May 2017
Summary of the American Health Care Act
This summary describes key provisions of H.R. 1628, the American Health Care Act, as approved by the House
of Representatives on May 4, 2017, as a plan to repeal and replace the Affordable Care Act (ACA) through the
Fiscal Year 2017 budget reconciliation process.
American Health Care Act
H.R. 1628
Date plan
announced
March 6, 2017; passed by the House of Representatives on May 4, 2017
Overall
approach
Repeal ACA mandates (2016), standards for health plan actuarial values (2020),
and, premium and cost sharing subsidies (2020).
Modify ACA premium tax credits for 2018-2019 to increase amount for younger
adults and reduce for older adults; allow tax credits to apply to coverage sold outside
of exchanges and to catastrophic policies. In 2020, replace ACA income-based tax
credits with flat tax credits adjusted for age. Eligibility for new tax credits phases out
at income levels between $75,000 and $115,000
Retain private market rules, including requirement to guarantee issue coverage,
prohibition on pre-existing condition exclusions, requirement to extend dependent
coverage to age 26. Modify age rating limit to permit variation of 5:1, unless states
adopt different ratios, effective 2018. Retain essential health benefits requirement,
with state option to waive. Retain prohibition on health status rating with state
option to waive for individual market applicants who have not maintained continuous
coverage.
Retain health insurance marketplaces, annual Open Enrollment periods (OE), and
special enrollment periods (SEPs).
Impose late enrollment penalty for people who don’t stay continuously covered.
Establish Patient and State Stability Fund with federal funding of $115 billion over
9 years available to all states, and additional funding of $8 billion over 5 years for
states that elect community rating waivers. States may use funds to provide financial
help to high-risk individuals, promote access to preventive services, provide cost
sharing subsidies, and for other purposes. In 2020, $15 billion of funds shall be used
only for services related to maternity coverage and newborn care, and mental health
and substance use disorders. [For 2018-2026, a further $15 billion is allocated
through the fund for Federal Invisible Risk Sharing Program (reinsurance). This
program is established as part of the fund, though administered by CMS to make
payments directly to health insurers.] In states that don’t successfully apply for
grants, funds will be used for reinsurance program.
Repeal funding for Prevention and Public Health Fund at the end of Fiscal Year
2018 and rescind any unobligated funds remaining at the end of FY 2018. Provide
supplemental funding for community health centers of $422 million for FY 2017
Encourage use of Health Savings Accounts by increasing annual tax free
co.
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
The document provides an overview of key provisions and timelines in the Senate healthcare reform bill that was passed in 2010:
- Individuals can keep current health policies on a grandfathered basis until 2014 when state health insurance exchanges will be set up.
- Small businesses are eligible for tax credits to help pay employee premiums starting in 2010.
- Several new consumer protections and benefit requirements go into effect for plans in 2010-2014, including coverage of preexisting conditions for children, preventive care with no cost sharing, and allowing adult children to stay on parents' plans until age 26.
- Health insurance exchanges with standardized plans will be set up in each state starting in 2014, along with penalties for individuals
Frequently asked questions about Obamacareexchangeenvoy
The document summarizes key provisions of the Affordable Care Act (ACA) related to health insurance exchanges, the individual mandate, employer penalties, and dependent coverage requirements. It explains that the ACA requires states to establish health insurance exchanges by 2014 to offer qualified health plans. It also outlines the individual mandate requiring most individuals to have minimum essential health coverage beginning in 2014, and penalties for employers not offering coverage. The ACA extends dependent coverage to age 26.
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 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.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required in the immediate future in 2010, as well as changes phased in between now and 2014 such as establishing insurance exchanges, essential benefits packages, and penalties for individuals and employers who do not obtain qualified health insurance coverage. The summary concludes by encouraging questions and feedback from readers to help with understanding and implementing the complex health reform law.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required immediately in 2010, and what will be required annually from 2011 through 2014, including establishing health insurance exchanges, essential benefits packages, employer and individual mandates, subsidies and penalties. The implementation is described as bringing challenges for years to come through ongoing rulemaking and changes.
The document provides an overview of the Affordable Care Act (ACA) and its implementation in South Carolina. Some key points:
- The ACA requires most Americans to have health insurance or pay a penalty. It also prohibits denying coverage due to preexisting conditions and prohibits charging sick individuals higher premiums.
- South Carolina has a federally-facilitated health insurance marketplace for individuals and small businesses. Health plans must cover essential health benefits.
- Beginning in 2014, there is no annual or lifetime limits on coverage, no preexisting condition exclusions, guaranteed issue of policies, and limits on out-of-pocket costs. However, grandfathered plans are exempt from some provisions.
-
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
The document provides an overview of key provisions and timelines in the Senate healthcare reform bill that was passed in 2010:
- Individuals can keep current health policies on a grandfathered basis until 2014 when state health insurance exchanges will be set up.
- Small businesses are eligible for tax credits to help pay employee premiums starting in 2010.
- Several new consumer protections and benefit requirements go into effect for plans in 2010-2014, including coverage of preexisting conditions for children, preventive care with no cost sharing, and allowing adult children to stay on parents' plans until age 26.
- Health insurance exchanges with standardized plans will be set up in each state starting in 2014, along with penalties for individuals
Frequently asked questions about Obamacareexchangeenvoy
The document summarizes key provisions of the Affordable Care Act (ACA) related to health insurance exchanges, the individual mandate, employer penalties, and dependent coverage requirements. It explains that the ACA requires states to establish health insurance exchanges by 2014 to offer qualified health plans. It also outlines the individual mandate requiring most individuals to have minimum essential health coverage beginning in 2014, and penalties for employers not offering coverage. The ACA extends dependent coverage to age 26.
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 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.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required in the immediate future in 2010, as well as changes phased in between now and 2014 such as establishing insurance exchanges, essential benefits packages, and penalties for individuals and employers who do not obtain qualified health insurance coverage. The summary concludes by encouraging questions and feedback from readers to help with understanding and implementing the complex health reform law.
The document provides a summary of the key provisions and implementation timelines of the Affordable Care Act (ACA) health reform legislation passed by Congress and signed into law by President Obama in 2010. It outlines what is required immediately in 2010, and what will be required annually from 2011 through 2014, including establishing health insurance exchanges, essential benefits packages, employer and individual mandates, subsidies and penalties. The implementation is described as bringing challenges for years to come through ongoing rulemaking and changes.
The document provides an overview of the Affordable Care Act (ACA) and its implementation in South Carolina. Some key points:
- The ACA requires most Americans to have health insurance or pay a penalty. It also prohibits denying coverage due to preexisting conditions and prohibits charging sick individuals higher premiums.
- South Carolina has a federally-facilitated health insurance marketplace for individuals and small businesses. Health plans must cover essential health benefits.
- Beginning in 2014, there is no annual or lifetime limits on coverage, no preexisting condition exclusions, guaranteed issue of policies, and limits on out-of-pocket costs. However, grandfathered plans are exempt from some provisions.
-
4 A Road Map For Americas Future Paul Ryanjenkan04
The document outlines Congressman Paul Ryan's proposal called "A Roadmap for America's Future" which includes reforms to healthcare, Social Security, taxes, and the federal budget. The healthcare section proposes providing tax credits to individuals for purchasing health insurance, creating state-based insurance exchanges, and transitioning Medicaid into a system that provides direct assistance for purchasing private plans. The Social Security reforms give workers under 55 the option to invest some of their payroll taxes into personal retirement accounts. The tax reforms aim to simplify the tax code and reduce rates while eliminating special deductions and broadening the tax base.
A Road Map For Americas Future by Paul Ryanjenkan04
The document outlines Congressman Paul Ryan's proposal called "A Roadmap for America's Future" which includes reforms to healthcare, Social Security, taxes, and the federal budget. The healthcare section proposes providing tax credits to individuals for purchasing health insurance, creating state-based insurance exchanges, and transitioning Medicaid into a system that provides direct assistance for purchasing private plans. The Social Security reforms give workers under 55 the option to invest some of their payroll taxes into personal retirement accounts. The tax reforms aim to simplify the tax code and lower rates while eliminating special deductions and maintaining progressivity.
How Does Obamacare Impact Your Business Planning?Tilson
The Supreme Court has upheld the PPACA and its implementation is full steam ahead. Now is the time to begin preparing for the impact on your business and your employees. Many have forgotten the complexity, decisions, and regulatory requirements of this legislation. As we all know, the devil is in the details.
The document provides an overview of various federal, state, and local benefits programs available to individuals with disabilities or low incomes. It summarizes the eligibility requirements and services provided by key programs like Social Security Disability Insurance (SSDI), Supplemental Security Income (SSI), Medicare, Medicaid, housing assistance, food stamps, and fuel assistance at both the federal and Vermont state levels. Contact information is provided for learning more about various Vermont health programs.
The document provides answers to frequently asked questions about the new US health care reform laws. Some key points:
- Major provisions of the laws will be phased in between 2010-2020, with many taking effect in 2014.
- Beginning in 2014, all citizens must have qualifying health insurance or pay a tax penalty.
- Starting in 2014, individuals and small businesses can purchase qualified coverage through state-based insurance exchanges.
- Employers with over 50 employees that do not offer coverage will face penalties starting in 2014.
- High-risk individuals unable to get coverage due to preexisting conditions will have access to a federal program until 2014.
- Preventive care must be covered without co
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
The document discusses the implications of the Affordable Care Act on individuals, employers, and the healthcare industry. It finds that the Act will provide coverage to around 30 million uninsured Americans through Medicaid expansion and insurance subsidies. For individuals, there will be a penalty for not obtaining coverage starting in 2014. Employers with over 50 employees will face a penalty starting in 2015 if they do not provide affordable coverage. The healthcare industry will see both costs and revenues impacted, with insurers expected to gain many new customers but also facing new regulations, and hospitals losing some funding but gaining new insured patients. Overall the impacts are viewed as manageable for most employers and positive for the healthcare sector in the long run.
