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Mnet Health News delivers the latest news and information articles for the world of healthcare.

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Health Care Law Delivers Free Preventative Services

The Centers for Medicare & Medicaid Services (CMS) announced on June 11, 2012, that the Affordable Care Act helped 14.3 million people within original Medicare get at least one preventive service at no cost to them during the first five months of 2012. This includes 1.1 million who have taken advantage of the Annual Wellness Visit provided by the Affordable Care Act. In 2011, 32.5 million people in Medicare received one or more preventive benefits free of charge.

Prior to 2011, people with Medicare faced cost-sharing for many preventive benefits such as cancer screenings. Under the Affordable Care Act, preventive benefits are offered free of charge to beneficiaries, with no deductible or co-pay. The law also added an important new service for people with Medicare - an Annual Wellness Visit with the doctor of their choice - at no cost to beneficiaries.

Written by Pulse


U.S. Supreme Court Upholds Affordable Care Act

On June 28, 2012, the U.S. Supreme Court primarily upheld the Affordable Care Act. In a 5-4 ruling, the Court found the Act's individual health insurance mandate, which requires most Americans to obtain health insurance by 2014, is within Congress' constitutional taxing power.

The ruling initially holds that under the Commerce Clause (a Constitutional provision enabling the federal government to regulate interstate commerce), Congress does not have the power to force people to engage in commerce by requiring the purchase of health insurance.

Despite the Court's finding that the Commerce Clause does not authorize the mandate, however, the Court ruled the individual mandate can stand, finding that the penalty the law would impose on people who fail to purchase insurance is essentially a tax. The opinion holds, "it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but [who] choose to go without health insurance. Such legislation is within Congress's power to tax."

The Court objected to one provision of the law related to Medicaid expansion. The Court found that the federal government cannot withdraw existing Medicaid funding from states that decide not to participate in an expansion of Medicaid eligibility that the law would require. Chief Justice John Roberts wrote, "[a]s for the Medicaid expansion, that portion of the Affordable Care Act violates the Constitution by threatening existing Medicaid funding. Congress has no authority to order the States to regulate according to its instructions. Congress may offer the States grants and require the States to comply with accompanying conditions, but the States must have a genuine choice whether to accept the offer."

Justices Kennedy, Scalia, Thomas, and Alito issued a dissent, in which they characterized the majority's opinion as a "vast judicial overreaching" and one that "makes enactment of sensible healthcare regulation more difficult, since Congress cannot start afresh but must take as its point of departure a jumble of now senseless provisions, provisions that certain interests favored under the Court's new design will struggle to retain."

Written by Pulse


Department of Treasury Proposes Limitations on Patient Debt Collections

On June 22, 2012, the U.S. Department of Treasury released proposed regulations on a provision in the Affordable Care Act that addresses the collection of unpaid hospital debt. The proposed rules require non-profit hospitals, as a condition of receiving a tax-exemption, to establish billing and collections procedures for patients eligible for financial assistance. It also requires non-profit hospitals to provide patients with the information needed to apply for such assistance.

According to the proposed rule, nonprofit hospitals must:

- Provide patients with a plain language summary of the financial assistance policy before discharge and with the first three bills;

- Give patients at least 120 days following the first bill to submit an application for financial assistance before commencing certain collection actions;

- Give the patient an additional 120 days (for 240 days total) to submit a complete application;

- If a patient is determined eligible for financial assistance during these 240 days, refund any excess payments made before applying for aid and seek to reverse any collections actions already commenced.

The proposed rule also outlines requirements for providing financial assistance, seeks to limit charges and mandates a non-discriminatory emergency medical care policy.

According to the American Hospital Association, approximately 2,900 out of all 5,750 U.S. hospitals are classified as nonprofit institutions.

ACA International will prepare comments in advance of the comment period deadline on Sept. 24, 2012.

Written by Pulse


New Federal Agency to Examine Collections Process

On January 2, 2013 the Consumer Financial Protection Bureau (CFPB) will begin its oversight of debt collection in the United States. In connection with the Dodd-Frank Wall Street Reform and Consumer Protection Act, under the Larger Market Participant (LMP) rule released by the CFPB on October 23, 2012, the final rule defines "consumer debt collection" markets and exclusions, explains how to determine if you are an LMP and offers an examination manual.

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