- -Patient Protection and Affordable Care Act (Wikipedia.org)
"The Patient Protection and Affordable Care Act (PPACA), is a United States federal statute signed into law by President Barack Obama on March 23, 2010. The law (along with the Health Care and Education Reconciliation Act of 2010) is the principal health care reform legislation of the 111th United States Congress. PPACA reforms certain aspects of the private health insurance industry and public health insurance programs, increases insurance coverage of pre-existing conditions, expands access to insurance to over 30 million Americans, and increases projected national medical spending while lowering projected Medicare spending."
"Insurers are prohibited from imposing lifetime dollar limits on essential benefits, like hospital stays, in new policies issued.
Dependents (children) will be permitted to remain on their parents' insurance plan until their 26th birthday, and regulations implemented under the Act include dependents that no longer live with their parents, are not a dependent on a parent’s tax return, are no longer a student, or are married.
Insurers are prohibited from excluding pre-existing medical conditions (except in grandfathered individual health insurance plans) for children under the age of 19.
Insurers are prohibited from charging co-payments, co-insurance, or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans.
Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011. The gap will be eliminated by 2020.
Insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014.
Insurers are prohibited from dropping policyholders when they get sick.
Insurers are required to reveal details about administrative and executive expenditures.
Insurers are required to implement an appeals process for coverage determination and claims on all new plans.
Enhanced methods of fraud detection are implemented.
Medicare is expanded to small, rural hospitals and facilities.[36
]Medicare patients with chronic illnesses must be monitored/evaluated on a 3 month basis for coverage of the medications for treatment of such illnesses.
Non-profit Blue Cross insurers are required to maintain a loss ratio (money spent on procedures over money incoming) of 85% or higher to take advantage of IRS tax benefits.
Companies which provide early retiree benefits for individuals aged 55–64 are eligible to participate in a temporary program which reduces premium costs.
A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.
A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention. 01-12