The Patient Protection and Affordable Care Act (ACA) was passed on March 23, 2010. On September 23, ACA’s six-month anniversary, a number of provisions regulating health insurance plans will go into effect:
1. Health plans are required to allow individuals up to age 26 may remain on a parent’s plan, although regulations aren’t yet final.
2. New health plans are prohibited from excluding children based on pre-existing conditions. Again, no final regulations.
3. Health plans are prohibited from rescinding coverage, absent fraud or related act by the beneficiary.
4. Health plans are prohibited from implementing a lifetime limit on coverage. Annual limits on coverage may not be less than $750,000 (limit to be increased annually).
5. Beginning plan years after September 23, health plans are required to cover certain preventive services, in some cases without co-pays or deductible payments. Interim regulations for implementation have been published.
6. As scheduled, the protocol for self-disclosure of Stark Law violations has been promulgated by CMS.
It remains to be seen how these changes will impact insurers and other payors. However, as Kate Pickert reports in the Time Magazine article HHS Explicitly Threatens the Insurance Lobby, Health and Human Services Secretary Kathleen Sebelius is threatening insurance companies that use ACA requirements as an excuse to raise rates. Check out the article to see the full text of Sebelius’ comments.
