Shining a Light on Health Insurance Rate Increases. Affordable Care Act Requires Insurance Companies to Justify High Rate Hikes. Health insurance premiums have risen rapidly, straining pocketbooks for American families and businesses. Since 1. 99. 9, the health insurance premiums for family coverage have risen 1. Premium increases have forced families to spend more money for less coverage. And insurance companies have been able to raise rates without explaining their actions or justifying the reasons for their high premiums. Microsoft Volume Licensing programs for government, education, healthcare, and nonprofits offer flexible and affordable solutions that are tailored by organization size and purchasing preference. Office 365 is available to. The Agency For HealthCare Administration. Welcome to the website for the Florida Agency for Health Care Administration. Our mission is 'Better Health Care for All Floridians.'. Affordable Care Act Requires Insurance Companies to Justify High Rate Hikes. Health insurance premiums have risen rapidly, straining pocketbooks for American families and businesses. Since 1999, the health insurance premiums. Guidelines for Preventing the Transmission of Mycobacterium tuberculosis in Health-Care Settings, 2005. Please note: This report has been corrected and replaces the electronic PDF version that was published on. The Act funds scholarships and loan repayment programs to increase the number of primary care physicians, nurses, physician assistants, mental health providers, and dentists in the areas of the country that need them most. Order and download substance abuse and mental health issues related publications from the SAMHSA Store. Welcome to Arizona Health Care Cost Containment System (AHCCCS) Arizona Health Care Cost Containment System (AHCCCS) is Arizona's Medicaid agency that offers health care programs to serve Arizona residents. Most health plans must cover a set of preventive services like shots and screening tests at no cost to you. This includes Marketplace private insurance plans. Thanks to the Affordable Care Act’s requirement that insurance companies publicly justify any unreasonable rate increases, consumers who experience large increases will know why they are paying the rates that they are. Some states review proposed increases in health insurance rates and disapprove them if they are excessive. Other states lack the legal authority or resources to effectively review rates. The proposed regulation will ensure that large rate increases in all states will be thoroughly reviewed. The proposed regulation will: In 2. If a state lacks the resources or authority to do thorough actuarial reviews, HHS would conduct them. Importantly, we know rate review works. For example, Connecticut regulators recently rejected a proposed 2. Unfortunately, some states lack the authority or resources to review proposed health insurance rates. The Affordable Care Act has already begun to help states strengthen or create rate review processes. This is part of $2. This funding will help assure consumers in every state that any premium increases requested by their insurance company, regardless of the size, is justified. Relief for Consumers. The proposed regulation will help safeguard consumers from unreasonably high rate increases by providing consumers with detailed information on proposed increases. Comprehensive Package of Consumer Protections. This new proposed rate review regulation will also work in conjunction with the medical loss ratio regulation released on November 2. This proposed rate review regulation allows consumers to see what increases are being proposed and why. These two provisions of the Affordable Care Act work together to assure consumers that any increase in their premium is reasonable and that their premium dollars are being spent on their medical care. Read the news release on the proposed rule at www. Health. Care. gov/news/releases/index. Find links to the regulation and other information about rate review at www. Posted: December 2. And to make sure that the quality of care for seniors drives all of our decisions, a group of doctors and health care experts, not Members of Congress, will be tasked with coming up with their best ideas to improve quality and reduce costs for Medicare beneficiaries. The Secretary has the authority to take steps to strengthen the Medicare program and implement reforms to improve the quality and efficiency of health care. TITLE III- -IMPROVING THE QUALITY AND EFFICIENCY OF HEALTH CARESubtitle A- -Transforming the Health Care Delivery System. PART I- -Linking Payment to Quality Outcomes Under the Medicare Program. Sec. Hospital Value- Based purchasing program. Sec. Improvements