Section 1557 of the Affordable Care Act

Section 1557 of the Affordable Care Act PDF Author: American Dental Association
Publisher: American Dental Association
ISBN: 1941807712
Category : Medical
Languages : en
Pages : 60

Book Description
Section 1557 is the nondiscrimination provision of the Affordable Care Act (ACA). This brief guide explains Section 1557 in more detail and what your practice needs to do to meet the requirements of this federal law. Includes sample notices of nondiscrimination, as well as taglines translated for the top 15 languages by state.

Health Care Fraud and Abuse

Health Care Fraud and Abuse PDF Author: Aspen Health Law Center
Publisher:
ISBN:
Category : Business & Economics
Languages : en
Pages : 156

Book Description
Stepped-up efforts to ferret out health care fraud have put every provider on the alert. The HHS, DOJ, state Medicaid Fraud Control Units, even the FBI is on the case -- and providers are in the hot seat! in this timely volume, you'll learn about the types of provider activities that fall under federal fraud and abuse prohibitions as defined in the Medicaid statute and Stark legislation. And you'll discover what goes into an effective corporate compliance program. With a growing number of restrictions, it's critical to know how you can and cannot conduct business and structure your relationships -- and what the consequences will be if you don't comply.

Don't Wait for Washington

Don't Wait for Washington PDF Author: Brian Blase
Publisher:
ISBN:
Category :
Languages : en
Pages :

Book Description


The Promise of Assistive Technology to Enhance Activity and Work Participation

The Promise of Assistive Technology to Enhance Activity and Work Participation PDF Author: National Academies of Sciences, Engineering, and Medicine
Publisher: National Academies Press
ISBN: 030945784X
Category : Medical
Languages : en
Pages : 503

Book Description
The U.S. Census Bureau has reported that 56.7 million Americans had some type of disability in 2010, which represents 18.7 percent of the civilian noninstitutionalized population included in the 2010 Survey of Income and Program Participation. The U.S. Social Security Administration (SSA) provides disability benefits through the Social Security Disability Insurance (SSDI) program and the Supplemental Security Income (SSI) program. As of December 2015, approximately 11 million individuals were SSDI beneficiaries, and about 8 million were SSI beneficiaries. SSA currently considers assistive devices in the nonmedical and medical areas of its program guidelines. During determinations of substantial gainful activity and income eligibility for SSI benefits, the reasonable cost of items, devices, or services applicants need to enable them to work with their impairment is subtracted from eligible earnings, even if those items or services are used for activities of daily living in addition to work. In addition, SSA considers assistive devices in its medical disability determination process and assessment of work capacity. The Promise of Assistive Technology to Enhance Activity and Work Participation provides an analysis of selected assistive products and technologies, including wheeled and seated mobility devices, upper-extremity prostheses, and products and technologies selected by the committee that pertain to hearing and to communication and speech in adults.

Medicaid Eligibility Quality Control

Medicaid Eligibility Quality Control PDF Author: United States. Social and Rehabilitation Service
Publisher:
ISBN:
Category : Medicaid
Languages : en
Pages : 460

Book Description


Shared Responsibility for Employers Regarding Health Coverage (Us Internal Revenue Service Regulation) (Irs) (2018 Edition)

Shared Responsibility for Employers Regarding Health Coverage (Us Internal Revenue Service Regulation) (Irs) (2018 Edition) PDF Author: The Law The Law Library
Publisher: Createspace Independent Publishing Platform
ISBN: 9781729729601
Category :
Languages : en
Pages : 128

Book Description
Shared Responsibility for Employers Regarding Health Coverage (US Internal Revenue Service Regulation) (IRS) (2018 Edition) The Law Library presents the complete text of the Shared Responsibility for Employers Regarding Health Coverage (US Internal Revenue Service Regulation) (IRS) (2018 Edition). Updated as of May 29, 2018 This document contains final regulations providing guidance to employers that are subject to the shared responsibility provisions regarding employee health coverage under section 4980H of the Internal Revenue Code (Code), enacted by the Affordable Care Act. These regulations affect employers referred to as applicable large employers (generally meaning, for each year, employers that had 50 or more full-time employees, including full-time equivalent employees, during the prior year). Generally, under section 4980H an applicable large employer that, for a calendar month, fails to offer to its full-time employees health coverage that is affordable and provides minimum value may be subject to an assessable payment if a full-time employee enrolls for that month in a qualified health plan for which the employee receives a premium tax credit. This book contains: - The complete text of the Shared Responsibility for Employers Regarding Health Coverage (US Internal Revenue Service Regulation) (IRS) (2018 Edition) - A table of contents with the page number of each section

Improving Medicare

Improving Medicare PDF Author: Adam K. Brooks
Publisher:
ISBN: 9781611229042
Category : Health care reform
Languages : en
Pages : 0

Book Description
The Medicare program enables millions of beneficiaries to obtain health care services; however, lacks many of the essential elements of a high-quality, high-value and efficient health system. Program spending and utilisation have increased substantially, without corresponding improvements in beneficiaries' health. This new and important book describes the need for Medicare to move away from payment policies that encourage service volume and are indifferent to quality and toward policies that promote better value for Medicare and its beneficiaries.

Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA)

Health Insurance Exchanges Under the Patient Protection and Affordable Care Act (ACA) PDF Author: Bernadette Fernandez
Publisher: Createspace Independent Pub
ISBN: 9781480152809
Category : Medical
Languages : en
Pages : 40

Book Description
The fundamental purpose of a health insurance exchange is to provide a structured marketplace for the sale and purchase of health insurance. The authority and responsibilities of an exchange may vary, depending on statutory or other requirements for its establishment and structure. The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) requires health insurance exchanges to be established in every state by January 1, 2014. ACA provides certain requirements for the establishment of exchanges, while leaving other choices to be made by the states. Qualified individuals and small businesses will be able to purchase private health insurance through exchanges. Issuers selling health insurance plans through an exchange will have to follow certain rules, such as meeting the private market reform requirements in ACA. While the fundamental purpose of the exchanges will be to facilitate the offer and purchase of health insurance, nothing in the law prohibits qualified individuals, qualified employers, and insurance carriers from participating in the health insurance market outside of exchanges. Moreover, ACA explicitly states that enrollment in exchanges is voluntary and no individual may be compelled to enroll in exchange coverage. Exchanges may be established either by the state itself as a “state exchange” or by the Secretary of Health and Human Services (HHS) as a “federally facilitated exchange.” All exchanges are required to carry out many of the same functions and adhere to many of the same standards, although there are important differences between the types of exchanges. States will need to declare their intentions to establish their own exchanges by no later than November 16, 2012. ACA and regulations require exchanges to carry out a number of different functions. The primary functions relate to determining eligibility and enrolling individuals in appropriate plans, plan management, consumer assistance and accountability, and financial management. ACA gives various federal agencies, primarily HHS, responsibilities relating to the general operation of exchanges. Federal agencies are generally responsible for promulgating regulations, creating criteria and systems, and awarding grants to states to help them create and implement exchanges. A state that is approved to operate its own exchange has a number of operational decisions to make, including decisions related to organizational structure (governmental agency or a nonprofit entity); types of exchanges (separate individual and Small Business Health Options Program (SHOP) exchanges, or a merged exchange); collaboration (a state may independently operate an exchange or enter into contracts with other states); service area (a state may establish one or more subsidiary exchanges in the state if each exchange serves a geographically distinct area and meets certain size requirements); contracted services (an exchange may contract with certain entities to carry out one or more responsibilities of the exchange); and governance (governing board and standards of conduct). In general, health plans offered through exchanges will provide comprehensive coverage and meet all applicable private market reforms specified in ACA. Most exchange plans will provide coverage for “essential health benefits,” at minimum; be subject to certain limits on cost-sharing, including out-of-pocket costs; and meet one of four levels of plan generosity based on actuarial value. To make exchange coverage more affordable, certain individuals will receive premium assistance in the form of federal tax credits. Moreover, some recipients of premium credits may also receive subsidies toward cost-sharing expenses.

Estimated Financial Effects of the 'Patient Protection and Affordable Care Act,' as Amended

Estimated Financial Effects of the 'Patient Protection and Affordable Care Act,' as Amended PDF Author: Richard S. Foster
Publisher: DIANE Publishing
ISBN: 143793353X
Category : Health & Fitness
Languages : en
Pages : 34

Book Description
This memorandum summarizes the Centers for Medicare and Medicaid Services (CMS) Office of the Actuary¿s estimates of the financial and coverage effects through FY 2019 of selected provisions of the ¿Patient Protection and Affordable Care Act¿ (PPACA) (P.L. 111-149) as enacted on March 23, 2010, and amended by the ¿Health Care and Education Reconciliation Act of 2010¿ (P.L. 111-152) as enacted on March 30, 2010. Included are the estimated net Federal expenditures in support of expanded health insurance coverage, the associated numbers of people by insured status, the changes in Medicare and Medicaid expenditures and revenues, and the overall impact on total national health expenditures. Charts and tables.

Law, Explanation and Analysis of the Patient Protection and Affordable Care Act

Law, Explanation and Analysis of the Patient Protection and Affordable Care Act PDF Author: CCH Incorporated
Publisher: Wolters Kluwer
ISBN: 0808022873
Category : Law
Languages : en
Pages : 2114

Book Description
The One Resource That Explains EVERY Provision of the Single Most Sweeping Piece of Legislation in 50 Years! CCH's Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact provides employers, legal, legislative, health, and insurance professionals with comprehensive explanation and analysis of every aspect of health care reform legislation. The information is crucial, current, and reliable and offers complete, clear and practical guidance on every provision. This is one of the most high-impact pieces of legislation passed in decades. Taken together, the laws are over 2,800 pages long. Many hundreds of changes are made to existing laws and– over 600 changes to the Social Security Act alone (which contains all of the Medicare and Medicaid law), including almost 50 newly added provisions. Other laws affected include the Employee Retirement Income and Security Act (ERISA), the Public Health Service Act, the Internal Revenue Code, and even the Fair Labor Standards Act, among others. Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact include contains almost 500 expert explanations telling you what all those law changes mean. Only Law, Explanation and Analysis of the Patient Protection and Affordable Care Act, Including Reconciliation Act Impact includes: An editorially enhanced version of the Patient Protection and Affordable Care Act that integrates in place changes made to it by the Reconciliation Act of 2010 and Title X amendments Text of the Joint Committee on Taxation report that provides background information on the revenue-related provisions of the laws Finding devices to help navigate between analysis and official text Caution notes The legislation contains the most significant health care changes in decades. Topics covered include the following: For employers: Enhanced employer responsibility Insurance market reforms Health insurance exchanges Individual responsibility mandate For health providers and beneficiaries: Expanded eligibility rules for Medicaid and the Children's Health Insurance Program Reimbursement changes for physicians and hospitals to focus on primary and preventive care Reimbursement changes for hospitals to increase coverage in rural areas Expansion of existing value-based purchasing and quality programs EXCLUSIVE ONLINE FEATURE! With your purchase of the book, you'll receive access to a special website that gives you access to SSA, ERISA, and IRC provisions amended by the Patient Protection and Affordable Care Act and the Reconciliation Act of 2010, as well as other valuable Health Care Reform information and resources. Full text of both Acts will also be provided on this exclusive website.