The Patient Protection and Affordable Care Act De.docxoreo10
The Patient Protection and Affordable Care Act
Detailed Summary
The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality,
affordable health care and will create the transformation within the health care system necessary to
contain costs. The Congressional Budget Office (CBO) has determined that the Patient Protection and
Affordable Care Act is fully paid for, will provide coverage to more than 94% of Americans while
staying under the $900 billion limit that President Obama established, bending the health care cost
curve, and reducing the deficit over the next ten years and beyond.
The Patient Protection and Affordable Care Act contains nine titles, each addressing an essential
component of reform:
Quality, affordable health care for all Americans
The role of public programs
Improving the quality and efficiency of health care
Prevention of chronic disease and improving public health
Health care workforce
Transparency and program integrity
Improving access to innovative medical therapies
Community living assistance services and supports
Revenue provisions
Title I. Quality, Affordable Health Care for All Americans
The Patient Protection and Affordable Care Act will accomplish a fundamental transformation of
health insurance in the United States through shared responsibility. Systemic insurance market reform
will eliminate discriminatory practices such as pre-existing condition exclusions. Achieving these
reforms without increasing health insurance premiums will mean that all Americans must be part of the
system and must have coverage. Tax credits for individuals and families will ensure that insurance is
affordable for everyone. These three elements are the essential links to achieve reform.
Immediate Improvements: Achieving health insurance reform will take some time to implement. In
the immediate reforms will be implemented in 2010. The Patient Protection and Affordable Care Act
will:
Eliminate lifetime and unreasonable annual limits on benefits
Prohibit rescissions of health insurance policies
Provide assistance for those who are uninsured because of a pre-existing condition
Require coverage of preventive services and immunizations
Extend dependant coverage up to age 26
Develop uniform coverage documents so consumers can make apples-to-apples comparisons
when shopping for health insurance
Cap insurance company non-medical, administrative expenditures
2
Ensure consumers have access to an effective appeals process and provide consumer a place to
turn for assistance navigating the appeals process and accessing their coverage
Create a temporary re-insurance program to support coverage for early retirees
Establish an internet portal to assist Americans in identifying coverage options
Facilitate administrative simplification to lower health system costs
Heal ...
Although the Affordable Care Act has benefited the health insurance consumer in many respects, it has also added to the confusion. This presentation, Given by Wanda Stephens in Raleigh, North Carolina, details some of the many facets to Obamacare in NC.
for more information visit http://www.hisonc.com/obamacare-north-carolina/
Health Reform Bulletin 116 | Year-End Wrap Up Dec. 29, 2015CBIZ, Inc.
The document summarizes new laws and guidance affecting the Affordable Care Act. Key points include:
- New laws delay several ACA taxes, including the "Cadillac tax" until 2020 and pause insurer fees and medical device taxes.
- IRS guidance provides details on employer shared responsibility rules, including affordability calculations and penalty amounts.
- Deadlines for reporting health coverage on Forms 1095-B and 1095-C were extended to March 31, 2016 for furnishing to individuals and May 31, 2016 for filing with the IRS.
Health Reform Bulletin 116 Year End Wrap Up 12-29-15Daniel Michels
The most recent CBIZ Health Reform Bulletin: Year-End Wrap Up (HRB 116). This issue includes specific information and guidance on:
1. Late breaking development, IRS delays new Affordable Care Act's (ACA) reporting and disclosure obligations!
2. On December 18, 2015 Consolidate Appropriations Act, 2016, and the Protecting Americans from Tax Hikes (PATH) Act of 2015 (H. R. 2029; now Public Law No. 114-113) were signed by the President, and amend several provisions of the Affordable Care Act.
3. The IRS Issued guidance relating to ACA implementation
4. Year-End Reminders
The Supreme Court upheld the constitutionality of the Patient Protection and Affordable Care Act in a 5-4 decision. The Court ruled that the individual mandate is a tax that Congress has the authority to impose. It limited but did not invalidate the pieces that expand Medicaid. The decision means that key components of the healthcare reform law can move forward including individual and employer responsibilities, health insurance exchanges, insurance market reforms, and quality improvements.
The document provides a timeline of key provisions from the Affordable Care Act (ACA) being implemented between 2010-2013. Some key reforms include expanding dependent coverage up to age 26 (2010), prohibiting pre-existing condition exclusions for children (2010), requiring coverage of preventive care with no cost sharing (2010), eliminating lifetime and annual limits on coverage (2010), and establishing health insurance exchanges and individual mandates (2014).
The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
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.
Compliance Bulletin - Washington Enacts Employee-paid Long-term Care ProgramKelley M. Bendele
Starting in 2022, Washington will enact the nation's first state-operated long-term care program. Employees will pay a 0.58% payroll tax to fund benefits. In 2025, eligible individuals may receive up to $36,500 (adjusted for inflation) to pay for services like in-home care or nursing homes. To qualify, individuals must have paid into the program for 10 years without a five-year break or for three of the last six years, and require assistance with daily living activities. The program aims to help seniors pay for long-term care and reduce Medicaid costs for the state.
Learn how you can successfully navigate the Affordable Care Act, "Obama Care".
This easy to read outline will benefit your family and business.
Call (816-224-9466) for more information today.
Patient Protection and Affordable Care Act Disciples CareMichael Porter, GBA
This document summarizes key provisions and changes to healthcare laws by year from 2010-2018 as a result of the Patient Protection and Affordable Care Act. Some of the major changes include expanding dependent coverage until age 26, eliminating pre-existing conditions for dependents under 19, eliminating lifetime maximums, establishing health insurance exchanges and subsidies, and implementing individual and employer mandates and penalties by 2014. The document also reviews caveats and opens the floor for any questions.
Staffscapes, Inc. is a Human Resources Outsourcing firm that specializes in HR, Payroll & Benefits. We recently presented this slide show to a group of Colorado Small Business Owners and Managers and are sharing it with the general public today.
Continually in our changing society we are learning how to interact .docxalfredacavx97
Continually in our changing society we are learning how to interact with people who have different beliefs, values, and attitudes. In 1-2 pages, describe a time when you had to learn about a new culture or way of life. (This could be another country, a different part of the USA, a new business, or a different school or family, and so on.) Using one theory from Module 02's reading and study, explain how the experience helped sharpen your communication skills. Explain how you were enriched by the experience.
If you quote an outside resource, please follow APA citation format.
.
Context There are four main categories of computer crimeComput.docxalfredacavx97
Context:
There are four main categories of computer crime:
Computer as the target of criminals,
criminals using computers to commit crimes,
computers being incidental to a crime, and
crime being facilitated due to the vast numbers of computers and digital devices in use today.
It is important to distinguish between these categories of computer crime in order to realize the different ways that digital devices can be involved in criminal activity.
Task Description:
Search the Internet or the library and find a real-world example of each of the four types of computer crime. Write a 5 page (1800 words) paper using APA Style. Discuss the specific crime that you found in each category, its effects on the target, and the social and economic cost of recovering from the crime.
.
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- Starting in 2014, individuals and small businesses can purchase qualified coverage through state-based insurance exchanges.
- Employers with over 50 employees that do not offer coverage will face penalties starting in 2014.
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This Health Care Reform Bulletin provides information on the following topics:
a. Interim Guidance on Expatriate Health Coverage
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The document discusses the implications of the Affordable Care Act on individuals, employers, and the healthcare industry. It finds that the Act will provide coverage to around 30 million uninsured Americans through Medicaid expansion and insurance subsidies. For individuals, there will be a penalty for not obtaining coverage starting in 2014. Employers with over 50 employees will face a penalty starting in 2015 if they do not provide affordable coverage. The healthcare industry will see both costs and revenues impacted, with insurers expected to gain many new customers but also facing new regulations, and hospitals losing some funding but gaining new insured patients. Overall the impacts are viewed as manageable for most employers and positive for the healthcare sector in the long run.
The Patient Protection and Affordable Care Act De.docxoreo10
The Patient Protection and Affordable Care Act
Detailed Summary
The Patient Protection and Affordable Care Act will ensure that all Americans have access to quality,
affordable health care and will create the transformation within the health care system necessary to
contain costs. The Congressional Budget Office (CBO) has determined that the Patient Protection and
Affordable Care Act is fully paid for, will provide coverage to more than 94% of Americans while
staying under the $900 billion limit that President Obama established, bending the health care cost
curve, and reducing the deficit over the next ten years and beyond.
The Patient Protection and Affordable Care Act contains nine titles, each addressing an essential
component of reform:
Quality, affordable health care for all Americans
The role of public programs
Improving the quality and efficiency of health care
Prevention of chronic disease and improving public health
Health care workforce
Transparency and program integrity
Improving access to innovative medical therapies
Community living assistance services and supports
Revenue provisions
Title I. Quality, Affordable Health Care for All Americans
The Patient Protection and Affordable Care Act will accomplish a fundamental transformation of
health insurance in the United States through shared responsibility. Systemic insurance market reform
will eliminate discriminatory practices such as pre-existing condition exclusions. Achieving these
reforms without increasing health insurance premiums will mean that all Americans must be part of the
system and must have coverage. Tax credits for individuals and families will ensure that insurance is
affordable for everyone. These three elements are the essential links to achieve reform.