to the physician quality reporting system. Sec. Improvements to the physician feedback program. Sec. Quality reporting for long- term care hospitals, inpatient rehabilitation hospitals, and hospice programs. Sec. Quality reporting for PPS- exempt cancer hospitals. Sec. Plans for a Value- Based purchasing program for skilled nursing facilities and home health agencies. Sec. Value- based payment modifier under the physician fee schedule. Sec. Payment adjustment for conditions acquired in hospitals. PART II- -National Strategy to Improve Health Care Quality. Sec. National strategy. Sec. Interagency Working Group on Health Care Quality. Sec. Quality measure development. Sec. Quality measurement. Sec. Data collection; public reporting. PART III- -Encouraging Development of New Patient Care Models. Sec. Establishment of Center for Medicare and Medicaid Innovation within CMS. Sec. Medicare shared savings program. Sec. National pilot program on payment bundling. Sec. Independence at home demonstration program. Sec. Hospital readmissions reduction program. Sec. Community- Based Care Transitions Program. Sec. Extension of gainsharing demonstration. Subtitle B- -Improving Medicare for Patients and Providers. PART I- -Ensuring Beneficiary Access to Physician Care and Other Services. Sec. Increase in the physician payment update. Sec. Extension of the work geographic index floor and revisions to the practice expense geographic adjustment under the Medicare physician fee schedule. Sec. Extension of exceptions process for Medicare therapy caps. Sec. Extension of payment for technical component of certain physician pathology services. Sec. Extension of ambulance add- ons. Sec. Extension of certain payment rules for long- term care hospital services and of moratorium on the establishment of certain hospitals and facilities. Sec. Extension of physician fee schedule mental health add- on. Sec. Permitting physician assistants to order post- Hospital extended care services. Sec. Exemption of certain pharmacies from accreditation requirements. Sec. Part B special enrollment period for disabled TRICARE beneficiaries. Sec. Payment for bone density tests. Sec. Revision to the Medicare Improvement Fund. Sec. Treatment of certain complex diagnostic laboratory tests. Sec. Improved access for certified nurse- midwife services. PART II- -Rural Protections. Sec. Extension of outpatient hold harmless provision. Sec. Extension of Medicare reasonable costs payments for certain clinical diagnostic laboratory tests furnished to hospital patients in certain rural areas. Sec. Extension of the Rural Community Hospital Demonstration Program. Sec. Extension of the Medicare- dependent hospital (MDH) program. Sec. Temporary improvements to the Medicare inpatient hospital payment adjustment for low- volume hospitals. Sec. Improvements to the demonstration project on community health integration models in certain rural counties. Sec. Med. PAC study on adequacy of Medicare payments for health care providers serving in rural areas. Sec. Technical correction related to critical access hospital services. Sec. Extension of and revisions to Medicare rural hospital flexibility program. PART III- -Improving Payment Accuracy. Sec. Payment adjustments for home health care. Sec. Improvement to medicare disproportionate share hospital (DSH) payments. Sec. Misvalued codes under the physician fee schedule. Sec. Modification of equipment utilization factor for advanced imaging services. Sec. Revision of payment for power- driven wheelchairs. Sec. Hospital wage index improvement. Sec. Treatment of certain cancer hospitals. Sec. Payment for biosimilar biological products. Sec. Medicare hospice concurrent care demonstration program. Sec. Application of budget neutrality on a national basis in the calculation of the Medicare hospital wage index floor. Sec. HHS study on urban Medicare- dependent hospitals. Sec. Protecting home health benefits. Subtitle C- -Provisions Relating to Part CSec. Medicare Advantage payment. Sec. Benefit protection and simplification. Sec. Application of coding intensity adjustment during MA payment transition. Sec. Simplification of annual beneficiary election periods. Sec. Extension for specialized MA plans for special needs individuals. Sec. Extension of reasonable cost contracts. Sec. Technical correction to MA private fee- for- service plans. Sec. Making senior housing facility demonstration permanent. Sec. Authority to deny plan bids. Sec. Development of new standards for certain Medigap plans. Subtitle D- -Medicare Part D Improvements for Prescription Drug Plans and MA- PD Plans. Sec. Medicare coverage gap discount program. Sec. Improvement in determination of Medicare part