HHS Extends Transition Policy for Non-ACA Compliant Health PlansKelley M. Bendele
Due to President Donald Trump's executive order directing federal agencies to provide relief from the burdens of the ACA, HHS is now promoting the availability of these waivers.
HHS Extends Transition Policy for Non-ACA Compliant Health Plansntoscano50
On Feb. 29, 2016, the Department of Health and Human Services (HHS) extended an existing transition policy for certain health plans that do not comply with the Affordable Care Act (ACA) for an additional year, to policy years beginning on or before Oct. 1, 2017.
In states that allow it, this transition policy gives health insurance issuers the option of renewing current policies for current enrollees without adopting all of the ACA’s market reforms that took effect in 2014. Originally announced on Nov. 14, 2013, the transition policy was intended to apply in 2014 only. However, it was previously extended for two years, to policy years beginning on or before Oct. 1, 2016...
Health Reform Bulletin 137 | Delay of Certain ACA Taxes and Fees; Benefit and...CBIZ, Inc.
On January 22, 2018, President Trump signed H.R. 195. Along with providing short-term government funding, it also extends funding of the Children's Health Insurance Program (CHIP) for six years through 2023. This program provides low-cost health coverage to children in families who do not qualify for Medicaid, as well as for pregnant women residing in certain states.
Although many key reforms of the Affordable Care Act (ACA) are effective for 2014, additional reforms will become effective in 2015 for employers sponsoring group health plans. For 2015, the most significant ACA change is the shared responsibility penalty for applicable large employers. To prepare for 2015, employers should review upcoming requirements and develop a compliance strategy. This Legislative Brief provides a health care reform checklist for 2015.
The Affordable Care Act (ACA) includes certain market reforms that apply to group health plans and health insurance issuers in the group and individual markets.
On Nov. 18, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) published final regulations regarding a number of the ACA’s market reform requirements.
Health Reform: Interim Guidance on Expatriate Plans; Updates on ACA Reportin...CBIZ, Inc.
This Health Care Reform Bulletin provides information on the following topics:
a. Interim Guidance on Expatriate Health Coverage
b. Updates on Section 6055/6056 Reporting
i. Revised and Increased Reporting Penalties
ii. E-filing requirements for Employers
c. Final Rules: Preventive Services
d. Reminder on PCOR Fees and Transitional Reinsurance
i. Checklist for PCOR and Transitional Reinsurance Fee
Compliance Overview - Employee Benefits Compliance Checklist for Large Employersntoscano50
Federal law imposes numerous requirements on the group health coverage that employers provide to their employees. Many federal compliance laws apply to all group health plans, regardless of the size of the sponsoring employer. However, there are some additional requirements for large employers. For this purpose, a large employer is one with 50 or more employees.
Unlike smaller employers, large employers must comply with the Affordable Care Act’s (ACA) employer shared responsibility rules, the ACA’s Form W-2 reporting rules and the Family and Medical Leave Act’s (FMLA) requirements.
This Compliance Overview provides a checklist for employee benefit laws applicable to large employers.
HHS Extends Transition Policy for Non-ACA Compliant Health PlansKelley M. Bendele
Due to President Donald Trump's executive order directing federal agencies to provide relief from the burdens of the ACA, HHS is now promoting the availability of these waivers.
HHS Extends Transition Policy for Non-ACA Compliant Health Plansntoscano50
On Feb. 29, 2016, the Department of Health and Human Services (HHS) extended an existing transition policy for certain health plans that do not comply with the Affordable Care Act (ACA) for an additional year, to policy years beginning on or before Oct. 1, 2017.
In states that allow it, this transition policy gives health insurance issuers the option of renewing current policies for current enrollees without adopting all of the ACA’s market reforms that took effect in 2014. Originally announced on Nov. 14, 2013, the transition policy was intended to apply in 2014 only. However, it was previously extended for two years, to policy years beginning on or before Oct. 1, 2016...
Health Reform Bulletin 137 | Delay of Certain ACA Taxes and Fees; Benefit and...CBIZ, Inc.
On January 22, 2018, President Trump signed H.R. 195. Along with providing short-term government funding, it also extends funding of the Children's Health Insurance Program (CHIP) for six years through 2023. This program provides low-cost health coverage to children in families who do not qualify for Medicaid, as well as for pregnant women residing in certain states.
