Health Care Reform Timeline

 

Pulling resources from The Common Wealth Fund, Kaiser Family Foundation, National Federation of Independent Business, and the National Association of Health Underwriters, we have assembled this timeline as an assistant to the average citizen in understanding the legislation and effects that make up the Patient Protection and Affordable Care Act. While many pieces of the legislation go into effect on the first of each year, others have not been assigned specific dates, and as such are scattered through the year of their enactment. 

[similetimeline cats="44" id="my-timeline"]

The Common Wealth Fund listed several provisions without dates; they are as follows:

  • Review Medicare Fee Schedule. Direct the HHS secretary to regularly review Medicare fee schedule rates for physician services, including services that have experienced high growth rates. Strengthen the secretary’s authority to adjust fee schedule rates that are found to be misvalued or inaccurate.
  • Recover Overpayments. Extrapolate risk score errors in risk adjustment data validation audits to Medicare Advantage plans to recover overpayments.
  • Cures Acceleration Network. HHS will establish the Cures Acceleration Network to expedite development of drugs, devices, and biological products for diagnosis, mitigation, prevention, or treatment from any disease or condition that the NIH determines is a priority; and the commercial market will provide sufficient financial incentive for timely development of these products.
  • Coordinate with IRS to Reduce Fraud. Establish a CMS-IRS data match to identify fraudulent providers who have seriously delinquent tax debt. Include strict controls to protect taxpayer privacy.
  • One PI Database. Eliminate fraud, waste, and abuse in public programs through the development of an integrated database to capture and share data across federal and state programs.
  • Reduce Paperwork. Streamline procedures to conduct Medicare prepayment reviews to facilitate additional reviews designed to reduce fraud and abuse.
  • Disclosure of Financial Relationships. Require disclosure of financial relationships between health entities, including physicians, hospitals, pharmacists, and other providers, and manufacturers and distributors of covered drugs, devices, biologicals, and medical supplies.
  • Office of Women’s Health. Permanently establish an Office of Women’s Health in HHS, CDC, the Agency for Healthcare Research and Quality, FDA, and the Health Resources and Services Administration (HRSA); provide grants to accomplish the goals of the Offices of Women’s Health.
  • Office of Minority Health. Permanently establish an Office of Minority Health in CDC, AHRQ, FDA, CMS, HRSA, and the Substance Abuse and Mental Health Services Administration (SAMHSA); provide grants to accomplish the goals of the Offices of Minority Health.
  • Congenital Heart Disease. Enhance and expand infrastructure to track epidemiology of congenital heart disease.
  • Depressive Disorders. Provide grants to establish Centers of Excellence for Depressive Disorders that will develop treatments for these diseases. Although no effective date given, grants are funded 2011–2020; at least 20 centers must be created within one year of enactment.
  • State Grants to Test Tort Alternatives. Authorize grants to states to test alternatives to civil tort litigation. Models are required to emphasize patient safety, disclosure of health care errors, and early resolution of disputes. Patients can opt out. HHS must conduct an evaluation to determine the effectiveness of alternatives. $50 million in funds appropriated beginning in 2011; first report to Congress required by December 31, 2016.
  • Sense of the Senate Regarding Tort Alternatives. Encourage states to develop and test alternatives to the current civil litigation system as a way to improve patient safety, reduce medical errors, increase the availability of a prompt and fair resolution of disputes, and improve access to liability insurance, while preserving an individual’s right to seek redress in court. Recommend that Congress consider establishing a state demonstration project to evaluate alternatives to the current litigation system.
  • State Grants to Pursue Workforce Development Strategies. Establish a grant program to states to plan and implement activities leading to health care workforce development strategies.
  • State Grants to Provide Mid-Career Public Health Professional Training. HHS shall authorize grants to states to provide scholarships for mid-career training for public and allied health professionals at the Federal, State, Tribal or local level. $60 million in funds are authorized in 2010; “such sums as may be necessary” are available between 2011 and 2015.
  • Requires that all group health plans (including self-insured plans) and group and individual health insurers provide a summary of benefits and a coverage explanation to all applicants at the time of application, to all enrollees prior to the time of enrollment or reenrollment and to all policyholders or certificate holder at the time of issuance of the policy or delivery of the certificate. The summary must include specific information to be determined by the Secretary of DHHS in consultation with the National
  • Association of Insurance Commissioners and can be provided in paper or electronic form. It must be no more than 4 pages in length with print no smaller than 12 point font written in a culturally linguistically appropriate manner.
  • If a group health plan or health insurance issuer makes any material modification in any of the terms of the plan or coverage involved that is not reflected in the most recently provided summary of benefits and coverage, the plan or issuer shall provide notice of such modification to enrollees not later than 60 days prior to the date on which such modification will become effective.
  • Employers and health plans that willfully fail to provide the information required can be fined up to $1,000 for each such failure. Each failure to provide information to an enrollee constitutes a separate offense.”
  • Requires employers of 200 or more employees to auto-enroll all new employees into any available employer-sponsored health insurance plan. Waiting periods in existing law can apply. Employees may opt out if they have another source of coverage.”
  • Requires all group health plans to comply with the Internal Revenue Section 105(h) rules that prohibit discrimination in favor of highly compensated individuals.
  • New federal premium tax on fully-insured and self-insured group health plans to fund comparative effectiveness research program begins. As financing mechanism to fund Patient Centered Outcome
  • Research, imposes a fee on private insurance plans equal to $2 annually for each individual covered under a specified individual or group health insurance policy.
  • Non-profit hospitals must meet new requirements to satisfy tax exempt status.
  • Elimination of employer deductible subsidy under Medicare Part D. This provision will have an immediate impact on employers’ liability and income statements — FAS 109 requires employers to immediately take a charge against current earnings to reflect the higher anticipated tax costs and higher FAS 106 liability.
  • Under ASC 740, the expense or benefit related to adjusting deferred tax liabilities and assets as a result of a change in tax laws must be recognized in income from continuing operations for the period that includes the enactment date. Therefore, the expense resulting from this change will be recognized in the first quarter of 2010 even though the change in law may not be effective until later years.”