Immediate Improvements: Achieving health insurance reform will take some time to implement. In
the immediate reforms will be implemented in 2010. The Patient Protection and Affordable Care Act
will:
Eliminate lifetime and unreasonable annual limits on benefits
Prohibit rescissions of health insurance policies
Provide assistance for those who are uninsured because of a pre-existing condition
Require coverage of preventive services and immunizations
Extend dependant coverage up to age 26
Develop uniform coverage documents so consumers can make apples-to-apples comparisons
when shopping for health insurance
Cap insurance company non-medical, administrative expenditures
2
Ensure consumers have access to an effective appeals process and provide consumer a place to
turn for assistance navigating the appeals process and accessing their coverage
Create a temporary re-insurance program to support coverage for early retirees
Establish an internet portal to assist Americans in identifying coverage options
Facilitate administrative simplification to lower health system costs
Heal ...
Although the Affordable Care Act has benefited the health insurance consumer in many respects, it has also added to the confusion. This presentation, Given by Wanda Stephens in Raleigh, North Carolina, details some of the many facets to Obamacare in NC.
for more information visit http://www.hisonc.com/obamacare-north-carolina/
Health Reform Bulletin 116 | Year-End Wrap Up Dec. 29, 2015CBIZ, Inc.
The document summarizes new laws and guidance affecting the Affordable Care Act. Key points include:
- New laws delay several ACA taxes, including the "Cadillac tax" until 2020 and pause insurer fees and medical device taxes.
- IRS guidance provides details on employer shared responsibility rules, including affordability calculations and penalty amounts.
- Deadlines for reporting health coverage on Forms 1095-B and 1095-C were extended to March 31, 2016 for furnishing to individuals and May 31, 2016 for filing with the IRS.
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The most recent CBIZ Health Reform Bulletin: Year-End Wrap Up (HRB 116). This issue includes specific information and guidance on:
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3. The IRS Issued guidance relating to ACA implementation
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The document provides a timeline for key provisions of the Affordable Care Act (ACA) being implemented between 2010-2014. Some 2010 provisions included requiring plans to cover adult children up to age 26, prohibiting pre-existing condition exclusions for children, covering preventive care with no cost sharing, and establishing a high-risk pool. An improved claims/appeals process and rebates for the Medicare Part D "donut hole" also took effect in 2010. Future provisions will expand insurance coverage and reforms through 2014.
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.
Compliance Bulletin - Washington Enacts Employee-paid Long-term Care ProgramKelley M. Bendele
Starting in 2022, Washington will enact the nation's first state-operated long-term care program. Employees will pay a 0.58% payroll tax to fund benefits. In 2025, eligible individuals may receive up to $36,500 (adjusted for inflation) to pay for services like in-home care or nursing homes. To qualify, individuals must have paid into the program for 10 years without a five-year break or for three of the last six years, and require assistance with daily living activities. The program aims to help seniors pay for long-term care and reduce Medicaid costs for the state.
Learn how you can successfully navigate the Affordable Care Act, "Obama Care".
This easy to read outline will benefit your family and business.
Call (816-224-9466) for more information today.
Patient Protection and Affordable Care Act Disciples CareMichael Porter, GBA
This document summarizes key provisions and changes to healthcare laws by year from 2010-2018 as a result of the Patient Protection and Affordable Care Act. Some of the major changes include expanding dependent coverage until age 26, eliminating pre-existing conditions for dependents under 19, eliminating lifetime maximums, establishing health insurance exchanges and subsidies, and implementing individual and employer mandates and penalties by 2014. The document also reviews caveats and opens the floor for any questions.
Staffscapes, Inc. is a Human Resources Outsourcing firm that specializes in HR, Payroll & Benefits. We recently presented this slide show to a group of Colorado Small Business Owners and Managers and are sharing it with the general public today.
Similar to May 2017 Summary of the American Health Care Act T.docx (20)
Continually in our changing society we are learning how to interact .docxalfredacavx97
Continually in our changing society we are learning how to interact with people who have different beliefs, values, and attitudes. In 1-2 pages, describe a time when you had to learn about a new culture or way of life. (This could be another country, a different part of the USA, a new business, or a different school or family, and so on.) Using one theory from Module 02's reading and study, explain how the experience helped sharpen your communication skills. Explain how you were enriched by the experience.
If you quote an outside resource, please follow APA citation format.
.
Context There are four main categories of computer crimeComput.docxalfredacavx97
Context:
There are four main categories of computer crime:
Computer as the target of criminals,
criminals using computers to commit crimes,
computers being incidental to a crime, and
crime being facilitated due to the vast numbers of computers and digital devices in use today.
It is important to distinguish between these categories of computer crime in order to realize the different ways that digital devices can be involved in criminal activity.
Task Description:
Search the Internet or the library and find a real-world example of each of the four types of computer crime. Write a 5 page (1800 words) paper using APA Style. Discuss the specific crime that you found in each category, its effects on the target, and the social and economic cost of recovering from the crime.
.
Continue to use the case study (A&D High Tech) and Risk Management .docxalfredacavx97
Continue to use the case study (A&D High Tech) and Risk Management Plan Template to identify, evaluate, and assess risk. For this part of your risk plan, use qualitative and quantitative processes, such as:
Sensitivity analysis.
Expected monetary analysis.
Monte Carlo simulation.
Decision tree analysis.
PERT tree analysis.
Also, use compare and contrast techniques for identifying risks, such as:
Brainstorming.
The Delphi Technique.
Ishikawa diagrams.
Interviewing processes.
Include the following sections in your Risk Management Plan submission:
3.1 Determine the Risks
(Identify and evaluate the types of risk that the project may encounter.)
3.2 Evaluate and Assess the Risks
(Define the elements of the risk breakdown structure for use in evaluating project risk. Analyze the impact of risk on project outcomes. Integrate risk analysis techniques to create a risk breakdown structure).
3.3 Qualitative and Quantitative Processes
(Apply qualitative and quantitative risk analysis. Use sensitivity analysis, expected monetary analysis, decision tree analysis, Monte Carlo simulation, and/or the PERT tree analysis).
.
Continue to use the case study, evaluate, and assess risk. Use quali.docxalfredacavx97
Continue to use the case study, evaluate, and assess risk. Use qualitative and quantitative processes, such as:
Sensitivity analysis.
Expected monetary analysis.
Monte Carlo simulation.
Decision tree analysis.
PERT tree analysis.
Also, use compare and contrast techniques for identifying risks, such as:
Brainstorming.
The Delphi Technique.
Ishikawa diagrams.
Interviewing processes.
Include the following sections:
Section 3—Risk Identification
3.1 Determine the Risks
(Identify and evaluate the types of risk that the project A&D may encounter.)
3.2 Evaluate and Assess the Risks
(Define the elements of the risk breakdown structure for use in evaluating project risk. Analyze the impact of risk on project outcomes. Integrate risk analysis techniques to create a risk breakdown structure).
3.3 Qualitative and Quantitative Processes
(Apply qualitative and quantitative risk analysis. Use sensitivity analysis, expected monetary analysis, decision tree analysis, Monte Carlo simulation, and/or the PERT tree analysis).
.
CONTEXT ASSIGNMENT # 6For this assignment, we are going to take .docxalfredacavx97
CONTEXT ASSIGNMENT # 6
For this assignment, we are going to take president Obama’s State-of the-Union speech
out of context
. You will go through the speech looking for phrases to spin out-of-context.
You will use at least three quotes from the speech. Please put the quotes in a
bold
font. Pay extra attention to how the quote is introduced. Make sure it flows. Make sure it is set up so that the quote
illustrates a point
. Also, pay extra attention to your rhetoric after the quote. Make sure it explains (or feeds off of) the quote you used.
Just like all the assignments in this portfolio, you will be developing points. The difference here is that your example / illustration will be a quote from the president.
ADDITIONAL REQUIREMENTS
1. Exactly 1 page long so the last word is the last word that can fit on the page.
2. No grammar errors!
3. Pay extra close attention to the way the quotes are introduced.
4. Make sure your writing is clear, direct, concise, and strong.
In other words, revise, proofread and edit your work.
Use the 5-editing techniques after you’ve written the first draft
eliminate redundancies
avoid wordy expressions
cut awkward sentence openings
vary your sentence structure
use strong verbs
.
Media and SocietyMedia HistoryJOHN DEWEY – 185.docxalfredacavx97
Media and Society
Media History
JOHN DEWEY – 1859-1952
Harold A. Innis
1894-1952
Marshall McLuhan – 1911-1980
Walter J. Ong, S.J.
1912-2003
Robert W. McChesney – 1952-
Three Historical Narratives:
Oral to Electronic Culture
Oral Culture – all interactions take place in face-to-face discussions.
Written Culture – a shared system of inscription in a literate society exists so that communication can take place outside of face-to-face discussions across time and space.
Print Culture – an expansion of Written Culture that encompasses the consequent social and cultural changes that result from the proliferation of printer material.
Electronic Culture – communication transcends time and space.
There is a different sense of time in Oral Culture, according to Ong.
Since there are no records, memory cannot be recorded. History
can only reside in the present, in the telling of the story. Memory
is thematic and formulaic. The story may vary very little from telling to
telling over time, but the words and phrases used may differ.
Performance is the key to authorship. Every time a story is told or a work is
performed, it is shaped by the performer and provides a new model for future performances.
Oral cultures are relatively homogeneous with respect to knowledge and social norms but public and shared across generations.
Written Culture, according to McLuhan , has been the means of creating
‘civilized man.’
According to Innis, written communication allowed societies to persevere through time by creating durable texts which could be handed down and referred to. This allowed for control of knowledge by certain hierarchies and also allowed for centralized control to expand over a wider area.
Audiences could be remote in time and space, and the communicator could guarantee that the message received is identical to the one sent without having to rely on the memory of the messenger. The communicator could reach a wider and more disparate audience.
Print Culture – the ability to mechanically reproduce text freed writing
from its reliance on an elite group of individuals and guaranteed that
each copy of the text would be identical to every other copy.
Printing was instrumental in the development of a secular society and in the establishment of a democracy among the upper classes in early
modern Europe, according to historian, Elizabeth Eisenstein.
