21 Responses

  1. No … Not the Income Tax Marriage Penalty

    Do you know of the built-in “marriage penalty” in both House and Senate versions of the ACA? For some low and middle-income couples, it could mean an increase of about $2,000 or more in annual insurance premiums the moment they get married.

    The disparity could come about in part because subsidies for purchasing health insurance are pegged to federal poverty guidelines. That would have the effect of limiting subsidies for married couples with a combined income, compared with unmarried individuals.

    So, is this another “new-wave” marriage penalty that harms the American family?

    Phillip

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  2. Reinhardt Opines on the ACA

    Healthcare economist Uwe Reinhardt PhD believes repealing healthcare reform might be a healthy process, he said in an interview with the Fiscal Times.

    http://www.kaiserhealthnews.org/Stories/2010/November/29/Fiscal-Times-Reinhardt.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewFromKaiserHealthNews+%28New+From+Kaiser+Health+News%29

    Reinhardt, the James Madison professor of political economy at Princeton University, contends that a repeal of the Patient Protection and Affordable Care Act would actually put pressure on congressional Republicans to come up with an alternative.

    http://online.wsj.com/article/SB10001424052748704675104575001101419588486.html

    What do you think?

    Ann Miller RN MHA
    [Executive-Director]

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  3. Judge rejects part of health care law

    A federal judge in Virginia just invalidated a key element of the landmark health care law that requires individuals to buy health insurance.

    http://www.msnbc.msn.com/id/40642879/ns/politics-more_politics

    Shane

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  4. Bill,

    It is true – VA Judge Says Healthcare Law Unconstitutional

    A federal judge declared the Obama administration’s healthcare law unconstitutional Monday, siding with Virginia’s attorney general in a dispute that both sides agree will ultimately be decided by the U.S. Supreme Court. U.S. District Judge Henry E. Hudson is the first federal judge to strike down the law, which has been upheld by two others in Virginia and Michigan. Several other lawsuits have been dismissed and others are pending, including one filed by 20 other states in Florida.

    Administration officials told reporters last week that a negative ruling would have virtually no impact on the law’s implementation, noting that its two major provisions—the coverage mandate and the creation of new insurance markets—don’t take effect until 2014. The central issue in Virginia’s lawsuit was whether the federal government has the power under the constitution to impose the insurance requirement. The Justice Department said the mandate is a proper exercise of the government’s authority under the Commerce Clause.

    Source: Associated Press [12/13/10]

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  5. TIMELY CLAIMS SUBMISSION REQUIREMENTS FOR MEDICARE F/S CLAIMS

    As a reminder to all Medicare fee-for-service physicians, providers and suppliers submitting claims to Medicare for payment, the Patient Protection and Affordable Care Act (the “Affordable Care Act”) shortened the time period for submitting Medicare claims. Specifically, all claims for services furnished on or after January 1, 2010 must be filed with the applicable Medicare contractor no later than one calendar year (12 months) from the date of service or Medicare will deny those claims, unless there is an applicable regulatory exception. Prior to the enactment of the Affordable Care Act, providers and suppliers had between 15 and 27 months to file Medicare fee-for-service claims.

    Please note that if you have Medicare fee-for-service claims with service dates from October 1, 2009 through December 31, 2009, those claims MUST be filed by December 31, 2010, or Medicare will deny those claims as being untimely.
    Claims with dates of service prior to October 1, 2009 will be subject to the original timely filing rules and associated edits.

    All fee-for-service claims for services furnished on or after January 1, 2010 must be filed with Medicare contractors no later than one calendar year (i.e., 365 days) from the date of service or Medicare will deny those claims.

    It should be noted that for claims for services that require the reporting of a line item date of service, the line item date is used to determine the date of service. For other claims, the claim statement’s “From” date is used to determine the date of service.

    Garfunkel Wild PC

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  6. Of you go – To the Supreme Court

    Article 1, Section 8, Clause 3 of the Constitution, better known as the Commerce Clause, states that Congress has the power to “regulate Commerce … among the several States.”

    Is Obamacare on the fast track to the Supreme Court of the land, where a ruling on the Commerce Clause could have far reaching implications for health reform?

