Affordable Care Act (ACA)

Affordable Care Act (ACA). What is the Affordable Care Act?. Patient Protection and Affordable Care Act (PPACA), a.k.a. ACA Federal health care reform law March 23, 2010 signed into law by President Obama Goals: Expand coverage Control health care costs Improve health care delivery system.

Share Presentation

Embed Code

Link

Download Presentation

mandates health
health coverage
march
new program integrity
advanced premium tax credit
caretaker relatives

adli

adli + Follow

Download Presentation

Affordable Care Act (ACA)

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

Presentation Transcript

Affordable Care Act (ACA) www.dpw.state.pa.us
What is the Affordable Care Act? Patient Protection and Affordable Care Act (PPACA), a.k.a. ACA • Federal health care reform law • March 23, 2010 signed into law by President Obama • Goals: • Expand coverage • Control health care costs • Improve health care delivery system www.dpw.state.pa.us
What does it do? • Requires coverage regardless of pre-existing conditions or gender • Intended to increase rate of individuals covered by insurance through: • Creation of insurance exchanges and expansion of Medicaid eligibility • Mandates on employers and individuals • Premium subsidies • Tax credits • Intended to decrease number of uninsured individuals www.dpw.state.pa.us
What does it establish? Facilitates provision of qualified health coverage Mandates health benefit exchanges (also known as Marketplaces) by January 2014 in every state Regulatory overhaul of the U.S. healthcare system www.dpw.state.pa.us
State Requirements – Insurance Exchanges Choose an Insurance Exchange Option by December 14, 2012 3 options: www.dpw.state.pa.us
What role will be played by the FFM? • The federally facilitated exchange is also referred to as the FFE or federally facilitated marketplace (FFM). • Individuals may apply for insurance through the Exchange. • The Exchange will determine eligibility for: • Advanced Premium Tax Credit (APTC) • Cost Sharing Reductions (CSR) www.dpw.state.pa.us
What are APTC and CSR? Advance Premium Tax Credit (APTC): A new tax credit to help individuals and families afford health coverage purchased through the Exchange. Cost Sharing Reduction (CSR): A discount that lowers the amount paid out-of-pocket for deductibles, coinsurance, and copayments. www.dpw.state.pa.us
How does ACA affect DPW? What Has DPW Already Done Related to ACA? Extended Medicaid Drug Rebates to drugs paid by Medicaid Managed Care Organizations. Implemented several new program integrity and provider enrollment screening processes. Began paying increased payments to Medicaid primary care providers. Implemented a recovery audit contract to identify payment issues and recoup overpayments. Implemented payment policies for hospitals that prohibited payment for a Health-Care Acquired Condition, such as infections acquired at the hospital. www.dpw.state.pa.us
How does ACA affect DPW? One goal of ACA is to provide a seamless and simplified enrollment process for all Insurance Affordability programs. Pennsylvania will accomplish this requirement for simplified enrollment by providing multiple ways to apply, including: • Exchange • Electronic Application • Paper Application • New Pennsylvania paper application form called the PA 600HC • COMPASS – Updated to comply with ACA • Phone Applications There is ‘no wrong door’ when applying for Medical Assistance and other Health Care Plans! www.dpw.state.pa.us
How does ACA affect DPW? • The Modified Adjusted Gross Income (MAGI) standard will now be used for Medicaid eligibility. • MAGI will apply to adults, children, pregnant women, parents, caretaker relatives, and individuals eligible for family planning services. • MAGI does NOT apply to SSI recipients; children in foster care; individuals eligible based on being aged, blind, or disabled; working disabled; or individuals in a facility/eligible for home and community based care. www.dpw.state.pa.us
What is Early MAGI? • PA applied for an Early MAGI waiver to start MAGI October 1, 2013 rather than January 1, 2014. • Early MAGI will increase efficiency and reduce duplicative processes in the County Assistance Offices. www.dpw.state.pa.us
How does ACA affect DPW? • Medicaid Eligibility Changes: • Children ages 6-18 - Income up to 133% of Federal Poverty Level (FPL) • Former foster care children up to age 26 • ACA will NOT change eligibility or benefits for our waiver programs for individuals with physical and intellectual disabilities. www.dpw.state.pa.us
System Updates and Enhancements • COMPASS • System design, screening, eligibility questions and routing • Ability to link to Federal Exchange • Ability to obtain information from data matches in “real time” • CIS/eCIS/PROMISe • Medicaid eligibility rules under ACA • System design and screen changes www.dpw.state.pa.us
Consumer Service Center (CSC) • The Commonwealth has taken steps to ensure that the needs of its citizens are met under the new Federal ACA mandate. • CMS mandates the availability of a call center to take applications on the phone for ACA. • The CSC opened on October 1, 2013 to answer questions about ACA and take COMPASS applications for health care only. www.dpw.state.pa.us
Critical Milestones • October 2013 • Enrollment applications under the new Modified Adjusted Gross Income (MAGI) eligibility rules begin to be accepted • January 2014 • Exchange coverage begins for Pennsylvania www.dpw.state.pa.us
Questions and Comments More information on Pennsylvania’s implementation of the Affordable Care Act is available at www.dpw.state.pa.us. www.dpw.state.pa.us

Related
More by User

Affordable Care Act (ACA) Basics

Affordable Care Act (ACA) Basics. Workshop Overview. Affordable Care Act basics Provide a foundation for ACA Regulations, Act interpretations, and implementation dates occurring regularly Engage the employer Be proactive. Spending vs. Health.