Printing reinforced the sense of individuality and privacy and makes
Introspection possible.
Printing enabled the emergence of the newspaper and the novel, and
altered the very structure of human consciousness and thought.
Electronic Culture – the telegraph reorganized people’s perception of space and time; it enabled the transmission of messages across space, and it fostered a rational reorganization of time. The telegraph also separated transportation from communication.
According to Innis, electronic culture allows for a new fo.
Coping with Terrorism Is the United States making progress in re.docxalfredacavx97
Coping with Terrorism"
Is the United States making progress in reducing or preventing terrorism? Explain your answer.
If the United States is NOT making progress, what would have to happen to make the efforts against terrorism more effective?
If the United States IS making progress, to what do you attribute this success?
.
MEDIA AND DIVERSITY IN CULTURECOM-530 MEDIA AND DIVE.docxalfredacavx97
This document discusses key concepts related to microcultures and media, including media literacy, hyper-commercialism, critical culture approach, and stereotypes. It also discusses representations of microcultures in terms of identity, participation, community, and diversity. Finally, it addresses audience perception, critical culture and media approaches, and the importance of media literacy in developing strong critical thinking skills from a young age to understand different media messages and interpretations.
Medeiros LNB de, Silva DR da, Guedes CDFS et al. .docxalfredacavx97
Medeiros LNB de, Silva DR da, Guedes CDFS et al. Prevalence of pressure ulcers in intensive...
English/Portuguese
J Nurs UFPE on line., Recife, 11(7):2697-703, July., 2017 2697
ISSN: 1981-8963 ISSN: 1981-8963 DOI: 10.5205/reuol.10939-97553-1-RV.1107201707
PREVALENCE OF PRESSURE ULCERS IN INTENSIVE CARE UNITS
PREVALÊNCIA DE ÚLCERAS POR PRESSÃO EM UNIDADES DE TERAPIA INTENSIVA
PREVALENCIA DE ÚLCERAS POR PRESIÓN EN UNIDADES DE TERAPIA INTENSIVA
Luan Nogueira Bezerra de Medeiros1, Deyvisson Ribeiro da Silva2, Cintia Danielle Faustino da Silva Guedes3,
Thuanne Karla Carvalho de Souza4, Belisana Pinto de Abreu Araújo Neta5
ABSTRACT
Objective: to detect the prevalence of Pressure Ulcers (PUs) in patients admitted to Intensive Care Units
(ICUs). Method: cross-sectional, quantitative study, developed in an emergency and trauma reference
hospital in the State of Rio Grande do Norte located in the eastern sanitary district of Natal (RN), Brazil.
Results: the prevalence found of PUs was 69% in the four ICUs. Individually, the Cardiac ICU had an incidence
of 44.4%; the Bernadete ICU, 85.7%; the General ICU, 60%; and the Emergency ICU, 87.5%. Conclusion: It is
necessary to focus on a strategic planning for prevention and treatment measures to reduce the PU indexes in
the institution. Descriptors: Nursing; Pressure Ulcer; Intensive Care Units; Prevalence.
RESUMO
Objetivo: detectar a prevalência de Úlceras por Pressão (UPs) em pacientes internados em Unidades de
Terapia Intensiva (UTIs). Método: estudo transversal, de abordagem quantitativa, desenvolvido em um
hospital de referência para o estado do Rio Grande do Norte em urgência e trauma, situado no distrito
sanitário leste do município de Natal (RN), Brasil. Resultados: a prevalência encontrada de UPs foi de 69% nas
quatro UTIs. Individualmente, a UTI Cardiológica apresentou 44,4%; UTI Bernadete, 85,7%; UTI Geral, 60%; e
UTI do Pronto-Socorro, 87,5% de prevalência de UPs. Conclusão: é necessário nortear um planejamento
estratégico para medidas de prevenção e tratamento para redução dos índices de UPs na instituição.
Descritores: Enfermagem; Úlcera por Pressão; Unidades de Terapia Intensiva; Prevalência.
RESUMEN
Objetivo: detectar la prevalencia de Úlceras por Presión (UPs) en pacientes internados en Unidades de
Terapia Intensiva (UTIs). Método: estudio transversal, de enfoque cuantitativo, desarrollado en un hospital de
referencia para el estado de Rio Grande do Norte en urgencia y trauma, situado en el distrito sanitario este
del municipio de Natal (RN), Brasil. Resultados: la prevalencia encontrada de UPs fue de 69% en las cuatro
UTIs. Individualmente, la UTI Cardiológica presentó 44,4%; UTI Bernadete, 85,7%; UTI General, 60%; y UTI de
Pronto-Socorro, 87,5% de prevalencia de UPs. Conclusión: es necesario guiar un planeamiento estrategico
para medidas de prevención y tratamiento para reducción de los índices de U.
Measuring to Improve Medication Reconciliationin a Large Sub.docxalfredacavx97
Measuring to Improve Medication Reconciliation
in a Large Subspecialty Outpatient Practice
Elizabeth Kern, MD, MS; Meg B. Dingae, MHSA; Esther L. Langmack, MD; Candace Juarez, MT; Gary Cott, MD;
Sarah K. Meadows, MS
Background: To assess performance in medication reconciliation (med rec)—the process of comparing and reconciling
patients’ medication lists at clinical transition points—and demonstrate improvement in an outpatient setting, sustainable
and valid measures are needed.
Methods: An interdisciplinary team at National Jewish Health (Denver) attempted to improve med rec in an ambulatory
practice serving patients with respiratory and related diseases. Interventions, which were aimed at physicians, nurses (RNs),
and medical assistants, involved changes in practice and changes in documentation in the electronic health record (EHR).
New measures designed to assess med rec performance, and to validate the measures, were derived from EHR data.
Results: Across 18 months, electronic attestation that med rec was completed at clinic visits increased from 9.8% to 91.3%
(p < 0.0001). Consistent with this improvement, patients with medication lists missing dose/frequency for at least one prescription-
type medication decreased from 18.1% to 15.8% (p < 0.0001). Patients with duplicate albuterol inhalers on their list decreased
from 4.0% to 2.6% (p < 0.0001). Percentages of patients increased for printing of the medication list at the visit (18.7% to
94.0%; p < 0.0001) and receipt of the printed medication list at the visit (52.3% to 67.0%; p = 0.0074). Documentation
that patient education handouts were offered increased initially then declined to an overall poor performance of 32.4% of
clinic visits. Investigation of this result revealed poor buy-in and a highly redundant process.
Conclusion: Deriving measures reflecting performance and quality of med rec from EHR data is feasible and sustainable
over the time periods necessary to demonstrate change. Concurrent, complementary measures may be used to support the
validity of summary measures.
Medication reconciliation (med rec) is the process of sys-tematically and comprehensively reviewing the
medications a patient is taking, to ensure that medications
added, changed, or discontinued are evaluated for poten-
tial safety concerns. One of the three current Joint
Commission National Patient Safety Goals (NPSGs) on med-
ication safety (Goal 3), concerns medication reconciliation,
which ambulatory care organizations have been expected to
perform since 2005. The current version of the goal
(NPSG.03.06.01), effective July 1, 2011, stipulates that am-
bulatory care organizations maintain and communicate
accurate patient medication information.1 One require-
ment is that the organization obtain the patient’s medication
information at the beginning of an episode of care, with the
information to be updated when the patient’s medications
change. Ideally, med rec should occur at each transition of
care or han.
Contributing to the Team’s Work Score 20 pts.20 - 25 pts..docxalfredacavx97
Contributing to the Team’s Work
Score : 20 pts.
20 - 25 pts.
Feedback:
High contribution
Interacting with Teammates
Score : 19 pts.
13 - 23 pts.
Feedback:
Moderate level of interaction
Keeping the Team on Track
Score : 23 pts.
20 - 25 pts.
Feedback:
Highly skilled at keeping on track
Expecting Quality
Score : 14 pts.
12 - 15 pts.
Feedback:
High quality expectations
Having Relevant Knowledge, Skills, and Abilities (KSAs)
Score : 9 pts.
8 - 10 pts.
Feedback:
Highly relevant knowledge and skills
Feedback score:
Score : 85 pts.
Range-based Feedback:
84 - 105 pts.
Feedback:
Highly effective team member
Complete
the "Evaluate Team Member Effectiveness" self-assessment.
Write
a 700- to 1,050-word paper in which you address the following:
Do you agree with your results?
Based on your self-assessment, what do you see as your strengths and weaknesses regarding working on a team?
Have you ever engaged in social loafing while on a team? Why or why not?
How does working effectively on a team give you an advantage in the workplace?
How do groups normally develop?
How does the effectiveness of the team members influence the group's development process?
Format
your paper consistent with APA guidelines.
.
Measuring Performance at Intuit A Value-Added Component in ERM Pr.docxalfredacavx97
Measuring Performance at Intuit: A Value-Added Component in ERM Programs
ABC Organization is looking to improve on their Enterprise Risk Management (ERM) program. A board member saw Intuit’s ERM Performance Measurement Model case study. As with any ERM program, Intuit’s program has continued to evolve since 2009.
Intuit’s ERM program began with the company's practice of risk management on an ad hoc basis. When a problem occurred, team were formed to address the issue. When it was over, it was back to business as usual. In the late 2000’s, Intuit’s ERM program focused on building a sustainable risk management capability. The program provided leadership with current and emerging risks to help them make strategic decisions. Intuit built the program using a ERM maturity model to get the right foundation. It was realized that executive leadership needed to measure the performance of the program. So key risk indicators (KRIs) were used to understand the potential emerging risks and any trends that may impact current risks. Also, key performance indicators (KPIs) can help in understanding and manage current risks. By identifying these KRIs and KPIs in the, the case study reader should gain an understanding of the importance of and the need to incorporate these indicators.