Although many key reforms of the Affordable Care Act (ACA) are effective for 2014, additional reforms will become effective in 2015 for employers sponsoring group health plans. For 2015, the most significant ACA change is the shared responsibility penalty for applicable large employers. To prepare for 2015, employers should review upcoming requirements and develop a compliance strategy. This Legislative Brief provides a health care reform checklist for 2015.
The Affordable Care Act (ACA) includes certain market reforms that apply to group health plans and health insurance issuers in the group and individual markets.
On Nov. 18, 2015, the Departments of Labor (DOL), Health and Human Services (HHS) and the Treasury (Departments) published final regulations regarding a number of the ACA’s market reform requirements.
Health Reform: Interim Guidance on Expatriate Plans; Updates on ACA Reportin...CBIZ, Inc.
This Health Care Reform Bulletin provides information on the following topics:
a. Interim Guidance on Expatriate Health Coverage
b. Updates on Section 6055/6056 Reporting
i. Revised and Increased Reporting Penalties
ii. E-filing requirements for Employers
c. Final Rules: Preventive Services
d. Reminder on PCOR Fees and Transitional Reinsurance
i. Checklist for PCOR and Transitional Reinsurance Fee
Compliance Overview - Employee Benefits Compliance Checklist for Large Employersntoscano50
Federal law imposes numerous requirements on the group health coverage that employers provide to their employees. Many federal compliance laws apply to all group health plans, regardless of the size of the sponsoring employer. However, there are some additional requirements for large employers. For this purpose, a large employer is one with 50 or more employees.
Unlike smaller employers, large employers must comply with the Affordable Care Act’s (ACA) employer shared responsibility rules, the ACA’s Form W-2 reporting rules and the Family and Medical Leave Act’s (FMLA) requirements.
This Compliance Overview provides a checklist for employee benefit laws applicable to large employers.
Health Care Reform -- 2016 Compliance Checklistntoscano50
The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted over four years ago. Many of these key reforms became effective in 2014 and 2015, including health plan design changes, increased wellness program incentives and the employer shared responsibility penalties.
Additional reforms take effect in 2016 for employers sponsoring group health plans. To prepare for 2016, employers should review upcoming requirements and develop a compliance strategy.
On Nov. 8, 2013, the DOL, HHS and the Treasury released Frequently Asked Questions (FAQs) regarding implementation of the Mental Health Parity and Addiction Equity Act. These FAQs were released in conjunction with final rules on the MHPAEA, which contain some clarification regarding the law's protections.
ACA Compliance Bulletin - Final Rule Expands Short-Term, Limited-Duration Ins...Kelley M. Bendele
Although short-term, limited-duration insurance is not an excepted benefit, it is specifically exempt from the definition of "individual health insurance coverage" and, therefore, is not subject to the ACA's market reform requirements.
Health Reform Bulletin 122 | 2017 Inflationary Adjustments and moreCBIZ, Inc.
1) 2017 Inflationary Adjustments; 2) Final Rules: Excepted Benefits, Lifetime and Annual Limits, and Short-Term, Limited-Duration Insurance; and 3) Whistleblower and Retaliation Protections
Health Reform Bulletin 131 | The ACA Remains The Law of The LandCBIZ, Inc.
As has been covered extensively in the press, Congress went on its summer recess without repealing, replacing or modifying the Affordable Care Act. What this means for employers is that it is “business as usual”, including all reporting obligations, as more fully described below. So where does health care reform stand at this point? The answer to this question is far from clear.
Health Reform Bulletin 125 | Updated Employer Shared Responsibility Guidance,...CBIZ, Inc.
The latest HRB has been released. Get updates on the following: 1) Updated Employer Shared Responsibility Guidance; 2) ACA Implementation Guidance; 3) Gender Identity Discrimination: Preliminary Injunction Issued; 4) Final Rules - Premium Tax Credit; and 5) 2018 Benefit and Payment Parameters.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
After our first ACA reporting season, it’s time to regroup and review what we’ve learned for 2016. The IRS is eliminating extensions and good faith efforts, raising penalties, and strictly limiting transitional relief.
With higher stakes, ERISA attorney Larry Grudzien reviews the changes to ACA reporting for 2016 and common ACA management issues.
Health Reform Bulletin 135 | Repeal of Individual Penalty Mandate, Review of ...CBIZ, Inc.
