Health Care Reform Refresher

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Refresher on topics from 2010

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Health Care Reform Refresher

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

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