As risk manager, you are responsible for ensuring your organization minimizes its risks. Your board became aware of this case study and has asked you to create a presentation for the next board meeting where you will present information about this case study and the effects of implementing KPIs and KRIs at Intuit.
Create a PowerPoint® narration report of at least 20 slides based on your findings about this case study along with the message that is delivered based upon this case (not including the cover page and reference page). If you do not own a copy of Microsoft PowerPoint use a comparable slide software or Google Slides (free and accessible from Google.com). In the presentation, address the following from the Intuit ERM program:
· What represents the key performance indicators of the ERM program?
· What represents the key risk indicators of the ERM program?
· What improvements would you make?
· Does this represent an effective risk management program? If not, what is missing? (Support your response with details from the case study and properly cited references.)
· Would this program work for a publicly traded corporation of similar size?
· How important do you view alignment and accountability among a management team?
Make sure to provide a reference slide that provides APA citations of any sources used in the PowerPoint presentation. This slide does not require narration. Written Parameters/Expectations:
· At least 20 slides in length, with each slide having a written narration in Standard English explaining the key ideas in each slide.
· The written narrative presentation should have a highly developed and sustained viewpoint and purpose.
· The written communication.
Controversial Issue in Microbiology Assignment Use of antibacte.docxalfredacavx97
Controversial Issue in Microbiology Assignment
:
Use of antibacterial soaps. Are they helpful? Are they potentially harmful?
Assignment due (uploaded to Acorn) on: Oct 16
Format: Essay (1-2 pages, double spaced plus references)
The assignment should include:
- a discussion of a controversial issue in microbiology (in list provided or propose an idea to me)
- literature supporting / denying the controversial issue
- your ideas on the issue
- the real world relevance of the issue
- a list of references (primary literature should be the majority of your sources and each idea mentioned should be cited)
.
Control measures for noncommunicable disease may start with basic sc.docxalfredacavx97
Control measures for noncommunicable disease may start with basic screening initiatives and end with the development and implementation of preventive population-based measures and activities.
As a newly trained Epidemic Intelligence Service (EIS) officer, you are asked to develop a population-based prevention program for a chronic disease.
Identify a chronic disease that can be detected through screening. Describe how screening influences and enhances prevention. Discuss how and where you would implement a screening initiative and who would be the core or target population.
.
Contrasting Africa and Europes economic development.Why did Europ.docxalfredacavx97
Contrasting Africa and Europe's economic development.
Why did Europe develop more quickly than Africa?
Using the text book and/or lecture notes:
list and explain 5 advantages Europe possessed that Africa lacked in its economic development.
Minimum requirement 1 (one) page, typed, doubled spaced.
due 10/26 noon LAtime
.
Measure the dependence of the resistance in the spinel Lu2V2O7 on .docxalfredacavx97
Measure the dependence of the resistance in the spinel Lu2V2O7 on ionic liquid doping
"I Have a Dream," Address Delivered at the March on Washington for Jobs and Freedom
Author:
King, Martin Luther, Jr. (Southern Christian Leadership Conference)
Date:
August 28, 1963
Location:
Washington, D.C.
Genre:
Audio
Speech
Topic:
March on Washington for Jobs and Freedom, 1963
Audio:
Listen to Audio
Details
In his iconic speech at the Lincoln Memorial for the 1963 March on Washington for Jobs and Freedom, King urged America to "make real the promises of democracy." King synthesized portions of his earlier speeches to capture both the necessity for change and the potential for hope in American society.
I am happy to join with you today in what will go down in history as the greatest demonstration for freedom in the history of our nation. [applause]
Five score years ago, a great American, in whose symbolic shadow we stand today, signed the Emancipation Proclamation. This momentous decree came as a great beacon light of hope to millions of Negro slaves [Audience:] (Yeah) who had been seared in the flames of withering injustice. It came as a joyous daybreak to end the long night of their captivity. (Hmm)
But one hundred years later (All right), the Negro still is not free. (My Lord, Yeah) One hundred years later, the life of the Negro is still sadly crippled by the manacles of segregation and the chains of discrimination. (Hmm) One hundred years later (All right), the Negro lives on a lonely island of poverty in the midst of a vast ocean of material prosperity. One hundred years later (My Lord) [applause], the Negro is still languished in the corners of American society and finds himself in exile in his own land. (Yes, yes) And so we’ve come here today to dramatize a shameful condition.
In a sense we’ve come to our nation’s capital to cash a check. When the architects of our republic wrote the magnificent words of the Constitution and the Declaration of Independence (Yeah), they were signing a promissory note to which every American was to fall heir. This note was a promise that all men, yes, black men as well as white men (My Lord), would be guaranteed the unalienable rights of life, liberty, and the pursuit of happiness. It is obvious today that America has defaulted on this promissory note insofar as her citizens of color are concerned. (My Lord) Instead of honoring this sacred obligation, America has given the Negro people a bad check, a check which has come back marked insufficient funds. [enthusiastic applause] (My Lord, Lead on, Speech, speech)
But we refuse to believe that the bank of justice is bankrupt. (My Lord) [laughter] (No, no) We refuse to believe that there are insufficient funds in the great vaults of opportunity of this nation. (Sure enough) And so we’ve come to cash this check (Yes), a check that will give us upon demand the riches of freedom (Yes) and the security of justice. (Yes Lord) [enthusiastic applause]
.
Measures of Similaritv and Dissimilaritv 65the comparison .docxalfredacavx97
The document discusses measures of similarity and dissimilarity between data objects. It defines similarity and dissimilarity, and how they are related. It describes how to measure proximity between objects with a single attribute, including nominal, ordinal, interval and ratio attributes. It also discusses various dissimilarity measures between data objects with multiple attributes, including distances like Euclidean distance.
MDS 4100 Communication Law Case Study Privacy CASE .docxalfredacavx97
MDS 4100 Communication Law
Case Study: Privacy
CASE STUDY: PRIVACY
You are a reporter for WKRN-TV, covering local police activity as part of your beat. Your editor
tells you to get over to McGavock High School as quickly as possible. An anonymous caller,
saying she lives across the street from the public school, told a news editor she heard four or
five gunshots coming from the school building as she was outside walking her dog. Within
seconds, she says, students were running outside and screaming. A listen to the police band
receiver in the newsroom indicates something is up at the school.
You take a videographer and arrive on the scene about 1:30 p.m. Five or six Metro police cars
are parked near the school, and an ambulance arrives seconds later as you get out of your car.
The entrance to the school building is blocked off and police are guarding the area, admitting no
one except authorities into the building.
After questioning police, you confirm the fact there has been a shooting, but that’s as far as you
get. You begin asking bystanders for more information. A number of McGavock students have
remained at the scene. Several tell you a student was shot in a first-floor restroom. A girl who
claims to be a friend of the victim says his name is James DeVore, a freshman. She said she
thinks he is 14 years old. Another student says DeVore recently turned 15.
No one present knows who is responsible for the shooting. Minutes later police escort a young
man, handcuffed, from the school building. They place him in a squad car and drive away. You
ask people in the crowd if anyone can identify the alleged suspect. At least four tell you he is
Brian Samuels, a sophomore. You ask police at the scene to confirm this information, but no one
will reply.
Your videographer tells you she got footage of the boy being placed in the squad car. While
talking to her, you hear screams in the background. You run around the side of the building to
the loading dock area. Police have taped off the immediate area but you can see what’s going
on. EMTs are wheeling the covered body of the victim to an ambulance waiting near the dock.
Some students are crying. The videographer gets shots of the body being placed into the
ambulance and close-ups of crying students.
You approach several police officers standing near a squad car, hoping to get more facts. Inside
the squad car an officer is radioing into police headquarters. You hear him saying “the victim is
James DeVore, age 15.” The officer radios that the suspect, Samuels, has admitted to the
shooting. You also hear the following: “Samuels said it was it was payback, that DeVore had
sexually assaulted Samuels’ 6-year-old sister.” Because you are under deadline, you decide not
to interview the officers personally and head back to the station.
When you get back to the station, a colleague tells you he covered a story two years ago on
another in.
Walmart Business+ and Spark Good for Nonprofits.pdfTechSoup
"Learn about all the ways Walmart supports nonprofit organizations.
You will hear from Liz Willett, the Head of Nonprofits, and hear about what Walmart is doing to help nonprofits, including Walmart Business and Spark Good. Walmart Business+ is a new offer for nonprofits that offers discounts and also streamlines nonprofits order and expense tracking, saving time and money.
The webinar may also give some examples on how nonprofits can best leverage Walmart Business+.
The event will cover the following::
Walmart Business + (https://business.walmart.com/plus) is a new shopping experience for nonprofits, schools, and local business customers that connects an exclusive online shopping experience to stores. Benefits include free delivery and shipping, a 'Spend Analytics” feature, special discounts, deals and tax-exempt shopping.
Special TechSoup offer for a free 180 days membership, and up to $150 in discounts on eligible orders.
Spark Good (walmart.com/sparkgood) is a charitable platform that enables nonprofits to receive donations directly from customers and associates.
Answers about how you can do more with Walmart!"
Main Java[All of the Base Concepts}.docxadhitya5119
This is part 1 of my Java Learning Journey. This Contains Custom methods, classes, constructors, packages, multithreading , try- catch block, finally block and more.
This document provides an overview of wound healing, its functions, stages, mechanisms, factors affecting it, and complications.
A wound is a break in the integrity of the skin or tissues, which may be associated with disruption of the structure and function.
Healing is the body’s response to injury in an attempt to restore normal structure and functions.
Healing can occur in two ways: Regeneration and Repair
There are 4 phases of wound healing: hemostasis, inflammation, proliferation, and remodeling. This document also describes the mechanism of wound healing. Factors that affect healing include infection, uncontrolled diabetes, poor nutrition, age, anemia, the presence of foreign bodies, etc.