While there has been much energy over the past year focused on repealing, replacing, or repealing and replacing the Affordable Care Act (ACA), the bulk of the law remains in full force and effect.
This notwithstanding, Congress passed the “Tax Cuts and Jobs Act” (H.R. 1) on December 20, 2017; the President is expected to sign the bill into law. This tax reform bill repeals the individual penalty mandate. As background, beginning in 2014, all individuals residing in the United States are required to maintain a minimum level of health coverage, or be subject to a tax penalty. This tax penalty will be repealed, effective for tax years beginning January 1, 2019.
News Flash October 27 2014 Transitional Reinsurance Fee Counts Due By Nove...Annette Wright, GBA, GBDS
The transitional reinsurance fee is one of several different fees established by the Patient Protection and Affordable Care Act (PPACA). The enrollment count for 2014, used to calculate the reinsurance fee, is officially due by November 15, 2014, although the Department of Health and Human Services (HHS) has indicated that submissions made through November 17, 2014 will be considered timely, because November 15, 2014 falls on a Saturday. Employers with self-insured plans will need to ensure that they take the necessary steps to submit the required information and make the required payments by the applicable deadlines.
The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted in 2010. Many of these key reforms became effective in 2014 and 2015, including health plan design changes, increased wellness program incentives and the employer shared responsibility penalties.
Certain changes to some ACA requirements take effect in 2017 for employers sponsoring group health plans, such as increased dollar limits. To prepare for 2017, employers should review upcoming requirements and develop a compliance strategy.
Galen Benshoof, Robert Wood Johnson Foundation, presented on Realizing the Promise of the ACA: Implementation of State Health Reform at the State Legislative Conference on November 6, 2015.
The Road Ahead for Health Care ComplianceFrank Sheeder
The Health Care Reform Package has significant implications for health care compliance professionals. This presentation addresses many of the issues that they will be compelled to face right away, and in the next several years.
Health Reform Bulletin 133 | Executive Order Directing Modifications to the A...CBIZ, Inc.
An Executive Order, signed on October 12, 2017, promotes modifications of certain aspects of the Affordable Care Act (ACA) (also see press statement). In a nutshell, this Executive Order directs the ACA’s governing agencies (Health and Human Services/Labor/Treasury) to address three
elements: formation of association health plans, expansion of short-term, limited-duration insurance, and expanding the rules to allow individual premium to be reimbursed through health reimbursement arrangements (HRAs). Briefly, this Executive Order directs the governing agencies to
Created by WEA Trust Vice President & General Counsel Vaughn Vance, this presentation helps explain to employers the changing health insurance marketplace. You'll learn about new fees and taxes, plan restrictions and employer obligations under health care reform.
Health Care Reform -- 2016 Compliance Checklistntoscano50
The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted over four years ago. Many of these key reforms became effective in 2014 and 2015, including health plan design changes, increased wellness program incentives and the employer shared responsibility penalties.
Additional reforms take effect in 2016 for employers sponsoring group health plans. To prepare for 2016, employers should review upcoming requirements and develop a compliance strategy.
On Nov. 8, 2013, the DOL, HHS and the Treasury released Frequently Asked Questions (FAQs) regarding implementation of the Mental Health Parity and Addiction Equity Act. These FAQs were released in conjunction with final rules on the MHPAEA, which contain some clarification regarding the law's protections.
ACA Compliance Bulletin - Final Rule Expands Short-Term, Limited-Duration Ins...Kelley M. Bendele
Although short-term, limited-duration insurance is not an excepted benefit, it is specifically exempt from the definition of "individual health insurance coverage" and, therefore, is not subject to the ACA's market reform requirements.
Health Reform Bulletin 122 | 2017 Inflationary Adjustments and moreCBIZ, Inc.
1) 2017 Inflationary Adjustments; 2) Final Rules: Excepted Benefits, Lifetime and Annual Limits, and Short-Term, Limited-Duration Insurance; and 3) Whistleblower and Retaliation Protections
Health Reform Bulletin 131 | The ACA Remains The Law of The LandCBIZ, Inc.
As has been covered extensively in the press, Congress went on its summer recess without repealing, replacing or modifying the Affordable Care Act. What this means for employers is that it is “business as usual”, including all reporting obligations, as more fully described below. So where does health care reform stand at this point? The answer to this question is far from clear.
Health Reform Bulletin 125 | Updated Employer Shared Responsibility Guidance,...CBIZ, Inc.
