The Patient Protection and Affordable Care Act (PPACA) was signed into law on March 23. The bill, which has a price tag of just under $940 billion over 10 years, will overhaul the nation’s health care system and guarantee access to 32 million Americans who currently lack health care insurance.
Some of the key provisions of the legislation:
- Requires most people to have health insurance coverage by 2014
- Gives a tax credit for small businesses to help make employee insurance coverage more affordable
- Expands Medicaid to 133 percent of the federal poverty level
- Imposes new regulations on all health plans that prevent insurers from denying coverage for any reason (including preexisting conditions) or rescinding coverage for people who get sick
- Provides a $250 rebate to Medicare beneficiaries who are impacted by the Part D coverage gap
- Gives small businesses, the self-employed and uninsured access to coverage through new state-based exchange programs
- Allows young people up to age 26 to remain on their parents’ insurance policy
We asked a sample of Nuesoft clients about whether the new healthcare legislation will impact their practice/business.
Michael Seyfried, M.D.
Family Practice Associates – Atlanta
“In short, anything Government does in relation to payment of healthcare services will impact our practices. The larger issue is in what way and to what magnitude. As members of the most highly regulated and price controlled industry in America we have seen an incredible systematic usurpation of our capacity to determine freely what services we provide, to whom, at what fee for years. This has been led primarily by the federal government by its Medicare reimbursement rules. When payment formulas, coding and documentation rules and fixed fee schedules (DRGs) etc. are imposed by Medicare, and physicians continue to provide the same care despite the cut in reimbursement, the private payers are right behind with similar cuts or restrictions because we (physicians) have proven, we may complain, but we won’t quit.
He who pays makes the rules!!!”
Marcy Beahm, CMA
Ernest Beasley, M.D. – Atlanta
“Yes. It will decrease revenue by lowering reimbursement and increasing taxes. It will decrease the income of physicians and staff because of decreased revenue and the need for cost cutting. It will work to the detriment of the patient by limiting Medicare services. It will cause physicians, in some instances, to totally withdraw from Medicare/Medicaid programs.”
NP Operations Director
NueMD EHR user
“No. TransformHealthRx feels it is well situated to deal with a broad array of potential outcomes. We have developed our offering around the delivery of primary care services, so even with the addition of potentially hundreds of new patients with new access to medical care, we feel confident that we can accommodate them.”
Brenda Dalton, MBA, MSN, RN-C, WHNP
Director, Department of Student Health Services
Spelman College – Atlanta
Nuesoft Xpress user
“At this stage, I don’t know how the new health care reform will impact college health. I perceive only positive benefits and not much change in the way we currently do business. I have always thought college health is the most cost effective health care around and the ways we provide these services are typically quite thrifty. What I hope will happen is that we won’t have student health insurance companies denying claims because they term a “urinary tract infection” a “pre-existing condition” to keep from paying the claim when there is no evidence that this is nothing more than an episodic condition.”
Barbara Dunn, President/Owner
MedRecovery Solutions, Inc. – Houston
“I see this as a positive impact for the physicians we bill for.
Too many uninsured patients are seen in the ER / hospital with no payment source – even Medicaid rates are better than no payment at all!”
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