Blogs

2012 PPACA Implementation Highlights

The implementation train for the Patient Protection and Affordable Care Act (PPACA) continues to pick- up speed with a number of important implementation dates in 2012. 

Keeping up with the pace can be challenging. To assist, the U.S. Department of Health and Human Services (HHS) offers  a website that helps track the major reform efforts, titled “What’s Changing and When.” Also useful is an online article posted by the White House that gives a year-by-year overview of the PPACA timeline.  

Author: Michael Gomes

Obama Administration Defends Affordable Care Act in Opening Brief Filed with U.S. Supreme Court

On January 6, 2012, the U.S. Department of Justice (DOJ) filed a brief with the U.S. Supreme Court in support of the Patient Protection and Affordable Care Act (PPACA), one of the most talked about pieces of legislation passed in recent memory. In addition, over a half dozen amicus curiae briefs have been filed since then by interested parties wanting to weigh in on the case.  Oral arguments on the merits of the new health care reform law are scheduled for late March.

Author: Michael Gomes

PPACA Establishes New Outcomes Research Institute to Promote Evidence Based Medicine: Some Express Concerns About Funding and Objectives

Buried in the thousands of pages of the Patient Protection and Affordable Care Act (PPACA) is Section 1181, which authorized the establishment of the Patient Center for Outcomes Research Institute (PCORI), an independent, non-profit organization charged with “evaluating and comparing health outcomes and the clinical effectiveness, risks, and benefits of medical treatments, services, procedures, drugs, and other strategies or items that treat, manage, diagnose, or prevent illness or injury.”

Author: Michael Gomes

Federal Government Taps 32 Organizations to be Pioneer ACOs

On December 19, 2011, the U.S. Department of Health and Human Services (HHS) announced that the federal agency has approved 32 organizations to become Pioneer Accountable Care Organizations. 

Through the Patient Protection and Affordable Care Act (PPACA), the federal government has promised to deliver improved health care while attempting to better control future costs. Among other initiatives, the new health care reform law authorizes the creation of Accountable Care Organizations (ACOs). 

Author: Michael Gomes

U.S. Supreme Court Schedules Hearings on PPACA

The United States Supreme Court will hear oral arguments regarding the constitutionality of the Patient Protection and Affordable Care Act (PPACA) from March 26 through 28of 2012, according to the New York Times and several other media services. The amount of time set aside for the hearings, over three days, signals the gravity and importance of the issue, and is without precedent in modern times. 

The U.S. Supreme Court docket outlines the three days of arguments to help resolve the legal issues associated with PPACA.

Author: Michael Gomes

Health Insurers Facing New Financial Pressure Points under Emerging Reforms: MLR Restrictions & ICD-10 Conversion Add to Complexity

The Patient Protection and Affordable Care Act (PPACA) is not only forcing health insurers to undergo fundamental changes in the way they do business, but the law is requiring new infrastructure investment while also mandating Medical Loss Ratios (MLR) that limit the amount insurers can spend on administrative costs.

Health plans are spending money upgrading key IT systems and developing risk management compliance programs as they gear up for each new PPACA requirement. Adding to the financial tension is the need for health plans to make significant changes to their respective information technology (IT) systems to enable a seamless enrollment process when state health insurance exchanges become operational in a couple of years.

Author: Michael Gomes

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