The latest HRB has been released. Get updates on the following: 1) Updated Employer Shared Responsibility Guidance; 2) ACA Implementation Guidance; 3) Gender Identity Discrimination: Preliminary Injunction Issued; 4) Final Rules - Premium Tax Credit; and 5) 2018 Benefit and Payment Parameters.
ACA (mis)Management: What Everyone Has Learned & the Game Plan for 2017benefitexpress
After our first ACA reporting season, it’s time to regroup and review what we’ve learned for 2016. The IRS is eliminating extensions and good faith efforts, raising penalties, and strictly limiting transitional relief.
With higher stakes, ERISA attorney Larry Grudzien reviews the changes to ACA reporting for 2016 and common ACA management issues.
Health Reform Bulletin 135 | Repeal of Individual Penalty Mandate, Review of ...CBIZ, Inc.
While there has been much energy over the past year focused on repealing, replacing, or repealing and replacing the Affordable Care Act (ACA), the bulk of the law remains in full force and effect.
This notwithstanding, Congress passed the “Tax Cuts and Jobs Act” (H.R. 1) on December 20, 2017; the President is expected to sign the bill into law. This tax reform bill repeals the individual penalty mandate. As background, beginning in 2014, all individuals residing in the United States are required to maintain a minimum level of health coverage, or be subject to a tax penalty. This tax penalty will be repealed, effective for tax years beginning January 1, 2019.
News Flash October 27 2014 Transitional Reinsurance Fee Counts Due By Nove...Annette Wright, GBA, GBDS
The transitional reinsurance fee is one of several different fees established by the Patient Protection and Affordable Care Act (PPACA). The enrollment count for 2014, used to calculate the reinsurance fee, is officially due by November 15, 2014, although the Department of Health and Human Services (HHS) has indicated that submissions made through November 17, 2014 will be considered timely, because November 15, 2014 falls on a Saturday. Employers with self-insured plans will need to ensure that they take the necessary steps to submit the required information and make the required payments by the applicable deadlines.
The Affordable Care Act (ACA) has made a number of significant changes to group health plans since the law was enacted in 2010. Many of these key reforms became effective in 2014 and 2015, including health plan design changes, increased wellness program incentives and the employer shared responsibility penalties.
Certain changes to some ACA requirements take effect in 2017 for employers sponsoring group health plans, such as increased dollar limits. To prepare for 2017, employers should review upcoming requirements and develop a compliance strategy.
Galen Benshoof, Robert Wood Johnson Foundation, presented on Realizing the Promise of the ACA: Implementation of State Health Reform at the State Legislative Conference on November 6, 2015.
The Road Ahead for Health Care ComplianceFrank Sheeder
The Health Care Reform Package has significant implications for health care compliance professionals. This presentation addresses many of the issues that they will be compelled to face right away, and in the next several years.
Health Reform Bulletin 133 | Executive Order Directing Modifications to the A...CBIZ, Inc.
An Executive Order, signed on October 12, 2017, promotes modifications of certain aspects of the Affordable Care Act (ACA) (also see press statement). In a nutshell, this Executive Order directs the ACA’s governing agencies (Health and Human Services/Labor/Treasury) to address three
elements: formation of association health plans, expansion of short-term, limited-duration insurance, and expanding the rules to allow individual premium to be reimbursed through health reimbursement arrangements (HRAs). Briefly, this Executive Order directs the governing agencies to
Created by WEA Trust Vice President & General Counsel Vaughn Vance, this presentation helps explain to employers the changing health insurance marketplace. You'll learn about new fees and taxes, plan restrictions and employer obligations under health care reform.
Health Reform - Additional IRS Approaches to the Cadillac Tax; Transitional R...CBIZ, Inc.
Guidance on:
1. Additional IRS Approaches to Cadillac Tax. On July 30, 2015, the IRS released a second pronouncement (IRS Notice 2015-52), which like the first, does not carry the weight of the law or regulation, but rather is an effort to test the waters to see how the law should be formulated. The new guidance expands the discussion with regard to identifying taxpayers liable for the excise tax, employer aggregation, allocation of the tax, payment of the applicable tax and determining the cost of applicable coverage.