Complications of wound healing like infection, hyperpigmentation of scar, contractures, and keloid formation.
This presentation includes basic of PCOS their pathology and treatment and also Ayurveda correlation of PCOS and Ayurvedic line of treatment mentioned in classics.
LAND USE LAND COVER AND NDVI OF MIRZAPUR DISTRICT, UPRAHUL
This Dissertation explores the particular circumstances of Mirzapur, a region located in the
core of India. Mirzapur, with its varied terrains and abundant biodiversity, offers an optimal
environment for investigating the changes in vegetation cover dynamics. Our study utilizes
advanced technologies such as GIS (Geographic Information Systems) and Remote sensing to
analyze the transformations that have taken place over the course of a decade.
The complex relationship between human activities and the environment has been the focus
of extensive research and worry. As the global community grapples with swift urbanization,
population expansion, and economic progress, the effects on natural ecosystems are becoming
more evident. A crucial element of this impact is the alteration of vegetation cover, which plays a
significant role in maintaining the ecological equilibrium of our planet.Land serves as the foundation for all human activities and provides the necessary materials for
these activities. As the most crucial natural resource, its utilization by humans results in different
'Land uses,' which are determined by both human activities and the physical characteristics of the
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changes, conversion trends, and other related patterns. The spatial dimensions of land use and
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9
Changes in vegetation cover refer to variations in the distribution, composition, and overall
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Date: May 29, 2024
Tags: Information Security, ISO/IEC 27001, ISO/IEC 42001, Artificial Intelligence, GDPR
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May 2017 Summary of the American Health Care Act T.docx
1. May 2017
Summary of the American Health Care Act
This summary describes key provisions of H.R. 1628, the
American Health Care Act, as approved by the House
of Representatives on May 4, 2017, as a plan to repeal and
replace the Affordable Care Act (ACA) through the
Fiscal Year 2017 budget reconciliation process.
American Health Care Act
H.R. 1628
Date plan
announced
March 6, 2017; passed by the House of Representatives on May
4, 2017
Overall
approach
2. actuarial values (2020),
and, premium and cost sharing subsidies (2020).
-2019 to increase
amount for younger
adults and reduce for older adults; allow tax credits to apply to
coverage sold outside
of exchanges and to catastrophic policies. In 2020, replace
ACA income-based tax
credits with flat tax credits adjusted for age. Eligibility for new
tax credits phases out
at income levels between $75,000 and $115,000
guarantee issue coverage,
prohibition on pre-existing condition exclusions, requirement to
extend dependent
coverage to age 26. Modify age rating limit to permit variation
of 5:1, unless states
adopt different ratios, effective 2018. Retain essential health
benefits requirement,
with state option to waive. Retain prohibition on health status
rating with state
option to waive for individual market applicants who have not
maintained continuous
3. coverage.
Enrollment periods (OE), and
special enrollment periods (SEPs).
alty for people who don’t stay
continuously covered.
funding of $115 billion over
9 years available to all states, and additional funding of $8
billion over 5 years for
states that elect community rating waivers. States may use
funds to provide financial
help to high-risk individuals, promote access to preventive
services, provide cost
sharing subsidies, and for other purposes. In 2020, $15 billion
of funds shall be used
only for services related to maternity coverage and newborn
care, and mental health
and substance use disorders. [For 2018-2026, a further $15
billion is allocated
through the fund for Federal Invisible Risk Sharing Program
(reinsurance). This
program is established as part of the fund, though administered
by CMS to make
4. payments directly to health insurers.] In states that don’t
successfully apply for
grants, funds will be used for reinsurance program.
und at the
end of Fiscal Year
2018 and rescind any unobligated funds remaining at the end of
FY 2018. Provide
supplemental funding for community health centers of $422
million for FY 2017
annual tax free
contribution limit and through other changes
adopted the
expansion as of March 1, 2017, and sunset enhanced FMAP for
those states as of
January 1, 2020 except for beneficiaries enrolled as of
December 31, 2019 who
do not have a break in eligibility of more than 1 month.
Summary of the American Health Care Act 2
5. and limit growth in
federal Medicaid spending beginning in 2020 using 2016 as a
base year; provide
state option to receive a block grant for nonexpansion adults
and children or only
nonexpansion adults.
for nondisabled,
nonelderly, nonpregnant Medicaid adults.
clinics.
provider/Medicare Advantage
plan payment savings.
A revenue
provisions.
Individual
mandate
6. eliminated effective January
1, 2016
premium) applies for individuals
buying non-group coverage who have not maintained continuous
creditable coverage.
Current law definition of creditable coverage includes group
health plan, health
insurance coverage (including short-term non-renewable
coverage), Medicare,
Medicaid, TriCare, Indian Health Service, state high risk pool,
FEHBP, other public plan
coverage, and coverage for Peace Corps workers. Continuous
coverage is assessed
during a 12-month look back period prior to the date of
enrollment in new coverage.
If individual had a lapse in coverage of 63 consecutive days or
longer during the look
back period, late enrollment penalty applies during the plan
year in which the
individual enrolls in non-group coverage. (For SEP, penalty
applies for the remainder
of the plan year). Late enrollment penalty is effective for
special enrollments during
7. the 2018 plan year, for all other enrollments beginning with the
2019 plan year.
Private health plans continue to be required by law to provide
certificates of creditable
coverage; however, no requirement for governmental programs
(e.g., Medicaid, CHIP,
state high-risk pools) to provide such certificates.
Premium
subsidies to
individuals
-2019, modify premium tax credits as follows:
- Increase credit amounts for young adults with income above
150% FPL and
decrease amounts for adults 50 and older above that income
level.
- For end of year reconciliation of advance credits, the cap on
repayment of
excess advance payments does not apply.
- Tax credits cannot be used for plans that cover abortion.
- Premium tax credits can be used to purchase catastrophic
plans.
8. - Premium tax credits can be used to purchase qualified health
plans (i.e.,
covering essential health benefits) sold outside of the exchange,
but are not
advance-payable for such plans. Premium tax credits cannot be
used to
purchase short term policies or grandfathered or grandmothered
individual
health insurance policies sold outside of the exchange.
eplace ACA income-based tax credits with
flat tax credit adjusted
for age. Credits are payable monthly; annual credit amounts
are:
- $2,000 per individual up to age 29
- $2,500 per individual age 30-39
- $3,000 per individual age 40-49
- $3,500 per individual age 50-59
- $4,000 per individual age 60 and older
Families can claim credits for up to 5 oldest members, up to
limit of $14,000 per
year.
Amounts are indexed annually to CPI plus 1 percentage point.
9. U.S. citizens and legal immigrants who are not incarcerated and
who are not eligible
for coverage through an employer plan, Medicare, Medicaid or
CHIP, or TRICARE, are
eligible for tax credit. Married couples must file jointly to claim
the credit. In
addition, eligibility for the tax credit phases out starting at
income above $75,000
Summary of the American Health Care Act 3
(credit is reduced, but not below zero, by 10 cents for every
dollar of income above
this threshold; tax credit reduced to zero at income of $95,000
for single individuals
up to age 29, $115,000 for individuals age 60 and older. For
joint filers, credits begin
to phase out at income of $150,000; tax credit reduced to zero at
income of
$190,000 for couples up to age 29; tax credit reduced to zero at
income $230,000
for couples age 60 or older; tax credit reduced to zero at income
10. of $290,000 for
couples claiming the maximum family credit amount.)
Taxpayers who are also enrolled in qualified small employer
health reimbursement
arrangements (HRA) that apply to non-group coverage will have
tax credit reduced,
but not below zero, by the amount of the HRA benefit.
health insurance policy
(but not grandfathered or grandmothered policies or short term
policies) sold on or
off the exchange. Eligible policies do not include those for
which substantially all
coverage is for excepted benefits; policies that cover abortion
(with Hyde exceptions)
are not eligible policies. States shall certify plans eligible for
the credit. The federal
government must establish a program for making advance
payment of tax credits no
later than January 1, 2020; to the greatest extent practicable the
program will use
methods and procedures used for the ACA advance payable
premium tax credit.
11. Cost sharing
subsidies to
individuals
2020.
Individual
health
insurance
market rules
non-group health plans during
annual open
enrollment. Insurers also must offer 60-day special enrollment
periods (SEP) for
individuals after qualifying events. Short-term non-renewable
policies can continue to
be sold using medical underwriting.
permitted starting January 1,
2018, unless states adopt a different ratio. However, states that
use Patient and State
Stability Fund grants for high risk pools or reinsurance, or that
12. participate in the
Federal Invisible Risk Sharing Program, can apply to waive
community rating (thus
permitting health status as a rating factor) for individual market
participants who do
not maintain continuous coverage. Short-term non-renewable
policies can continue to
set premiums based on health status.
-existing condition exclusion periods is not
changed. Short term
non-renewable policies can continue to exclude pre-existing
conditions
Benefit
design
cover 10 essential health benefit
categories is not changed;
however, starting in 2020, states may apply for waivers to re-
define essential health
benefits for health insurance coverage offered in the individual
or small group
market. ACA requirement for maximum out-of-pocket limit on
cost sharing is not
13. changed. ACA requirement for plans to be offered at specified
actuarial values/metal
levels sunsets on 12/31/2019.
changed; however, the
prohibition applies to limits on essential health benefits, which
can be changed under
state waiver authority
preventive benefits with no cost
sharing is not changed.
all plans to apply in-network level of cost
sharing for out-of-network
emergency services is not changed
premium tax credits cannot
be applied to plans that cover abortion services, beyond those
for saving the life of
the woman or in cases of rape or incest (Hyde amendment).
Nothing prevents an
insurer from offering or an individual from buying separate
policies to cover abortion
as long as no premium tax credits are applied.