    Burton

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  7. The ACA Provisions

    The ACA has several provisions that report to mandate more generous health insurance benefits like:

    • Health plans generally must allow adult children up to age 26 to stay on their parents’ policies
    • Health Plans cannot charge co-payments for preventive services
    • Health plans cannot impose a lifetime limit on benefits.
    • Health plans must limit the percentage of revenues they can spend on administrative expenses
    • Health plans are prohibited from turning away individuals with pre-existing conditions.

    But, do these provisions actually increase costs for the rest of us?

    Dr. David Edward Marcinko MBA CMP™
    http://www.CertifiedMedicalPlanner.com
    [Publisher-in-Chief]

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  8. Physicians Generally Pleased With Obama’s Speech

    The nation’s physicians and hospitals were generally pleased with President Barack Obama’s State of the Union Address, in which he said he’s open to fixing certain provisions in last year’s Patient Protection and Affordable Care Act, including the much-debated 1099 filing requirement for American businesses.

    “President Obama outlined a vision for our nation’s future that includes key AMA priorities, such as lowering healthcare costs through medical liability reform, improvements to the new health reform law and investments in biomedical research,” Dr. Cecil Wilson, president of the American Medical Association, said in a statement. Wilson also said he is pleased that the president acknowledged that certain improvements should be made to the reform law, such as eliminating the 1099 provision that requires businesses to file a form with the Internal Revenue Service for every vendor with which they have had at least $600 in transactions.

    Source: Jessica Zigmond, Modern Physician [1/26/11]

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  9. Obama Likely to Oppose Some Parts of Med-Mal Bill

    The Obama administration is likely to oppose the Republican medical-malpractice legislation introduced Jan 25th, according to HHS Secretary Kathleen Sebelius. Following her first congressional testimony on the reform law enacted in March 2010, Sebelius told reporters Thursday that the administration has not yet taken an official position on the malpractice reform bill sponsored by Rep. Phil Gingrey (R-GA), who is a physician, and supported by the American Medical Association, but some of its central provisions are opposed by President Barack Obama.

    “It has some of the provisions that the president said he would clearly not support at the end of the day,” said Sebelius, regarding the bill’s creation of caps on awards for punitive damages and its “state-based framework.”

    Source: Rich Daly, Modern Healthcare [1/28/11]

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  10. Florida Judge Declares Reform Law Void

    U.S. District Court Judge Roger Vinson in Pensacola, FL on Monday declared the entire Patient Protection and Affordable Care Act void because its key provision—the individual mandate to buy health insurance—is unconstitutional. In a 78-page ruling, Vinson ruled that Congress, which aimed to give 32 million more Americans healthcare insurance by 2019 through the reform law, exceeded its constitutional authority by threatening Americans with fines if they don’t buy health insurance.

    Vinson declined the argument by states objecting to the law that Congress exceeded its authority by forcing states to expand their Medicaid programs. Vinson concluded, however, that the individual mandate is inextricable from the rest of the law and thus the entire law is void.

    Source: Joe Carlson and Gregg Blesch, modernhealthcare.com [1/31/11]

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  11. ACA Void?

    According to health economist Austin Frakt PhD:

    1. It will come down to the Supreme Court. Every other decision is just prelude.

    2. The lack of a severability clause is not a death knell for legislation that has parts ruled unconstitutional.

    3. There are many ways to fix PPACA without a mandate.

    Stuart

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  12. Call to Revisit the Healthcare Debate

    Unshackled by the need to get reelected, Sen. Kent Conrad (D-ND) just suggested that Democrats reopen the bitter healthcare debate, arguing that the reform law’s provisions could yield opportunities to cut the federal deficit.

    http://thehill.com/homenews/senate/144995-conrad-worries-democrats-calls-to-revisit-healthcare

    Debra

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  13. Healthcare Reform: [The Impact on Physicians]

    Hello Debra – The Patient Protection and Affordable Care Act (ACA) and the Health Care & Education Reconciliation Act (Reconciliation Act), collectively referred to as “healthcare reform,” will implement numerous changes impacting physician providers.

    Read more: http://www.healthcapital.com/hcc/newsletter/2_11/effects.pdf

    Several of these provisions affect primary care physicians and specialists separately, while other provisions will impact all physician providers with an increased focus on the coordination of patient care.

