What's the difference between fraud, waste and abuse when it comes to health care? What is the government doing to prevent fraud, waste and abuse from happening? Learn the definitions and differences in these legal terms and how CMS has worked to prevent these from happening since its inception in 1965.
What's the difference between fraud, waste and abuse when it comes to health care? What is the government doing to prevent fraud, waste and abuse from happening? Learn the definitions and differences in these legal terms and how CMS has worked to prevent these from happening since its inception in 1965.
Heritage Foundation has issued a set of five simple actions Congress must take in order to meet the electoral mandate of the American people. These five priorities represent the bare minimum of what is expected of our new representatives.
Health Reform Bulletin – Implementation Update: Women’s Preventive Health Se...CBIZ, Inc.
The women’s health services component of the Affordable Care Act’s (ACA) preventive services mandate continues to evolve. As background, the ACA requires non-grandfathered plans to provide specified preventive services at no cost to plan participants. These preventive services require coverage of certain women’s health services including contraceptive coverage. Recent challenges to this requirement have reached the Supreme Court.
Dallas health insurance agent say premium increases are because the cost of c...jthorn4
Rick Thornton, a Dallas health insurance agent, said premium increases are because the cost of care is increasing, adding that there has been a 9.1% increase from when the ACA was first introduced in 2010.
Heritage Foundation has issued a set of five simple actions Congress must take in order to meet the electoral mandate of the American people. These five priorities represent the bare minimum of what is expected of our new representatives.
Health Reform Bulletin – Implementation Update: Women’s Preventive Health Se...CBIZ, Inc.
The women’s health services component of the Affordable Care Act’s (ACA) preventive services mandate continues to evolve. As background, the ACA requires non-grandfathered plans to provide specified preventive services at no cost to plan participants. These preventive services require coverage of certain women’s health services including contraceptive coverage. Recent challenges to this requirement have reached the Supreme Court.
Dallas health insurance agent say premium increases are because the cost of c...jthorn4
Rick Thornton, a Dallas health insurance agent, said premium increases are because the cost of care is increasing, adding that there has been a 9.1% increase from when the ACA was first introduced in 2010.
Running head VERMONT HEALTH CARE REFORM2VERMONT HEALTH CARE.docxtoltonkendal
Running head: VERMONT HEALTH CARE REFORM
2
VERMONT HEALTH CARE REFORM
Vermont Health Care Reform
Yitsy Serrano
Health Care Policy
Florida National University
Vermont Health Care Reform
The Vermont Health Care Reform was established in 2011 after the state government of Vermont enacted a law that allowed for a single-payer system in the United States. This law established a functional first-level single-payer health care system that has since been embraced in other states within the United States of America. The Green Mountain Care allows subscribers of Vermont’s health care reform to receive universal care coverage as well as upgrades to the existing system (William, 2010).
In 2010, the state of Vermont, under the provisions of S88 law passed by the legislature, was allowed to form a commission to study the health care provision and delivery techniques within the state. In this quest, Dr. William Hsiao, a Harvard University professor, who previously had been contracted to advise the Taiwan’s commission during the transition to single-payer system, was enlisted to provide three reform policies for the Vermont health care system. On June, William alongside Steven Kappel and Jonathan Gruber presented the single payer system proposal to the legislature of Vermont.
Following the proposal, H202 was introduced by Senator Mark Larson which the titles as Single-Payer and Unified Health System. On March 24, 2011, the bill was passed with a 94 against 49. Consequently, the Senate passed the bill with a 21 against 9. The Governor, the Vermont State Peter Shumlin, then signed the bill into law on the 26th of May 2011. The Green Mountain Care then followed after the signing of the H202. This was a state-funded insurance pool that was established to provide universal care to residents with the aim of reducing spending on health care.