2. Transitional Reinsurance Fee Process for 2015 Benefit Year. In preparation for reporting and paying the transitional reinsurance fees for the 2015 benefit year, the Centers for Medicare and Medicaid services released an overview of the process and procedures
3. State Innovation Waivers. The Affordable Care Act includes a provision that takes effect in 2017 which would allow a state to apply for an innovation waiver; pursuant to which the state could be relieved from certain aspects of the ACA.
4. Applicability of ACA’s Employer Shared Responsibility Provisions. On July 31, 2015, President Obama signed the Surface Transportation and Veterans Health Care Choice Improvement Act of 2015 (H.R. 3236); now Public Law 114-41). This law provides that for purposes of determining whether an employer is an applicable large employer with regard to employee enrollment in minimum essential health coverage under an eligible employer sponsored plan, individuals covered for medical care under TRICARE or the Veterans Administration are not counted. In addition, a recent lawsuit challenged the applicability of the ACA’s employer shared responsibility mandate to a Native American tribe.
Healthcare check in the latest developments in health and welfare plansbenefitexpress
We work in an exciting industry—which means quick changes are the norm, and adaptability is a necessity.
Keep your compliance plan up-to-date with a download of recent legislative changes.
We'll cover legislation that's passed, what's on the way, and what it means for your organization.
Topics Covered Include:
• IRS Information Letters
• Tax Reform Legislation
• Wellness Regulations - EEOC, AARP
• Comprehensive Guidance on QSEHRAs
• ACA: Elimination of Individual Mandate Penalty
• Employer Tax Credit for Paid Family and Medical Leave
• DOL Annual Adjustments to Employee Benefit Plan Penalties
• “Good Faith” Penalty Relief
• Final Disability Claim Regulations
• Cadillac Tax Updates
• And More!
Presented by Larry Grudzien, Attorney at Law
Health Reform Bulletin 128 | House Passes the American Health Care ActCBIZ, Inc.
On May 4, 2017, the House passed the American Health Care Act of 2017 (“AHCA”, H. R. 1628). Since the initial bill was officially introduced on March 20, 2017 (see The GOP Proposal to Repeal and Replace the Affordable Care Act, HRB 127, 3/10/17), there have been several amendments made to the law’s text. The bill will now progress to the Senate for consideration; its fate in the Senate is unclear at this point. Every indication is that the bill with undergo significant scrutiny and probably substantial change. Following is a brief overview of certain provisions of the bill passed by the House.
Health Reform Bulletin 143 | Status of ACA Litigation; Murky Future of AHPs; ...CBIZ, Inc.
Litigation challenging and rescinding various aspects of the Affordable Care Act (ACA) continues to reign. Last December, Judge Reed O’Connor of the Fifth Circuit Court of Appeals opined that the individual mandate, in the absence of the tax repealed by the Tax Cuts and Jobs Act, is unconstitutional; and since it is a cornerstone of the ACA, then the entire ACA must fall (see our prior CBIZ Health Reform Bulletin 142).
Presentation by Michael Cohen, Daria Pelech, and Karen Stockley, analysts in CBO’s Health Analysis Division, to the Dartmouth Symposium on Health Care Delivery Science.
Health Reform Bulletin: Implementation Guidance & ACA UpdatesCBIZ MHM, LLC
1) Distribution of Marketplace Notice to Employees; 2) 90-day Waiting Period; 3) Individual Shared Responsibility- Final Regulations; 4) Employer Appeals in Marketplace Eligibility Determinations; 5) Small Business Tax Credit; 6) Preventive Care - Health Saving Accounts; and 7) Internal Claims, Appeals and External Review: Providing Culturally and Linguistically Appropriate Notices
The following Health Reform Checklist is intended to guide you through the general compliance requirements of
t he Affordable Care Act (ACA) as you prepare now for 2015 and beyond.
In general, these items apply to all employers.
Healthcare Check-in: The Latest Developments in Health and Welfare Plansbenefitexpress
We work in an exciting industry – which means quick changes are the norm, and adaptability is a necessity. Keep your compliance plans up to date with a download of all legislative changes since our last update webinar. This webinar covered legislation that's passed in the last six months, what's on the way, and what it means for your organization.
Compliance Bulletin - Washington Enacts Employee-paid Long-term Care ProgramKelley M. Bendele
Governor Jay Inslee signed a bill into law on May 13, 2019, that establishes a state-operated public insurance program to pay for long-term care services.
