, and the science that supports those options. The public comment period is closed and the Methodology Committee will deliver a final version of the report to the Board of Governors in November 2012.

 

July 3, 2012: ANA Analysis of Affordable Care Act:
The ANA describes the Court's decision in plain English and walks through those ACA provisions that specifically related to the nursing profession. You can always learn more as ANA continues to drill down this decision by visiting www.nursingworld.org Please direct questions to Cynthia Haney or Cheryl Peterson at ANA Headquarters.

 

CMS Final Rule on Conditions of Participation: On May 16, 2012, CMS issued its final rule on Conditions of Participation and there is significant acknowledgement of nursing's contribution and leadership in hospital care. Please read the ANA analysis of the ruling (Note: this link will require you to sign in). Read the final ruling at http://www.ofr.gov/OFRUpload/OFRData/2012-11548_PI.pdf

Emails from the Regional IX Director U.S. Department of HHS, Herb K. Schultz, provide an extensive overview of current health care reforms issues will be posted here.

 

January 12.2012: Short Guide to Federal Employees Health Benefits Program (FEHBP) and its Relationship with Affordable Care Act (ACA)of 2010:
The FEHBP is one of several options that a state may adopt as a benchmark for the minimum essential health benefit that plans must provide to be qualified to participate in state health exchanges. The ACA says, states must choose among four options for health insurance plans available to small businesses and individuals beginning in 2014. Three of these options are based on state based plans, but the fourth possibility is to choose among any of the three national FEHBP plans that have the largest enrollment. To learn more print the document that explains this in detail.

 

December 16, 2011: The Department of HHS has released a bulletin outlining proposed policies that will give states more flexibility and freedom to implement a provision in the Affordable Care Act that requires health insurance plans offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges, to offer a comprehensive package of items and services known as "essential benefits." For more information visit http://www.healthcare.gov/news/factsheets/2011/12/essential-health-benefits12162011a.html and for additional information about this action visit http://www.hhs.gov/news/press/2011pres/12/20111216b.html

 

December 14, 2011: The Office of Statewide Health Planning & Development has information about the Healthcare Reform Act and how it will impact from their point of view and specifically California Healthcare Reform. You can read about it now.

 

October 24, 2011: HHS Affordable Care Act Bulletin as of October 14, 2011.

 

October 17, 2011: Long Term Care Portion of Affordable Health Care Act-CLASS is suspended. Read an announcement from Secretary of Health and Human Services Kathleen Sebelius.

 

September 14, 2011: Accountable Care Organizations: A Progress Report. Is is provided by AMN Healthcare. Read the article at www.amnhealthcare.com/News/news-details.aspx?Id=37744

 

August 26, 2011: Six Announcements from H.K. Schultz. 1) HHS Awards $137 million to States to Boost Prevention and Public Health; 2) CDC Awards More than $49 million to Strengthen State and Local Health Departments; 3) New Affordable Care Act Policy Helps Consumers Better Understand and Compare Benefits and Coverage; 4) Affordable Care Act Initiative to Lower Costs, Help Doctors and Hospitals Coordinate Care; 5) Non-Federal Members Names to HHS Advisory Council on Alzheimer's; 6) Weekly Affordable Care Act Bulletin. Read the details.

 

August 25, 2011: CMS Trials Bundled Payments for Episodes of Care:

Medicare officials proposed yet another care payment structure this one has hospitals and physicians receiving bundled payments for specific episodes of patient illness that extend well after the patient leaves an acute care setting. "Instead of paying for each care separately, CMS will provide one lump payment to providers for an episode of care." K. Sebelius, Secretary of HHS. Review complete article from HealthLeaders.

 

Reports from California Office of Statewide Health Planning & Development

OSHPD report from 1.4.12

 

California Health Care Benefit Exchange Information: The web site for this aspect of the HC Reform process is www.healthexchange.ca.gov

 

  • Exchange Plans Date Extended: The deadline to submit insurance plans has been extended. Read all about it.


  • ANA Practice Policy Report from a bimonthly conference call asking about developments regarding selection of a benchmark plan for the establishment of State Health Insurance Exchanges. October 1 is the deadline for states to have informed HHS about their plan. (Note California is one of the first states to establish their plan). Read the entire report about their query of APRNs opportunity to provide services and be directly reimbursed by plans offered by the State Exchanges.

 

 

 

  • April 2012 Board Meeting Report:

  • Report from the 12.20.11 CA Health Benefit Exchange Board Meeting. There are imbedded website and if they don't provide the information you need please visit www.hbex.ca.gov for more information about the board meetings. ANA\C will be submitting ANA's testimony on Essential Benefits to Herb Schulz.

  • Peter V. Lee Named First Executive Director of the CA Health Benefit Exchange. Learn more about Mr. Lee.

  • CA has received $39 Million in funding to set up a new marketplace for health care insurance. This grant will help the state plan for and design a new health insurance marketplace to cover millions of Californians. Board Chair Diana Dooley announced the funds will be used to create a 3-year business and operational plan, begin development of an information technology infrastructure, and conduct other start-up activities including consumer outreach. The role of the group is to negotiate rates for insurance coverage for those in the individual and small business markets. Those interested can see the plans that have been approved side by side for comparison. There will be an outreach campaign to solicit public comment on three proposed rules regarding health insurance exchanges. One is scheduled for Sacramento. Date will be posted ASAP.

