Federal health care reform
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Federal health care reform



BCHN summary of Federal Health Care Reform

BCHN summary of Federal Health Care Reform



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Federal health care reform Federal health care reform Presentation Transcript

  • Federal Health Care Reform September 28, 2010
  • What is Health Care Reform?
    • Healthcare reform is a general term used for discussing major health policy creation or changes--for the most part, governmental policy that affects healthcare delivery.
  • Patient’s Bill of Rights
    • Effective September 23, 2010
    • Bans discrimination against kids with pre-existing conditions.
    • Allows young adults to remain on their parents’ plan until their 26th birthday.
    • Prohibits insurance companies from cutting off your coverage when you’re sick if you made a honest mistake on your application.
    • Prohibits insurance companies from putting a lifetime limit on the amount of coverage you may receive, and restricts the use of annual limits until they are banned completely in 2014.
    View slide
  • Patient’s Bill of Rights
    • And if you join a new plan:
      • You have the right to choose your own doctor in your insurer network.
      • Your insurer is banned from charging more for emergency services obtained outside of their network.
      • You will be guaranteed the right to appeal insurance company decisions to an independent third party.
    View slide
  • Patient’s Bill of Rights
      • You will receive recommended preventive care with no out-of-pocket cost. Services like mammograms, colonoscopies, immunizations, pre-natal and new baby care will be covered, and insurance companies will be prohibited from charging deductibles, co-payments or co-insurance. 
    • The following policies are already effective in NYS:
    • In New York, insurers cannot refuse to sell anyone health insurance just because they have a pre-existing condition.
    • New York State has ensured that parents could buy insurance through their employer’s group policy for children up to age 29, which is generally less expensive than buying individual insurance.
  • NEW YORK STATE continued
    • In New York Insurers may not require you to receive prior authorization for emergency services. In addition, your co-payment or co-insurance amount cannot be higher if you utilize an out-of-network hospital or provider in an emergency.
    • New York currently requires coverage of well-child visits and immunizations for children through age 19 without cost-sharing.
    • New York law currently requires direct access for OB/GYN services.
  • NEW YORK STATE continued
    • New York already requires that if an insurer refuses to cover some medical treatment, it must provide a means for the consumer to appeal that decision both within the company and to an independent outside entity.
    • This past August, Governor Paterson signed ‘Ian’s Law which will grant additional protections to New Yorkers who suffer from costly medical conditions.