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Health Care Reform Refresher

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Refresher on topics from 2010

Refresher on topics from 2010


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  • 1. Michael M. Fuselier, CPA, CITP, RN, FACHE
    Health Systems Leader
    www.MichaelFuselier.com
    What Does Health Care Reform Mean for You?
    Updated as of November 2010
  • 2. Michael M. Fuselier, CPA, CITP, RN, FACHE
    Health Systems Leader
    www.MichaelFuselier.com
    Michael is a seasoned healthcare executive with over eighteen years’ experience in the industry. As a financial, clinical and information technology professional, he brings a wealth of diverse perspectives to the teams and organizations he is fortunate to lead. He has proven success managing hospitals, outpatient surgical clinics, group medical practices, pharmacies, retail health ventures and more. Michael can be reached at michael@michaelfuselier.com.
  • 3. Today’s Presentation
    • New legislation and challenges
    • 4. Importance of being prepared and informed
    • 5. Overview of key provisions, rules and requirements, and what they mean to you
    • 6. 2010 to 2014 effective dates
    • 7. Q&A
    3
    2010 American Institute of CPAs
  • 8. 2010 Healthcare Reform Legislation
    • Patient Protection and Affordable Care Act
    • 9. Health Care and Education Reconciliation Act of 2010
    • 10. Legislation’s impact − substantial and long term
    4
    2010 American Institute of CPAs
  • 11. Provisions
    • National high-risk pool
    • 12. Lifetime limits and serious illness
    • 13. Pre-existing condition exclusion
    • 14. Dependent care coverage
    • 15. Medicare taxes
    • 16. Itemized deduction threshold for unreimbursed medical expenses
    • 17. Mandatory insurance coverage
    • 18. Premium assistance credit
    • 19. Adoption credit
    • 20. Adoption assistance program exclusion
    • 21. Health FSAs, HSAs, HRAs and Archer MSAs
    • 22. Indoor tanning services
    5
    2010 American Institute of CPAs
  • 23. National High-Risk Pool
    • Temporary high-risk pool and subsidized coverage for adults with pre-existing conditions available through 2013 
    • 24. Pre-existing conditions no longer excluded beginning 2014
    • 25. Pool dissolves in 2014
    6
    2010 American Institute of CPAs
  • 26. Lifetime Limits and Serious Illness
    • No lifetime limits on coverage allowed
    • 27. No policy cancellations for serious illness allowed
    • 28. Effective: September 23, 2010
    7
    2010 American Institute of CPAs
  • 29. Pre-Existing Condition Exclusion
    Plans may not exclude children due to pre-existing conditions
    Effective: September 23, 2010
    8
    2010 American Institute of CPAs
  • 30. Dependent Care Coverage
    Employer-provided accident or health plans
    Reimbursements excluded from taxable income for dependents up to age 27 (effective March 30, 2010)
    Continued coverage for adult child until age 26 (effective September 23, 2010)
    9
    2010 American Institute of CPAs
  • 31. Medicare Taxes
    0.9% increase depending on wages and filing status
    2.35% Medicare tax rate
    3.8% tax on investment income or modified adjusted gross income (MAGI) over the above limits depending on filing status
    Effective: 2013
    10
    2010 American Institute of CPAs
  • 32. Itemized Deduction Threshold for Unreimbursed Medical Expenses
    • Increased itemized deduction threshold – 10% of adjusted gross income (AGI)
    • 33. Age-based exception – remains at 7.5% if individual/individual’s spouse has turned 65 before close of tax year (to expire after 2016)
    • 34. Effective: 2013
    11
    2010 American Institute of CPAs
  • 35. Mandatory Insurance Coverage
    • Individuals are required to have health insurance
    • 36. Penalties for non-compliance based on fixed amount or percentage of income over filing thresholds
    • 37. Nocriminal penalties, or IRS liens or seizures
    12
    2010 American Institute of CPAs
  • 38. Mandatory Insurance Coverage
    Exceptions
    • Insurance cost exceeds 8% of income
    • 39. Incarcerated individuals
    • 40. Members of Native American Indian tribes
    • 41. Individuals not legally present in US
    • 42. Individuals claiming religious conscience exemption
    • 43. Effective: 2014
    13
    2010 American Institute of CPAs
  • 44. Premium Assistance Credit
    • Refundable tax credit
    • 45. Treasury payment directly to insurer
    • 46. Income-based eligibility
    • 47. Inflation adjustment 
    • 48. Effective: Years ending after December 31, 2013
    14
  • 49. Adoption Credit
    Maximum $13,170 credit per eligible child
    Applies to both non-special-needs and special-needs adoptions
    Refundable credit
    Inflation adjustment for new dollar limit and credit phase-out
    Effective: 2010
    15
    Caution: Credit reverts to $6,000 and available for special-needs children only after December 31, 2011
    2010 American Institute of CPAs
  • 50. Adoption Assistance Program Exclusion
    Maximum $13,170 per eligible child exclusion for employer-provided adoption assistance programs
    Inflation adjustment for new dollar limit and income limitations of exclusion
    Effective: 2010
    16
    Caution: Income exclusion goes away after 2011.
    2010 American Institute of CPAs
  • 51. Health FSAs, HSAs, HRAs and Archer MSAs
    • Increased penalty for non-health withdrawals from HSAs (10% ti 20%) and Archer MSAs(15% to 20%) (effective 2011)
    • 52. No over-the-counter drug purchases from health FSAs, HSAs, HRAs or Archer MSAs(effective 2011)
    • 53. Health FSA contribution limit of $2,500 (effective 2013)
    17
    2010 American Institute of CPAs
  • 54. Indoor Tanning Services
    • 10% excise tax
    • 55. Tax collection at time of payment
    • 56. Effective: July 1, 2010
    18
    2010 American Institute of CPAs
  • 57. The Road Ahead
    • A process not an event
    • 58. New proposals, adjustments and other changes
    • 59. Professional guidance
    • 60. www.360financialliteracy.org
    19
    2010 American Institute of CPAs