646 views • 37 slides

AFFORDABLE CARE ACT

AFFORDABLE CARE ACT. RESOURCES FOR LIBRARIES. OVERVIEW OF ACA.

279 views • 16 slides

Affordable Care Act

Affordable Care Act. What an HIV Provider Needs to Know Steve O’Brien, MD January 28, 2013. Pacific AIDS Education Training Center. Steve O’Brien, MD. Pacific AIDS Education Training Center. Steve O’Brien, MD. Agenda. What is ACA? What can Providers & Patients expect?

815 views • 68 slides

Affordable Care Act Overview

Affordable Care Act Overview. Session 1 Presented by Tokie Moriel & John Tvedt. What is ACA?. The Affordable Care Act (ACA) Comprehensive reforms that: Improve access to affordable health Protect consumers. ACA Key Facts. Stronger Consumer Rights and Protections

536 views • 30 slides

Affordable Care Act

Affordable Care Act . Health Care Reform Update September 14, 2013. Supervisor Dave Roberts San Diego County Board of Supervisors Third District. What is the Affordable Care Act (ACA)?. Insurance Reform. Health System Reform. What is expected to happen? More people covered

300 views • 13 slides

Affordable Care Act

Affordable Care Act. What does it mean for our families and communities?. Overview. Review of Affordable Care Act (ACA) Private insurance reforms and the Marketplace ACA and immigrants/refugees. Already Have Insurance?.

358 views • 20 slides

Affordable Care Act (ACA):

Affordable Care Act (ACA):. New Options for Rebalancing Long Term Services and Supports Arkansas: MFP State Balancing Incentive Payment. AR Money Follows the Person. 100% Administrative funds for Rebalancing Initiatives HCBS Transition Counselors

120 views • 4 slides

The Patient Protection and Affordable Care Act

The Patient Protection and Affordable Care Act. Update and Implications. Joseph Jefferson, MPH Director of Advocacy and Alliance Development. Presentation Preview. Assessing the Landscape ACA Implementation Update ACA Patient Protections and Access ACA and Ryan White

604 views • 46 slides

Affordable Care Act

Affordable Care Act. SHRM April 10 th , 2013. Chris Keen Keen Insurance Associates- President 410-213-9060 / 410-251-8605 cell ckeen@keeninsurance.com . Affordable Care Act. Acronyms & Synonyms ACA Patient Protection and Affordability Care Act PPACA (“Pa Pac a”) Free Health Care

508 views • 31 slides

The Affordable Care Act (ACA)

The Affordable Care Act (ACA). Overview Housekeeping (Introduction, Questions, Timing, ) Why Pre-Retirees are interested in the ACA Affordable Care Act Important Changes How much does health care cost Health plans offered through Covered California in Butte County Scenarios

309 views • 11 slides

Affordable care act

Affordable care act . Consumer impact. What’s changing with the ACA?. What’s not changing with the ACA? Will have broad impact that affects some population groups more than others. Impact by insurance status. Impact greatest on uninsured/underinsured

259 views • 10 slides

The Affordable Care Act (ACA)

The Affordable Care Act (ACA). What health reform means for Emergency Physicians. Main Provisions of ACA. Expanding Insurance Coverage Health Insurance Reform Improve Quality Contain Costs Consumer Protections. Expanding Coverage. Individual Mandate

317 views • 20 slides

Affordable Care Act

Affordable Care Act. f or American Indians and Alaska Natives Geoffrey Roth Senior Advisor Indian Health Service. Learn more about. Indian Health Care Improvement Act Medicare and the ACA Medicaid Expansion The Health Insurance Marketplace Eligibility and Enrollment

539 views • 25 slides

Affordable Care Act

OREGON DEPARTMENT OF CONSUMER AND BUSINESS SERVICES INSURANCE DIVISION. Affordable Care Act. Affordable Care Act – Primary Goal. Reduce the number of uninsured: It is estimated that that Affordable Care Act (ACA) will provide health insurance to 32 million uninsured when fully implemented

439 views • 22 slides

Affordable Care Act

Affordable Care Act. March 2014. What is ACA?.

381 views • 29 slides

Affordable Care Act Tools

Affordable Care Act Tools. Overview. The Affordable Care Act, or ACA, includes new requirements for employer insurance coverage and for individuals to have health care coverage.

204 views • 11 slides

ACA – Affordable Care Act

ACA – Affordable Care Act. Disclaimer – waiting on finalized policy from DAS/CHRO 30 hours a week or 1560 annually considered benefit eligible Initial Measurement Period – November 2013 to October 2014: OSPS Tracking ongoing employees: Agency Health Reform (ACA) trainings – coming soon…

365 views • 30 slides

Affordable Care Act

Affordable Care Act. SHRM April 10 th , 2013. Chris Keen Keen Insurance Associates- President 410-213-9060 / 410-251-8605 cell ckeen@keeninsurance.com. Affordable Care Act. Acronyms & Synonyms ACA Patient Protection and Affordability Care Act PPACA (“Pa Pac a”) Free Health Care

523 views • 31 slides

Affordable Care Act/ HB 1059

Affordable Care Act/ HB 1059. NDPERS September 2014. Today’s Agenda. Review of ACA Requirements & Changes in State Law for PERS Implementation Considerations ACA Q&A ACA New Hire Eligiblity Process ACA Reporting. PERS Plan Eligibility today. FTE under State Law.

1.38k views • 126 slides

Affordable Care Act

266 views • 25 slides

The Affordable Care Act (ACA)

207 views • 20 slides