It is important to note the Vermont Health Care Reform was established without a structured framework of funding and this is one of the reasons why it failed. The issue of paying for the reform became an issue when the prospective bodies failed to provide enough revenues to fund the program. The idea of funding the program was to increase the Medicaid funding by three percent and use the proceeds to set up the funding infrastructure for the Vermont Health Care Reform.
Holding other factors constant, the Vermont Health Care Reform was a sound idea. However, with political barriers and mismanagement, the reform did not pick up as expected. The failure of the Green Mountain Care significantly contributed to the fall of the program. The complexity and size of the initiative demanded a functional funding structure and a focused management system to ensure its full implementation (Joe, 2017).
However, the rise and fall of the Vermont Health Care reform have been a learning experience for most states as well as the federal government when it comes to implementing a reform of such a nature. The idea does not only revolve around th ...
Running Head ROLE OF EXECUTIVE ORDER IN ACARole of Executiv.docxtodd521
Running Head: ROLE OF EXECUTIVE ORDER IN ACA
Role of Executive Order in ACA
2
Role of Executive Order in ACA
By: Ameki Lee
Dr. White
MPA6501 SU01 State and Local Government and Intergovernmental Relations
Role of Executive Order in ACA
Affordable Act Care has been a significant issue in Texas State for the past seven years. Texas governor, Greg Abbott has been on the frontline in fighting the implementation of the Act in Texas and America. The governor's office claims that the penalties related to avoiding the Act are unconstitutional and not democratic (Toussaint, 2017). Furthermore, the Governor argues that the Affordable Care Act should be put on halt while the cause is being liquidated. However, the governor does not concentrate on improving the policy rather than doing away with it. Greg Abbott believes the pre-existing conditions are the major barriers for the effectiveness of the act. The Affordable Care Act allows people to purchase the policy even with pre-existing conditions. In favor of the governor, the act should limit the purchase of the act during such conditions with the aim of reducing the cost as well as the rates of insurance. Therefore, an appeal can be made based on the governors value since most Americans are complaining about the same issue (Toussaint, 2017).
Affordable Act Care was implemented under the executive administrative policy. In America, an executive order is directed by the president on the managers of various federal governments with the aim of forcing policy to law. In 2013, former president of America Barack Hussein Obama issued a directive on the implementation of the Affordable Care Act (Rovner, 2018). The current President, Donald Trump began fighting the Act by attacking the executive committee and even dismantling it. An executive order is written, signed and published by the president's office and directed to various federal departments. The Executive order directed all agencies responsible under the Affordable Care Act provision that will provide a regulatory and fiscal burden on entities that will be reluctant on adopting a policy. Also, the Executive Order directs the same agencies to offer greater flexibilities and collaboration on implementing such healthcare policies.
Since the implementation of the Affordable Care Act in 2010, the policy has suffered various criticisms in its debate. For those who believed that the primary goal of the Act was to make insurance more affordable didn’t achieve their purpose. However, the policy has caused more Americans to have access to medical insurance hence fostering a healthy nation. Since the Act is applicable in improving the public health of all Americans, it includes various resources in healthcare like materials, funds, personnel and other things that can be utilized in the provision of healthcare service. The act is also responsible for ensuring all medical care institutions have the necessary resource for effective operations (Ba.
Running head MASSACHUSETTS’ HEALTHCARE REFORMS1MASSACHUSE.docxglendar3
Running head: MASSACHUSETTS’ HEALTHCARE REFORMS 1
MASSACHUSETTS’ HEALTHCARE REFORMS 3
Memo
To: Prof. Thomas Smith
From: Student- Jane Doe
Reference: Health Care Policy
Date: March 18, 2018
Subject: Massachusetts’ Healthcare Reform Act
Massachusetts’ Healthcare Reform Act
Rationale
Massachusetts State is among the states that have made a number of attempts aimed at reforming the state's healthcare system to make access to quality healthcare available for its residents. Recently in 2006, Massachusetts passed the Healthcare Reform Act, which was later, signed into law by former Governor Mitt Romney (Van der Wees et al., 2013). The rationale for this healthcare reform was to provide near-universal health insurance coverage for Massachusetts’ residents.
