Health Reform Timeline for 2010

The following health reform legislation changes are scheduled to be implemented in 2010. A complete 2010–18 health reform timeline, along with specific requirements for physicians, for patients, for businesses, for hospitals, and for taxpayers, will be available here soon, or look for the June 2010 issue of San Diego Physician.

INSURANCE COVERAGE:

• Temporary high-risk pool with subsidized premiums created for uninsured individuals with preexisting conditions who have been denied healthcare coverage.
• Temporary reinsurance program created for employers providing health insurance coverage to retirees over age 55 who are not eligible for Medicare.
• Parents allowed to continue health insurance coverage for children up to age 26.
• Catastrophic-only health insurance coverage created for those up to 30 years of age.
• Tax credits to small employers — fewer than 25 employees, average annual wages less than $50,000 — that purchase health insurance for employees.
• Group and individual health insurance plans to cover certain preventive services without cost sharing.

INSURANCE REFORMS:

• Health insurance providers required to report the proportion of premium dollars spent on healthcare.
• Health insurance providers required to have adequate provider networks.
• Health insurance providers prohibited from denying children for preexisting conditions.
• Health insurance providers prohibited from rescinding coverage when a patient gets sick.
• Lifetime or annual limits on health insurance benefits prohibited.
• Health insurance providers required to implement operating rules for certain electronic transactions within specified time periods.

MEDICARE REIMBURSEMENTS TO PHYSICIANS:

• Payments for mental health psychotherapy services increased by 5 percent.
• Physician payments in some rural states — not California — increased.
• A national study on physician practice expenses mandated.
• Reimbursement rates for advanced imaging services reduced by changing utilization rate assumptions.

MEDICARE PRESCRIPTION DRUG:

• $250 rebate provided to Medicare beneficiaries who reach the Part D coverage gap in 2010.
• Medicare Part D coverage gap gradually eliminated by 2020.

MEDICARE REIMBURSEMENTS TO HOSPITALS:

• Annual market basket updates for inpatient hospital, home health, skilled nursing facility, hospice, and other Medicare providers reduced and adjusted for productivity.
• Additional requirements on nonprofit hospitals imposed, with penalties for non-compliance.
• Regulations issued to establish a process for public notice and comment for section 1115 Medicaid waivers.

BIOLOGICS:

• Biologics manufacturers granted 12 years of exclusive use before generics can be developed.
• FDA authorized to approve generic versions of biologic drugs.

WORKFORCE:

• Workforce Advisory Committee established to develop a national workforce strategy.
• Workforce supply increased and training of health professionals supported through scholarships and loans.
• Teaching Health Centers established to provide Medicare payments for primary care residency programs in Federally Qualified Health Centers.

COMPARATIVE EFFECTIVENESS RESEARCH (CER):

• Independent, nonprofit CER institute established to support clinical research on comparative effectiveness — board of governors with four physician representatives; use of research for coverage, payment, or policy recommendations prohibited.

REVENUE INCREASES:

• Ten percent tax on indoor tanning services imposed.