14. Women’s
health
small group health
insurance policies is not changed, including requirement to
cover maternity care as an
essential health benefit; however, EHB can be changed under
state waiver authority.
preventive benefits, such as
contraception and cancer screenings, with no cost sharing is not
changed.
Summary of the American Health Care Act 4
is not changed
-existing conditions exclusions, including
for pregnancy, prior C-
section, and history of domestic violence, is not changed.
clinics for one year,
15. effective upon date of enactment. Specifies that federal funds to
states including
those used by managed care organizations under state contract
are prohibited from
going to such entity.
would no longer be a
mandatory covered service.
abortion services,
beyond those for saving the life of the woman or in cases of
rape or incest (Hyde
amendment), effective in 2018
ederal premium tax credits from being applied to
plans that cover abortion
services, beyond Hyde limitations. Disqualify small employers
from receiving tax
credits if their plans include abortion coverage beyond Hyde
limitations, effective in
2018. Does not prevent an insurer from offering or an individual
from buying
separate policies to cover abortion as long as no tax credits are
applied.
16. Health
Savings
Accounts
(HSAs)
2018 unless otherwise
noted:
- Increase annual tax free contribution limit to equal the limit
on out-of-pocket
cost sharing under qualified high deductible health plans
($6,550 for self only
coverage, $13,100 for family coverage in 2017, indexed for
inflation).
- Additional catch up contribution of up to $1,000 may be made
by persons
over age 55. Both spouses can make catch up contributions to
the same HSA.
- Amounts withdrawn for qualified medical expenses are not
subject to income
tax. Qualified medical expense definition expanded to include
over-the-
counter medications and expenses incurred up to 60 days prior
17. to date HSA
was established
- Tax penalty for HSA withdrawals used for non-qualified
expenses is reduced
from 20% to 10%, effective January 1, 2017.
High-risk
pools
high-risk pools, and for
other purposes
new “Federal Invisible Risk
Sharing Program,” (FIRSP), a reinsurance program, which CMS
will establish to offset
claims costs of certain high-risk individuals covered by
participating individual health
insurance companies. CMS will establish a process for states to
operate the program
beginning in 2020.
2026), plus any other
unallocated funds under the Patient and State Stability Fund
18. (see below). FIRSP will be
administered by CMS and will make direct payments to health
insurers in all states.
Neither State application nor matching funding appear to be
required for FIRSP. No
later than 60 days after date of enactment, CMS will establish
parameters for FIRSP to
operate starting in 2018. Parameters shall include:
- Health status statements will be developed to identify eligible
individuals
- In addition, a list of health conditions will be developed;
individuals diagnosed
with listed conditions will be automatically eligible individuals
- Health insurers in the individual market may voluntarily
qualify other
individuals for the program
- Health insurers will pay a percentage (to be determined by
CMS) of the
premium for eligible individuals to FIRSP
- CMS will designate a dollar threshold for claims for eligible
individuals, and a
proportion of claims above that threshold, that FIRSP will pay
to health
19. insurers.
- CMS will also designate a process states can use to take over
operation of
FIRSP within their states starting in 2020
Summary of the American Health Care Act 5
FIRSP funds cannot be used to pay for any abortion or to assist
in the purchase, in
whole or in part, of health benefit coverage that includes
coverage of abortion, except
if the abortion is needed to save the life of the woman or if the
pregnancy resulted
from rape or incest.
Selling
insurance
across state
lines
20. Exchanges/
Insurance
through
associations
used for eligible non-
group policies regardless of whether they are sold through an
exchange. Through
2019, tax credits are only advance payable for policies
purchased through an
exchange.
after January 1, 2014 is
not changed.
Dependent
coverage to
age 26
to age 26 for all
individual and group policies is not changed.
Other private
21. insurance
standards
edical loss ratio standards for all health plans are
not changed.
review is not changed.
provide standard, easy-
to-read summary of benefits and coverage are not changed.
Employer
requirements
and
provisions
benefits is reduced to
zero, retroactive to January 1, 2016
ed under the ACA are not changed
-wage small employers, effective
January 1, 2020. Prohibit
small business tax credits from being used to purchase plans
that cover abortions
22. beyond Hyde limitations, effective in 2018
Medicaid
Financing
January 1, 2020 consisting
of “expansion enrollees” and “grandfathered enrollees”;
eliminate option to extend
coverage to adults above 133% FPL effective December 31,
2017; limit the enhanced
match for the Medicaid expansion to 133% FPL to states that
adopted expansion as of
March 1, 2017, and sunset enhanced FMAP for those states as
of January 1, 2020
(except for grandfathered enrollees who were enrolled through
the Medicaid
expansion as of December 31, 2019 and who do not have a
break in eligibility of
more than one month).
- Limit the “expansion state” enhanced match rate transition
percentage to CY
2017 levels of 80% (instead of phasing up the match to equal
the ACA
enhanced match rate by 2020).
23. beginning in FY 2020.
- Per enrollee caps for five enrollment groups—elderly, blind
and disabled,
children, expansion adults, and other adults—are based on 2016
expenditures
(excluding administrative costs, DSH, Medicare cost-sharing,
and safety net
provider payment adjustments in non-expansion states, and
certain categories
of individuals, including CHIP, those receiving services through
Indian Health
Services, those eligible for Breast and Cervical Cancer services,
and partial-
benefit enrollees) divided by full-year equivalent enrollees in
each category
and trended forward to 2019 by medical CPI.
- For states opting to adopt the Medicaid expansion after 2016,
the per enrollee
amount for this group would be the same as the other adult
group under the
per capita cap.
- Per enrollee amounts are adjusted to exclude non-DSH
24. supplemental
payments
- The target expenditures in 2020 are calculated based on the
2019 per
enrollee amounts for each enrollment group adjusted for non-
DSH
Summary of the American Health Care Act 6
supplemental payments and increased by an inflationary factor
multiplied by
the number of enrollees in each group. In 2021 and beyond, per
enrollee
amounts are based on the prior year amounts increased by an
inflationary
factor. The inflationary factor for the elderly and blind/disabled
groups is
medical CPI plus 1 percentage point. The inflationary factor for
children,
expansion adults, and other adults is medical CPI.
- States with medical assistance expenditures exceeding the
target amount for a
25. fiscal year will have payments in the following fiscal year
reduced by the
amount of the excess payments.
expenditures by the amount of
certain expenditures required by political subdivisions of
certain states that are
unreimbursed by the state beginning in FY 2020 – as written
appears to apply only to
New York.
1
capita cap for certain
populations for a period of 10 fiscal years, beginning in FY
2020 – if option is not
extended at the end of 10 FY period, per capita cap provisions
apply.
- States may elect block grant for children and nonexpansion
adults or only for
nonexpansion adults. States can set conditions of eligibility
(except that
states must cover mandatory pregnant women and children and
infants born
26. to eligible pregnant woman for1 year, depending on the
category elected),
- Block grant payments shall only be used for “block grant
health care
assistance” instead of “medical assistance” under Title XIX
(Medicaid). States
must provide hospital care, surgical care and treatment, medical
care and
treatment, obstetrical and prenatal care and treatment,
prescribed drugs,
medicines, and prosthetic devices, other medical supplies and
services, and
for children under 18, health care (but not Early, Periodic,
Screening,
Diagnosis and Treatment services). States determine cost
sharing and delivery
system. Federal Medicaid requirements for statewideness,
amount, duration,
and scope, reasonable standards for determining eligibility for
and the extent
of medical assistance, and free choice of provider do not apply.
- The total block grant amount for the initial FY is based on the
state’s target
27. per capita medical assistance expenditures for the FY multiplied
by the
number of enrollees in the category(ies) elected and the federal
average
medical assistance matching rate for the state for FY 2019. In
subsequent
FYs, the total block grant amount for the prior FY is increased
by annual CPI
for urban consumers. The federal portion of block grant funds
payable to
states is based on the CHIP enhanced FMAP, with the state
funding the
difference. States can rollover unused block grant funds into
the next FY as
long as they continue to elect the block grant option. States
must contract
with an independent entity to audit its expenditures for each FY
to ensure
spending is consistent with these provisions.
- State must submit plan to Secretary, which is deemed
approved unless
Secretary determines within 30 days that plan is incomplete or
actuarially
unsound.
28. FY 2018 and FY 2019 and
increase other administrative matching to 60% for expenses
related to implementing
new data requirements.
d DSH cuts for FY2020 - FY2025; exempt
non-expansion states from
DSH cuts for FY2018 - FY 2019
– FY 2022) to non-
expansion states for
safety-net funding (applies to states not adopting the expansion
by July 1 of the
previous year). Allotments based on the number of individuals
in the State with
income below 138% of FPL in 2015 relative to the total number
of individuals with
income below 138% of FPL for all the non-expansion States in
2015. Payments 100%
funded by the federal government in FY 2018-2021 and 95% in
FY 2022. Payments to
providers may not exceed providers’ costs in providing health
care services to
29. Summary of the American Health Care Act 7
Medicaid and uninsured patients. States receiving these funds in
a year in which they
also adopt expansion shall no longer be eligible to receive these
funds in any
subsequent year.
Other Changes
eligibility for nondisabled,
nonelderly, nonpregnant Medicaid enrollees as of October 1,
2017, by participating in
work activities as defined in the TANF program
2
for a period of time as determined by
the state and as directed and administered by the state.
- Exempts pregnant women through 60-days post-partum,
children under 19,
individuals who are only parent/caretaker relative in family of
child under age
6 or child with disability, and individuals under age 20 who are
30. married or
head of household and maintain satisfactory attendance at
secondary school
or equivalent or participate in education directly related to
employment.