    Ann Miller RN MHA
    [Managing Editor]

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  14. Feds Seek Quick Review of FL Judge’s Ruling

    The U.S. Justice Department has asked for expedited review of a judge’s decision that the entire Patient Protection and Affordable Care Act is void because the provision requiring individuals to buy health insurance is unconstitutional. U.S. District Judge Roger Vinson in Pensacola, FL. responded last week to a request for clarification of his sweeping Jan. 31 opinion with a combative order reiterating that it should be taken as the “functional equivalent of an injunction,” blocking further implementation of the law.

    Vinson added, however, that he would stay the ruling pending the outcome of the appeals process as long as the Obama administration pursued expedited review from the U.S. Supreme Court or the circuit court, which the Justice Department’s latest filing aims to satisfy.

    Source: Gregg Blesch, Modern Healthcare [3/9/11]

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  15. Federal Court Agrees to Fast-Track ACA Appeal

    A federal appeals court has agreed to act swiftly in considering a Florida judge’s ruling that President Barack Obama’s healthcare overhaul is unconstitutional. The 11th U.S. Circuit Court of Appeals in Atlanta said that it had agreed to expedite the appeal concerning the Patient Protection and Affordable Care Act, setting a faster timetable than even the federal government had requested

    The decision means the federal government must file its first set of court papers on the issues in the case by April 4, and the state of Florida has until May 4 to file its papers. The federal government would file additional papers by May 18. The appeals court said it had not made a decision on a request that the initial review be held before all 10 federal judges.

    Source: Associated Press [3/12/11]

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  16. ACA waivers climb above 1,000

    The number of temporary healthcare reform waivers granted by the Obama administration to organizations climbed to more than 1,000, according to new numbers disclosed by the Department of Health and Human Services.

    http://thehill.com/blogs/healthwatch/health-reform-implementation/147715-number-of-healthcare-reform-law-waivers-climbs-above-1000

    http://online.wsj.com/article/SB10001424052748703453804576191160443892904.html?mod=googlenews_wsj

    This includes the entire state of Maine and almost 3 million workers; half of whom are in the teachers union and who supported the ACA originally? So, go figure!

    Ken

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  17. Romney plan calls for Medicaid block grants, repeal of Obama health law

    Republican White House hopeful Mitt Romney said he would issue an executive order to slow implementation of the healthcare law on his first day in office if he were elected president.

    Romney also proposed major changes to Medicaid and said his plan for Medicare will be similar to Rep. Paul Ryan’s (R-Wis.) controversial proposal.

    http://thehill.com/blogs/healthwatch/politics-elections/179725-romney-plan-calls-for-medicaid-block-grants-repeal-of-obama-health-law

    Jan

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  18. NAHU Makes ‘Desperate’ Plea For ObamaCare ‘Rescue’

    Did you know that the 100,000 [plus] health insurance agents who belong to the National Association of Health Underwriters (NAHU) are begging their allies to help rescue them from ObmaCare, according to a report in LifeHealth Pro, an online newsletter?

    As a former health insurance agent – Doctor colleagues – please take note!

    Dr. David E. Marcinko MBA CMP™

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  19. 2015

    Well, not in 2014 at least? Maybe next year!

    Claude

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  20. House Passes AHCA; Now Fate of Obamacare is in the Senate

    The House Republicans passed the American Health Care Act (AHCA) with a slim majority on Thursday. The bill gives states the option of returning to a pre-Obamacare individual insurance approach of medical underwriting and high-risk pools.

    The bill passed by a vote of 217-213 in the U.S. House of Representatives yesterday afternoon, one vote over the 216-majority threshold. It is the GOP’s first successful attempt to move legislation to repeal President Barack Obama’s signature healthcare reform bill, the Affordable Care Act, during the Trump administration after two false starts.

    If it passes the Senate, the AHCA will make stark changes to the rules and regulations governing the healthcare industry for the last seven years. A number of Republican senators whose votes are needed for a replacement bill have said that the House version will not survive in their chamber.

    Source: Mara Lee, Modern Healthcare [5/4/17]

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