ACA Compliance Bulletin - Final Notice of Benefit and Payment Parameters for ...Kelley M. Bendele
In response to the White House announcing that it would no longer reimburse insurers for cost-sharing reductions made available to low-income individuals through the Exchanges, many issuers increased premiums in 2018 and 2019 only on silver level qualified health plans.
DOL audits can be triggered by negligence or mistakes on your part, or because your plan falls within one of the areas in which the DOL is focusing its investigative efforts.
Compliance Bulletin - Federal Court Strikes Down Association Health Plan RulesKelley M. Bendele
On March 28, 2019, a federal court stated that the final rule on association health plans was an "end-run" around the ACA and that the DOL exceeded its authority under ERISA.
ACA Compliance Bulletin - IRS Issues Letter 5699 to Noncompliant EmployersKelley M. Bendele
An ALE that fails to comply with the Section 6056 reporting requirements may be subject to penalties equal to $260 per violation for failure to file correct information returns by required deadlines.
ACA Compliance Bulletin - Affordability Percentages Will Increase for 2019Kelley M. Bendele
The updated affordability percentages, which are effective for taxable years and plan years beginning January 1, 2019, are significant increases from 2018.
Employers should ensure that their health FSA will not allow employees to make pre-tax contributions in excess of $2,650 for 2018, and they should communicate the new limit to their employees as part of the open enrollment process.
U.S. Justice Department Reverses Title VII Transgender PolicyKelley M. Bendele
The Department of Justice (DOJ) now takes the position that Title VII does not protect transgendered and other individuals from gender identity discrimination in the workplace.
On January 20, 2017, President Trump signed an executive order intended "to minimize the unwarranted economic and regulatory burdens" of the ACA until the law could be repealed and eventually replaced. However, the executive order does not include specific guidance regarding any particular ACA requirement or provision, and does not change any existing regulations.
Senate Republicans now plan to focus on repealing the ACA without a replacement plan, based on a budget reconciliation bill from 2015. This proposal would provide a two-year delay of the repeal to provide a stable transition period.
If the employer mandate is repealed, many ALEs will likely want to modify their plan designs to go back to pre-ACA eligibility rules. Employers may also consider increasing the amount that employees are required to contribute for group health plan coverage.
For 2018, Rev. Proc. 17-36 decreases the affordability contribution percentage to 9.56 percent. This means that employer-sponsored coverage will be considered affordable under the employer shared responsibility rules if the employee's required contribution for self-only coverage does not exceed 9.56 percent of the employee's household income for the tax year.
This infographic visually depicts five major consequences of adopting single-payer healthcare: eliminating upwards of 11 million U.S. jobs, forcing patients to wait for care, rationing prescription drugs, restricting research and development, and increasing taxes.
Because the cost-sharing limits for HDHPs will change for 2018, employers that sponsor these plans may need to make plan design changes for plan years beginning in 2018.
Unless a specific tax exemption applies, wellness incentives are generally subject to the same federal tax rules as any other employee rewards or prizes.
The Importance of Community Nursing Care.pdfAD Healthcare
NDIS and Community 24/7 Nursing Care is a specific type of support that may be provided under the NDIS for individuals with complex medical needs who require ongoing nursing care in a community setting, such as their home or a supported accommodation facility.
Health Education on prevention of hypertensionRadhika kulvi
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart diseases. Hypertension is a worldwide epidemic and important risk factor for coronary artery disease, stroke and renal diseases. Blood pressure is the force exerted by the blood against the walls of the blood vessels and is sufficient to maintain tissue perfusion during activity and rest. Hypertension is sustained elevation of BP. In adults, HTN exists when systolic blood pressure is equal to or greater than 140mmHg or diastolic BP is equal to or greater than 90mmHg. The
CHAPTER 1 SEMESTER V - ROLE OF PEADIATRIC NURSE.pdfSachin Sharma
Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
By fulfilling these objectives, pediatric nurses play a crucial role in ensuring the optimal health and well-being of children throughout all stages of their development.
CHAPTER 1 SEMESTER V PREVENTIVE-PEDIATRICS.pdfSachin Sharma
This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
Medical Technology Tackles New Health Care Demand - Research Report - March 2...pchutichetpong
M Capital Group (“MCG”) predicts that with, against, despite, and even without the global pandemic, the medical technology (MedTech) industry shows signs of continuous healthy growth, driven by smaller, faster, and cheaper devices, growing demand for home-based applications, technological innovation, strategic acquisitions, investments, and SPAC listings. MCG predicts that this should reflects itself in annual growth of over 6%, well beyond 2028.