D low- income benchmark premium. Sec. Voluntary de minimis policy for subsidy eligible individuals under prescription drug plans and MA- PD plans. Sec. Special rule for widows and widowers regarding eligibility for low- income assistance. Sec. Improved information for subsidy eligible individuals reassigned to prescription drug plans and MA- PD plans. Sec. Funding outreach and assistance for low- income programs. Sec. Improving formulary requirements for prescription drug plans and MA- PD plans with respect to certain categories or classes of drugs. Sec. Reducing part D premium subsidy for high- income beneficiaries. Sec. Elimination of cost sharing for certain dual eligible individuals. Sec. Reducing wasteful dispensing of outpatient prescription drugs in long- term care facilities under prescription drug plans and MA- PD plans. Sec. Improved Medicare prescription drug plan and MA- PD plan complaint system. Sec. Uniform exceptions and appeals process for prescription drug plans and MA- PD plans. Sec. Office of the Inspector General studies and reports. Sec. Including costs incurred by AIDS drug assistance programs and Indian Health Service in providing prescription drugs toward the annual out- of- pocket threshold under part D. Sec. Immediate reduction in coverage gap in 2. Subtitle E- -Ensuring Medicare Sustainability. Sec. Revision of certain market basket updates and incorporation of productivity improvements into market basket updates that do not already incorporate such improvements. Sec. Temporary adjustment to the calculation of part B premiums. Sec. Independent Medicare Advisory Board. Subtitle F- -Health Care Quality Improvements. Sec. Health care delivery system research; Quality improvement technical assistance. Sec. Establishing community health teams to support the patient- centered medical home. Sec. Medication management services in treatment of chronic disease. Sec. Design and implementation of regionalized systems for emergency care. Sec. Trauma care centers and service availability. Sec. Program to facilitate shared decisionmaking. Sec. Presentation of prescription drug benefit and risk information. Sec. Demonstration program to integrate quality improvement and patient safety training into clinical education of health professionals. Sec. Improving women's health. Sec. Patient navigator program. Sec. Authorization of appropriations. Subtitle G- -Protecting and Improving Guaranteed Medicare Benefits. Sec. Protecting and improving guaranteed Medicare benefits. Sec. No cuts in guaranteed benefits. TITLE X- -STRENGTHENING QUALITY, AFFORDABLE HEALTH CARE FOR ALL AMERICANSSubtitle C- -Provisions Relating to Title IIISec. Plans for a Value- Based purchasing program for ambulatory surgical centers. Sec. Revision to national strategy for quality improvement in health care. Sec. Development of outcome measures. Sec. Selection of efficiency measures. Sec. Data collection; public reporting. Sec. Improvements under the Center for Medicare and Medicaid Innovation. Sec. Improvements to the Medicare shared savings program. Sec. Revisions to national pilot program on payment bundling. Sec. Revisions to hospital readmissions reduction program. Sec. Repeal of physician payment update. Sec. Revisions to extension of ambulance add- ons. Sec. Certain payment rules for long- term care hospital services and moratorium on the establishment of certain hospitals and facilities. Sec. Revisions to the extension for the rural community hospital demonstration program. Sec. Adjustment to low- volume hospital provision. Sec. Revisions to home health care provisions. Sec. Revisions to extension of section 5. Sec. Revisions to transitional extra benefits under Medicare Advantage. Sec. Revisions to market basket adjustments. Sec. Expansion of the scope of, and additional improvements to, the Independent Medicare Advisory Board. Sec. Revision to community health teams. Sec. Quality reporting for psychiatric hospitals. Sec. Medicare coverage for individuals exposed to environmental health hazards. Sec. Protections for frontier States. Sec. Revision to skilled nursing facility prospective payment system. Sec. Pilot testing pay- for- performance programs for certain Medicare providers. Sec. Improvements to the physician quality reporting system. Sec. Improvement in part D medication therapy management (MTM) programs. Sec. Developing methodology to assess health plan value. Sec. Modernizing computer and data systems of the Centers for Medicare & Medicaid services to support improvements in care delivery. Sec. Public reporting of performance information. Sec. Availability of medicare data for performance measurement.
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