 

Health Policy Tutorials Available Now: The Kaiser Family Foundation is offering several tutorials on health policy.


U. S. Congress and Health Policy provided by Sheila Burke
Health Care Reform An Overview by Jennifer Colbert
Issue Module: Role of the States in Health Policy

 

Three articles on the Federal Implementation of Health Care Reform (6.1.11)

http://healthreform.kff.org/document-finder/cm's/cms-request-for-applications-for-the-pioneer-aco-program.aspx

http://healthreform.kff.org/document-finder/hah/hhs-final-rule-on-insurance-rate-review-program.aspx

http://healthreform.kff.org/document-finder/cm's/cms-final-rule-establishing-the-hospital-value-based-purchasing-program.aspx

 

The California Workforce Investment Board and Office of Statewide Health Planning are holding hearing on the health care workforce. We would like help in attending all of these meetings. If any of you can attend and want to monitor/testify at these hearings, please let me know.

 

Future of Nursing Campaign for Action: This information will now be provided on its own page. Please visit IOM/Institute for the Future of Nursing and the California Action Coalition page.

 

U.S. Supreme Court will decide on Med i-Cal Rate Cuts: On January 19th the Supreme Court agreed to review California's controversial proposals to cut Medicaid reimbursements to physicians, dentists, pharmacies, health clinics, and other medical providers. Read more....

 

CMS Regional Listening Sessions-Health Care Delivery System Reform ANA Resources and Talking Points for CMAs-December 2010.

Kaiser Family Foundation Report on Health Coverage and the Uninsured to Include Latest Census Data. Report dated 12.1.2010

 

November 16, 2010: Three Announcements about Center Medicare & Medicaid Innovation; Affordable Care Act for Americans with Disabilities; and Affordable Care Act Bulletin for 11.16.10.

 

October 25, 2010: California Governor Announces Major Milestone in HC Reform Implementation.

 

California State Legislation as of September 30, 2010

 

  • AB 1602/SB 900: Governor Schwarzenegger signed this bill creating California Health Benefit Exchange, an entity that will help California consumers and small businesses shop for and buy affordable health insurance starting in 2014. This makes California the first state in the nation to enact legislation creating a health benefit exchange under federal health care reform.
  • SB 1163: Health care coverage: denials: premium rates. This will require all premium filings to be reviewed and certified by an independent actuary to ensure premium costs are accurately calculated and all proposed rate increases be posted on both department and insurer web sites making costs more transparent.
  • SB 1088: Health care coverage: dependents. This bill prohibits health plans and health insurers from setting the limiting age for dependent children covered by their parent's health insurance policy at less that 26 years of age.
  • AB 2244: Health care coverage. This implements and phases in provision of federal health care reform, ensuring that children cannot be denied coverage or priced out of the market if they have pre-existing conditions.
  • AB 2345: Health care coverage-preventive services: Aligns state law with federal health care reform. It required health care service plan contracts to cover preventive services with no-cost sharing.
  • AB 2470: Health care coverage-cancellation: rescission. Prohibits a person's health care insurance policy from canceling insurance once the enrollee is covered unless there is a demonstration of fraud or intentional misrepresentation of material fact by the terms of contract or policy.

 

KaiserEDU.org presents two new tutorials that explain the new health reform law, how it passed through Congress and what it means for Medicaid. Titles of these tutorials are Health Reform: How Will Medicaid Change? and Health Reform: A Retrospective

Other related resources on health reform are also available on the web site. You can also following what's happening on kaiserEDU.org on Facebook.

August 31, 2010 Four Announcements: HHS Secretary Sebelius to Make Major Announcement Affecting Early Retirees Under Affordable Care Act; Secretary Sebelius announces $32 million to support rural health priorities; Secretary Sebelius Announces Expansion of the Rural Community Hospital Demonstration under the Affordable Care Act; and Sebelius announces 1 million Medicare beneficiaries have received prescription drug cost relief under the Affordable Care Act.

August 10, 2010: State Medicaid Director Letter on Improved Access to HCBS & HHS Press Release on Availability of Health Center New Access Point Grants & Weekly HHS Affordable Care Act Bulletin.

August 6, 2010: HHS Affordable Care Act Bulletin &
CMS Educational Series for Providers on the Medicare & Medicaid Electronic Health Record (EHR) Incentive Program
.

State by State fact sheets on the immediate benefits of the Affordable Care Act. You can print the information for California.

States of States Legal Challenges to Health Care Reform

Talking Points State Legal Challenges of Federal Health Care Reform

Healthcare Reform Over the Next 10 years

ANA Policy & Provisions of Health Reform Law April 27, 2010

Selected Patient Protection and Affordable Care Act (PPACA) implementation dates of interest to RNs as caregivers, RNs as patients, and RNs as employees

Medicaid Coverage and Spending in Health Reform: National and State-by-State Results for Adults at or Below 133% FPL