According to Chris Mouchabhani, Managing Partner at M Capital Group, “Despite all economic scenarios that one may consider, beyond overall economic shocks, medical technology should remain one of the most promising and robust sectors over the short to medium term and well beyond 2028.”
There is a movement towards home-based care for the elderly, next generation scanning and MRI devices, wearable technology, artificial intelligence incorporation, and online connectivity. Experts also see a focus on predictive, preventive, personalized, participatory, and precision medicine, with rising levels of integration of home care and technological innovation.
The average cost of treatment has been rising across the board, creating additional financial burdens to governments, healthcare providers and insurance companies. According to MCG, cost-per-inpatient-stay in the United States alone rose on average annually by over 13% between 2014 to 2021, leading MedTech to focus research efforts on optimized medical equipment at lower price points, whilst emphasizing portability and ease of use. Namely, 46% of the 1,008 medical technology companies in the 2021 MedTech Innovator (“MTI”) database are focusing on prevention, wellness, detection, or diagnosis, signaling a clear push for preventive care to also tackle costs.
In addition, there has also been a lasting impact on consumer and medical demand for home care, supported by the pandemic. Lockdowns, closure of care facilities, and healthcare systems subjected to capacity pressure, accelerated demand away from traditional inpatient care. Now, outpatient care solutions are driving industry production, with nearly 70% of recent diagnostics start-up companies producing products in areas such as ambulatory clinics, at-home care, and self-administered diagnostics.
Telehealth Psychology Building Trust with Clients.pptxThe Harvest Clinic
Telehealth psychology is a digital approach that offers psychological services and mental health care to clients remotely, using technologies like video conferencing, phone calls, text messaging, and mobile apps for communication.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
How many patients does case series should have In comparison to case reports.pdfpubrica101
Pubrica’s team of researchers and writers create scientific and medical research articles, which may be important resources for authors and practitioners. Pubrica medical writers assist you in creating and revising the introduction by alerting the reader to gaps in the chosen study subject. Our professionals understand the order in which the hypothesis topic is followed by the broad subject, the issue, and the backdrop.
https://pubrica.com/academy/case-study-or-series/how-many-patients-does-case-series-should-have-in-comparison-to-case-reports/
One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
1. Provided By:
eESI
MARKET STABILIZATION
FINAL RULE ISSUED
OVERVIEW
On April 14, 2017, the Department of Health and Human
Services (HHS) issued a market stabilization final rule under
the Affordable Care Act (ACA). The final rule includes new
reforms intended to help lower premiums, stabilize the
individual and small group health insurance markets and
increase choices for the 2018 plan year.
Specifically, the rule includes a variety of policy and
operational changes to existing standards to stabilize the
Exchanges, including changes to the annual open enrollment
period and special enrollment periods.
ACTION STEPS
The rule does not directly impact plans in the large group
market. Instead, it aims to stabilize the individual and small
group health insurance markets in light of pending changes
that may be made to the ACA.
The changes made under the final rule are effective for the
2018 plan year.
HIGHLIGHTS
• The market stabilization final rule
includes new reforms intended to
stabilize the individual and small
group health insurance markets
for the 2018 plan year.
• The rule makes changes to
existing standards that aim to
stabilize the Exchanges.
• The rule does not directly impact
large group market plans.
IMPORTANT DATES
April 14, 2017
HHS issued a market stabilization final
rule.
2018 Plan Year
The changes included in the final rule
are effective for the 2018 plan year.
2. 2This ACA Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal
advice. Readers should contact legal counsel for legal advice.
Overview of the Final Rule
The market stabilization final rule for 2018 includes new reforms that are aimed at stabilizing the individual
and small group health insurance markets. Specifically, this rule makes changes to:
Special enrollment periods;
The annual open enrollment period;
Guaranteed availability;
Network adequacy rules;
Essential community providers; and
Actuarial value requirements.
HHS also issued separate guidance concurrently with the final rule to update the qualified health plan (QHP)
certification timeline.
Open Enrollment Period for 2018
The rule shortens the upcoming annual open enrollment period for the individual market (for the 2018 plan
year). Under a previous final rule, HHS established an open enrollment period for the 2018 plan year that runs
from Nov. 1, 2017, through Jan. 31, 2018. However, that final rule sets a shortened open enrollment period for
the 2019 and later plan years.
