Federal health care reform


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BCHN summary of Federal Health Care Reform

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Federal health care reform

  1. 1. Federal Health Care Reform September 28, 2010
  2. 2. What is Health Care Reform? <ul><li>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. </li></ul>
  3. 3. Patient’s Bill of Rights <ul><li>Effective September 23, 2010 </li></ul><ul><li>Bans discrimination against kids with pre-existing conditions. </li></ul><ul><li>Allows young adults to remain on their parents’ plan until their 26th birthday. </li></ul><ul><li>Prohibits insurance companies from cutting off your coverage when you’re sick if you made a honest mistake on your application. </li></ul><ul><li>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. </li></ul>
  4. 4. Patient’s Bill of Rights <ul><li>And if you join a new plan: </li></ul><ul><ul><li>You have the right to choose your own doctor in your insurer network. </li></ul></ul><ul><ul><li>Your insurer is banned from charging more for emergency services obtained outside of their network. </li></ul></ul><ul><ul><li>You will be guaranteed the right to appeal insurance company decisions to an independent third party. </li></ul></ul>
  5. 5. Patient’s Bill of Rights <ul><ul><li>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.  </li></ul></ul>
  6. 6. NEW YORK STATE <ul><li>The following policies are already effective in NYS: </li></ul><ul><li>In New York, insurers cannot refuse to sell anyone health insurance just because they have a pre-existing condition. </li></ul><ul><li>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. </li></ul>
  7. 7. NEW YORK STATE continued <ul><li>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. </li></ul><ul><li>New York currently requires coverage of well-child visits and immunizations for children through age 19 without cost-sharing. </li></ul><ul><li>New York law currently requires direct access for OB/GYN services. </li></ul>
  8. 8. NEW YORK STATE continued <ul><li>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. </li></ul><ul><li>This past August, Governor Paterson signed ‘Ian’s Law which will grant additional protections to New Yorkers who suffer from costly medical conditions. </li></ul>