Tuesday, February 5, 2013

Administration Misses Health Law Deadlines

Several provisions of the Affordable Care Act that were supposed to go into effect on January 1st have been delayed by the Obama Administration, according to an article by Kaiser Health News. The delayed parts of the law include provisions that increase fees paid to Medicaid primary care doctors, increase funding to states that eliminate co-pays for Medicaid preemptive services, and change how Hospitals and doctors are paid through Medicaid.

This is not the first time that provisions of the Affordable Care Act have been delayed. Doctors who treat Medicaid patients were due for a rate increase of about 73 percent starting this year, but that has yet to go into effect. State officials are claiming that they have not had time to carry out the pay change yet, since the Administration didn’t publish the rules governing the pay increases until November. The Centers for Medicare and Medicaid Services (CMS) has said, however, that when states do implement the provision, doctors will be able to get the higher fees retroactively to Jan. 1st of this year.

CMS has also shown signs of movement on the preemptive services provision. Under the program, states would receive a 1 percent higher Medicaid matching rate if they eliminate co-pays for immunizations and other preventive services. On Friday, CMS published guidance on how to qualify for the payments.

The other provisions in the bill that were slated to go into effect on January 1st could continue to be held up for the time being. This includes a provision for setting up a health program that would offer lower cost-sharing for people who make too much to qualify for Medicaid.

A former health policy aide to President Barack Obama said some delays are inevitable given staff turnover after the November election, and the focus on emergencies such as Hurricane Sandy. Some other health policy experts think that the provisions have gotten put on the back burner as the Administration focuses on setting up the Health Insurance Marketplaces (formerly Health Insurance Exchanges). These have to be open for enrollment in October, with coverage to start in January 2014.

A Department of Health and Human Services (HHS) spokesman said that rules for the cost-sharing program should be out soon. Meanwhile, the Administration announced on Thursday the start of a pilot program to change how doctors and hospitals are paid. The program will test how bundling payments for episodes of care can result in more coordinated care for beneficiaries and lower costs for Medicare.

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