Adoption of the Reform
The Massachusetts Healthcare Reform Act was passed by the State legislators after years of negotiation between Mitt Romney and the legislators with a compromise reached in 2006 resulting in the enactment of the reform that was effectively signed into law by Romney on 12 April 206. The reform has made several changes to its healthcare system in a move aimed at achieving a near-universal healthcare coverage for the residents of the state. The first change was made to the state's Medicaid program that was broadened by providing a MassHealth waiver, extending health insurance coverage to children in low-income families with up to 300% of the federal poverty level (FPL) (Kaiser Family Foundation, 2012). Massachusetts created what is called Commonwealth Care, which provides the residents of the state with access to subsidized health insurance for eligible individuals with earnings below 300% of FPL. Under this new healthcare reform, individuals with income below 150% of FPL also have the option of selecting a plan without a monthly premium and low-cost sharing. However, eligible individuals with earnings falling between 150-300% PL are subsidized by the state using a sliding scale.
The Massachusetts Healthcare Reform Act also saw the state expand its Insurance Partnership Program by providing incentives and subsidies to the employers to give and workers to enroll in the state's employer-sponsored insurance. In this respect, Massachusetts State subsidized insurance costs for the workers in the state who would otherwise be eligible for programs subsidized by the government. However, small businesses are only eligible for up to $1,000 in support per qualified worker who falls below the 300% FPL (Van der Wees et al., 2013). Under the program, the state government pays the portion of qualified workers' premiums that is equal to what the employees would be expected to pay if employees were on a subsidized plan. Additionally, under this new healthcare reform, any employer in the state who fails to provide health insurance to its workers is expected to pay what is called a ‘fair share' assessment to the government of up to $295 per worker ever.
Running head MASSACHUSETTS’ HEALTHCARE REFORMS1MASSACHUSE.docxtodd581
Running head: MASSACHUSETTS’ HEALTHCARE REFORMS 1
MASSACHUSETTS’ HEALTHCARE REFORMS 3
Memo
To: Prof. Thomas Smith
From: Student- Jane Doe
Reference: Health Care Policy
Date: March 18, 2018
Subject: Massachusetts’ Healthcare Reform Act
Massachusetts’ Healthcare Reform Act
Rationale
Massachusetts State is among the states that have made a number of attempts aimed at reforming the state's healthcare system to make access to quality healthcare available for its residents. Recently in 2006, Massachusetts passed the Healthcare Reform Act, which was later, signed into law by former Governor Mitt Romney (Van der Wees et al., 2013). The rationale for this healthcare reform was to provide near-universal health insurance coverage for Massachusetts’ residents.
Adoption of the Reform
The Massachusetts Healthcare Reform Act was passed by the State legislators after years of negotiation between Mitt Romney and the legislators with a compromise reached in 2006 resulting in the enactment of the reform that was effectively signed into law by Romney on 12 April 206. The reform has made several changes to its healthcare system in a move aimed at achieving a near-universal healthcare coverage for the residents of the state. The first change was made to the state's Medicaid program that was broadened by providing a MassHealth waiver, extending health insurance coverage to children in low-income families with up to 300% of the federal poverty level (FPL) (Kaiser Family Foundation, 2012). Massachusetts created what is called Commonwealth Care, which provides the residents of the state with access to subsidized health insurance for eligible individuals with earnings below 300% of FPL. Under this new healthcare reform, individuals with income below 150% of FPL also have the option of selecting a plan without a monthly premium and low-cost sharing. However, eligible individuals with earnings falling between 150-300% PL are subsidized by the state using a sliding scale.