Under the market stabilization final rule, this shortened open enrollment period will apply beginning with the
2018 plan year. Therefore, for the 2018 plan year, the open enrollment period will run from Nov. 1, 2017,
through Dec. 15, 2017. This change is intended to align the Exchanges with the employer-sponsored insurance
market and Medicare, and help lower prices by reducing adverse selection.
This shortened open enrollment period applies in all Exchanges. However, HHS recognizes that some state-
based Exchanges may have operational difficulties this year in transitioning to the shorter open enrollment
period. As a result, HHS notes that existing regulatory authority allows state-based Exchanges the option of
supplementing the open enrollment period with a special enrollment period, as a transitional measure, to
account for those operational difficulties.
Special Enrollment Period Pre-enrollment Verification
The final rule expands pre-enrollment verification of eligibility to individuals who newly enroll through special
enrollment periods (SEPs) in Exchanges using the federal platform. Previously, HHS allowed individuals to self-
attest eligibility for most SEPs—and to enroll in coverage without further verification of eligibility—in an effort
to minimize barriers for individuals to obtain coverage. However, this practice led to abuses of SEPs, allowing
individuals to enroll in coverage that they would not otherwise qualify for.
Under the market stabilization
final rule, for the 2018 plan year,
the Exchange open enrollment
period will run from Nov. 1,
2017, through Dec. 15, 2017.
3. 3This ACA Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal
advice. Readers should contact legal counsel for legal advice.
To curb these abuses, the final rule requires HHS to conduct pre-enrollment verification of eligibility for all
categories of SEPs for all new consumers in all Exchanges using the www.HealthCare.gov platform. According
to HHS, this change will help make sure that SEPs are available to all who are eligible for them, but will require
individuals to submit supporting documentation—a common practice in the employer health insurance
market. This is intended to help place downward pressure on premiums, curb abuses and encourage year-
round enrollment.
Guaranteed Availability
The final rule also addresses potential abuses of the ACA’s “guaranteed availability” rules, which require
insurers to offer coverage to any eligible consumer who applies for coverage. HHS previously interpreted this
requirement to mean that an insurer cannot refuse enrollment to an individual even in cases where the
individual has failed to pay outstanding premiums for any prior coverage. According to HHS, issuers have
complained that some individuals are taking advantage of this provision by, for example, declining to make
premium payments for coverage at the end of a benefit year, and then enrolling in new coverage for the next
year, thereby avoiding having to pay outstanding premiums for the previous year’s coverage.
The final rule attempts to curb these abuses by allowing issuers to collect unpaid premiums for prior coverage
before enrolling a patient in the next year’s plan with the same issuer. This is intended to incentivize patients
to avoid coverage lapses.
Determining the Level of Coverage
The ACA requires QHPs offered through an Exchange to meet certain levels of actuarial value, referred to as
“metal levels.” HHS regulations have allowed for a de minimis variation in the actuarial valuations used in
determining the level of coverage of a plan to account for differences in actuarial estimates.
The final rule adjusts the de minimis range that is used for determining the level of coverage, allowing a
variation of -4/+2 percentage points (rather than +/- 2 percentage points) for all non-grandfathered individual
and small group market plans that are required to comply with actuarial value (except bronze plans, which can
vary -4/+5 percentage points). As a result, the final rule provides greater flexibility to issuers in the actuarial
value de minimis range to provide patients with more coverage options.
Network Adequacy
The final rule provides greater flexibility to states in the review of QHPs. Under the final rule, beginning with
the 2018 plan year, HHS will defer to the states’ reviews in states with the authority and means to assess
issuer network adequacy. According to HHS, states are best positioned to ensure their residents have access to
high quality care networks.
Qualified Health Plan Certification Calendar
Finally, HHS issued separate guidance concurrently with the final rule to update the QHP certification calendar
and the rate review submission deadlines. In light of the need for issuers to make modifications to their
4. 4This ACA Compliance Bulletin is not intended to be exhaustive nor should any discussion or opinions be construed as legal
advice. Readers should contact legal counsel for legal advice.
products and applications to accommodate the changes finalized in the market stabilization rule, the updated
calendar and deadlines are intended to give additional time for issuers to develop, and states to review, form
and rate filings for the 2018 plan year that reflect these changes.
Source: U.S. Department of Health and Human Services,
Centers for Medicare & Medicaid Services