New rules on federal health care

By CMTA Staff

Capitol Update, July 16, 2010

After the historic passage of the Patient Protection in the Affordable Care Act, the federal government is now working diligently to roll out a series of regulations related to Health Care Reform.


Earlier this week U.S. Health and Human Services (USHHS) Secretary Kathleen Sebelius released final rules on the expanded use of electronic health records (EHR).  Under the Health Information Technology for Economic and Clinical Health Act of 2009, eligible health care professionals and hospitals can qualify for Medicare and Medicaid incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.  These regulations are just a start in the multiple steps to lay the groundwork for the incentive payments program.  As much as $27 billion may be expended in incentive payments over ten years.  Eligible professionals may receive as much as $44,000 under Medicare and $63,750 under Medicaid, and hospitals may receive millions of dollars for implementation and meaningful use of certified EHRs under both Medicare and Medicaid.


USHHS also announced regulations requiring new private health plans to cover evidence-based preventive services and eliminate cost sharing requirements for such services.  The new rules will help Americans gain easier access to services such as blood pressure, diabetes, and cholesterol tests; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children. Under the regulations issued this week, new health plans beginning on or after September 23, 2010, must cover preventive services that have strong scientific evidence of their health benefits, and these plans may no longer charge a patient a copayment, coinsurance or deductible for these services when they are delivered by a network provider.


The California legislature wishes to quickly implement federal directives on health care reform and is watching closely all regulations being issued by USHHS.  CMTA will continue to monitor regulations that control cost and improve the quality and effectiveness of the health care delivery system.

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