The Massachusetts Healthcare Reform Act also saw the state expand its Insurance Partnership Program by providing incentives and subsidies to the employers to give and workers to enroll in the state's employer-sponsored insurance. In this respect, Massachusetts State subsidized insurance costs for the workers in the state who would otherwise be eligible for programs subsidized by the government. However, small businesses are only eligible for up to $1,000 in support per qualified worker who falls below the 300% FPL (Van der Wees et al., 2013). Under the program, the state government pays the portion of qualified workers' premiums that is equal to what the employees would be expected to pay if employees were on a subsidized plan. Additionally, under this new healthcare reform, any employer in the state who fails to provide health insurance to its workers is expected to pay what is called a ‘fair share' assessment to the government of up to $295 per worker ever.
Similar to Obama's CMS nominee Slavitt could face rough road to confirmation (20)
Running head MASSACHUSETTS’ HEALTHCARE REFORMS1MASSACHUSE.docx
Obama's CMS nominee Slavitt could face rough road to confirmation
1. Obama's CMS nominee Slavitt could face rough road to
confirmation
President Barack Obama has nominated Andrew Slavitt as CMS administrator, the position he has
held on an interim basis since Marilyn Tavenner stepped down in February.
As administrator, Slavitt oversees day-to-day decisions regarding implementation of the Affordable
Care Act, Medicare, Medicaid, the Children's Health Insurance Program, payment and delivery
reform, healthcare fraud and improving health outcomes.
Slavitt was appointed by HHS Secretary Sylvia Mathews Burwell as part of an attempt to create
clearer lines of authority at the CMS.
Some observers said a lack of clear leadership contributed to the botched launch of the federal
exchange and recommended creating a dedicated executive position for an exchange CEO.
Cheers, jeers and advice rolled in shortly after the news of the nomination broke on Twitter
Thursday afternoon. Republicans signaled he won't have a smooth ride to Senate confirmation.
U.S. Senate Majority Leader Mitch McConnell issued a statement saying that Slavitt's nomination
would receive "thorough consideration." He advised Slavitt to remain focused on serving the 140
million Americans estimated by the CMS to receive insurance under its programs.
"The head of the agency that oversees Medicare and Medicaid should be focused on what the
American people expect him to do: administer these important programs, not allow his attention to
be diverted instead to the implementation of some gigantic, unworkable healthcare law that hurts
hardworking Americans," McConnell said, "It has long been clear that no one can successfully
manage a law as unworkable as Obamacare."
Slavitt previously worked as group executive vice president of Optum, a unit of UnitedHealth Group.
He was one of the executives helping with the so-called tech surge to fix HealthCare.gov in the
months after it launched. He also served as CEO at UnitedHealth's Ingenix unit. It's that history that
concerns Senate Finance Committee Chairman Orrin Hatch (R-Utah) who issued a statement within
minutes internet marketing videos of the announcement.
"Mr. Slavitt's conflicted history in the medical services industry has produced mixed results and
raised a number of serious concerns. As such, he will be expected to demonstrate that he is up to the
challenge and capable of successfully leading the agency through the monumental tasks that lie
ahead," Hatch said. "Most importantly, Mr. Slavitt will need to answer a number of tough questions
regarding his former employer and their relationship with the agency."
HHS has previously issued an ethics waiver for Slavitt, who will have to recuse himself from matters
involving UnitedHealth, including contracts and analytics work from the Lewin Group, a
UnitedHealth unit. UnitedHealth is the largest carrier of Medicare Advantage plans.
Providers, on the other hand, commended the nomination.
Among them was American Hospital Association CEO Rich Umbdenstock, who said Slavitt "has a
deep understanding of the U.S. healthcare system and a commitment to improving patient care."
2. "We believe Andy's proven leadership in the public and private sectors speaks to the ongoing
contributions he will make at CMS," Umbendstock added.
Chip Kahn, CEO of the Federation of American Hospitals, urged the Senate to "act swiftly to confirm
Mr. Slavitt as the next CMS administrator so that America's critical healthcare programs will have
the true benefit of a strong and experienced leader."
