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The healthcare bill passed in 2010, President Obama’s signature legislative undertaking, bloomed into a new phase on January 1. As Republicans regain control of congress in 2011, no doubt their first course of action is to seek repeal certain aspects, if not all of the massive healthcare overhaul. In the meantime, healthcare reform is happening in the United States.
The historic healthcare reform bill expanded healthcare to about 32 million more Americans producing a coverage rate of about 95% over a ten-year period. The first phase stimulated minor changes in healthcare. However, the changes brought in with the New Year will prove noticeable to healthcare consumers and providers alike.
The changes that went into effect included a cap on administrative fees insurance companies charge their consumers. Now, insurance companies are required to spend at least 80-85 percent of premiums on actual patient related charges. Pharmaceutical companies can expect to see a change as well. They will now be required to provide a discount up to 50 percent to Medicare recipients on name brand drugs. In order to qualify for the discount, the Medicare recipients must fall into the Part D coverage gap.
General surgeons and physicians who serve as primary care doctors can expect a bonus of 10 percent for serving patients Medicare patients. In addition, physicians will receive payment for providing preventative screenings and personalized prevention plans for Medicare recipients.
Other notable changes include the cap for Medicare Advantage plans and the restrictions on purchases by flex spending health savings plans.