- Provides 5% enhanced federal matching funds for activities
carried out by the
state and approved by the Secretary to implement work
requirement.
receiving alternative
benefit packages, including the expansion group, as of
December 31, 2019.
children ages 6-19 as of
December 31, 2019. The minimum federal income eligibility
limit for these children
will revert to 100% FPL.
presumptive eligibility for
expansion adults, effective January 1, 2020
l enhanced FMAP for the Community First Choice
Option to provide attendant
31. care services effective January 1, 2020
one year, effective upon
date of enactment
r lottery winnings (and other lump
sum payments including
gambling winnings and liquid assets from an estate) as income
over a period of
months in determining Medicaid ineligibility for individual and
spouse beginning,
January 1, 2020. Secretary can establish hardship criteria and
state can intercept
lottery winnings for Medicaid recoupment.
-month retroactive coverage requirement (start
eligibility “in or after” the
month of application) beginning October 1, 2017.
es to limit home equity to federal minimum
(removes the option to
expand the limit from $500,000 to $750,000 (adjusted for CPI),
effective six months
after the bill is enacted or longer if states must pass legislation
to change.
y redeterminations every 6 months for
32. expansion enrollees beginning
October 1, 2017. Expands civil monetary penalties up to
$20,000 per individual for
intentionally claiming Medicaid matching funds for an
individual not eligible for
expansion. Provide a temporary (10/1/17 through 12/31/19) five
percentage point
FMAP increase for expenditures directly related to complying
with this provision.
Medicare
Revenues
December 31, 2022
peal the annual fee paid by branded prescription drug
manufacturers, beginning
after December 31, 2016
retiree drug subsidy
(RDS) payments to provide creditable prescription drug
coverage to Medicare
beneficiaries, beginning after December 31, 2016.
33. Summary of the American Health Care Act 8
Coverage enhancements
-cost preventive benefits;
phased-in coverage in the
Part D coverage gap) are not changed
Reductions to provider and plan payments
Advantage payments
are not changed
Other ACA provisions related to Medicare are not changed,
including:
rts B and D) for higher
income beneficiaries (those
with incomes above $85,000/individual and $170,000/couple).
recommend ways to reduce
Medicare spending if the rate of growth in Medicare spending
exceeds a target
growth rate.
changes, including a new
34. Center for Medicare and Medicaid Innovation to test, evaluate,
and expand methods
to control costs and promote quality of care; Medicare Shared
Savings Accountable
Care Organizations; and penalty programs for hospital
readmissions and hospital-
acquired conditions.
State role
standard of 5:1 applies.
ient and State Stability Fund. Funds can be
used by states for
financial help for high-risk individuals, to stabilize private
insurance premiums,
promote access to preventive services, provide cost sharing
subsidies, for maternity
coverage and newborn care, for mental health and substance use
disorder services,
and for other purposes. In states that do not successfully apply
for grants, funds will
be used for a default reinsurance program, administered by
CMS, that will pay 75% of
claims between $50,000 and 350,000 (starting in 2020, CMS
Administrator can
35. establish different reinsurance rate and claims thresholds.)
Funding available through the Patient and State Stability Fund
includes:
- $100 billion over 9 years ($15 billion per year for 2018-2019,
$10 billion per
year for 2020-2026) for grants to states or for default
reinsurance program;
- $15 billion for a new Federal Invisible Risk Sharing Program
(see below);
- $8 billion over 5 years (2018-2023) for states that elect
community rating
waivers (see below) to provide financial assistance to people
whose premiums
are surcharged based on health status under that waiver;
- $15 billion for the year 2020 to be used solely for maternity
coverage and
newborn care and mental health and substance use disorders.
- State matching funding of 7% required in 2020, phasing up to
50% in 2026. A
different state matching schedule applies for the CMS-
administered default
reinsurance program (10% in 2020, phasing up to 50% in 2024.)
Grants
36. cannot be made to a state unless it agrees to make matching
funds available.
Any remaining funds at year end will be re-allocated to the
Federal Invisible
Risk Sharing Program.
ance
exchange remains, but
premium subsidies are also available for plans sold outside of
exchanges, effective
January 1, 2018.
new “Federal Invisible Risk
Sharing Program,” (FIRSP) funded at $15 billion over 9 years,
plus any other
unallocated funds under the Patient and State Stability Fund.
State application and
matching funding does not appear to be required for FIRSP.
CMS will operate FIRSP
for first two years and establish a process for States to operate
beginning in 2020.
Service Act section 2701.
37. Summary of the American Health Care Act 9
- Starting in 2018 states may apply for waivers to permit age
rating ratios
higher than 5:1 (note, elsewhere, the bill permits states to adopt
any age
rating ratio they want)
- Starting in 2020, states may apply for waivers to redefine
essential health
benefits for health insurance coverage offered in the individual
and small
group market
- Starting in 2019, or for SEP enrollments in 2018, states that
use Patient and
State Stability Fund grants to establish high-risk pools or
reinsurance
programs, or that participate in the FIRSP, may apply for
waiver of the ACA
community rating requirement. Because CMS will operate
FIRSP in all states,
all states would appear to be eligible to apply for the
community rating waiver.
38. Under the waiver, States could allow insurers to use health
status as a rating
factor for applicants in the individual market who have not
maintained
continuous coverage. For these individuals, health status rating
could be used
instead of the 30% late enrollment penalty. The health status
rating would
only apply during the “enforcement period” – generally for one
entire plan
year, or in the case of SEP enrollments, for the remainder of the
plan year.
be granted
for 10 years, then extended, an additional $8 billion in Patient
and
State Stability grants is allocated over 5 years, 2018-2023.
Community
rating waiver states may only use this additional allocation to
provide
assistance to reduce premiums or other out of pocket costs of
individuals who are subject to health status rating under the
waiver.
39. States are not required to completely offset health status rating
surcharges, nor are they required to establish high-risk pools for
these
individuals.
- State waiver applications would be deemed approved within
60 days of
submission unless the Secretary denies the application.
Applications must
specify how the waiver would achieve at least one of the
following goals:
reduce average health insurance premiums, increase health
coverage
enrollment, stabilize the health insurance market, stabilize
premiums for
people with pre-existing conditions, or increase choice of health
plans.
- State waiver programs (to change age rating bands, redefine
essential health
benefits, or apply health status rating in the individual market)
cannot apply
with respect to the following ACA provisions
CO-OP
40. plans, multi-state plans, or to ACA innovation waivers (Section
1332),
Basic Health Plan programs (Section 1331), interstate compact
programs (Section 1333).
1312(d)(3)(D) of ACA, which requires the federal government
to
provide health benefits to Members of Congress through health
plans
created under the ACA or offered through Exchanges. Note that
separate, self-executing legislation, proposed by Rep. McSally,
would
eliminate this provision upon enactment of the AHCA.
is not
changed, and is not funded.
retained, though federal
subsidy funding that would flow through BHP would be
reduced. State option to
obtain a five-year waiver of certain ACA health insurance
requirements (Section 1332
waiver) is not changed.
41. Federal matching funds
available up to the federal cap with the choice of a per capita
cap or block grant for
certain populations.
Financing
otherwise noted:
- Tax penalties associated with individual and large employer
mandate, reduced
to zero effective on January 1, 2016
The Henry J. Kaiser Family Foundation Headquarters: 2400
Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center:
1330 G Street, NW, Washington, DC 20005 | Phone 202-347-
5270
www.kff.org | Email Alerts: kff.org/email |
facebook.com/KaiserFamilyFoundation |
twitter.com/KaiserFamFound
42. Filling the need for trusted information on national health
issues, the Kaiser Family Foundation is a nonprofit organization
based in Menlo Park, California.
- Cadillac tax on high-cost employer-sponsored group health
plans is
suspended for tax years 2020 through 2025, no revenues shall
be collected
during this period
- Increase in Medicare payroll tax (HI) rate on wages for high-
wage individuals,
effective January 1, 2023; also 3.8% net investment income tax
on unearned
income for high-income taxpayers
- Tax on tanning beds
- Tax on health insurers
- Tax on pharmaceutical manufacturers
- Excise tax on sale of medical devices
- Provision excluding costs for over-the-counter drugs from
being reimbursed
through a tax preferred health savings account (HSA)
- Provision increasing the tax (from 10% to 20%) on HSA
distributions that are
not used for qualified medical expenses.
- Annual limit on contributions to Flexible Spending Accounts
(FSAs) repealed
- Annual limit on deduction for salary in excess of $1 million
43. paid to employees
of publicly held corporations repealed
- Income threshold for medical expense deduction reduced from
10% to 5.8%
dicaid funding capped, effective FY 2020;
enhanced match for Medicaid
expansion population eliminated beginning January 1, 2020; and
Medicaid DSH cuts
repealed, effective FY 2020
administration of the
premium tax credit changes, Patent and State Stability Fund,
Medicaid changes, and
other implementation responsibilities.
Endnotes
1
State must have had FY 2016 DSH allotment more than six
times the national
average. Contributions required by the state from political
subdivisions that, as of
the 1
st
day of the CY in which the FY begins, has a population of
more than 5,000,000
44. and imposes a local income tax and those for administrative
expenses if required as
of January 1, 2107 are included.
2
Work activities under the TANF program include unsubsidized
employment,
subsidized private sector employment, subsidized public sector
employment, work
experience (including refurbishing publicly assisted housing) if
sufficient private
sector employment is not available, on-the-job training, job
search and job readiness
assistance, community service programs, vocational educational
training (not to
exceed 12 months for any individual), job skills training
directly related to
employment, education directly related to employment for those
who have not
received a high school diploma or certificate of high school
equivalency, satisfactory
attendance at secondary school or in a general equivalency
certificate course for
those who have not already completed, and provision of child
45. care services to an
individual participating in a community service program.
Sources of
information
https://www.congress.gov/115/bills/hr1628/BILLS-
115hr1628eh.pdf
https://www.congress.gov/115/bills/hr1628/BILLS-
115hr1628eh.pdf