The Patient Protection and Affordable Care Act

State the name of Title I of the ACA.

Quality, Affordable Heath Care for All Americans

By Title I, young people can stay on their parents' insurance until the age of ___.

26

Describe marketplace exchanges.

Web-based insurance exchanges to provide an easy, Expedia-like way to buy health insurance

Does Alabama have an exchange through the federal government or through our own state?

federal

Marketplace exchanges are the same as '___ ________ _____________ ________________'.

the Health Insurance Marketplace

Which groups are covered by insurance without the ACA?

people on employer-based plans or private plans, those with Medicaid/Medicare/CHIP, those with Tricare or Veterans Administration health covereage, those with retiree coverage

Premiums are....

the amount you pay for insurance every month

Deductibles are....

the amount you pay for health care services each year before your health insurance pays its portion of the cost of covered services

Cost-sharing is...

the copayments and coinsurance payments you make each time you get a medical service after reaching your annual deductible

Why is it important for young, healthy people to enroll in the exchanges?

it gives access to high-quality health care, and it lowers the cost of insurance for everyone

What is the individual mandate and why is it important to the ACA?

it requires individuals to purchase the minimum essential coverage or face a tax penalty unless eligible for exemption

When was the individual mandate penalty removed?

2019

State the name of Title II of the ACA.

The Role of Public Programs

Describe where Alabama currently stands regarding participation in the Medicaid expansion program.

they have not adopted it

What does it mean when a state does not participate in the Medicaid expansion program?

it is opting to not be a part of the plan to assist many of the people who the law was originally intended to help

State the name of Title III of the ACA.

Improving the Quality and Efficiency of Health Care

The emphasis of Title III is on ________ to......

Medicare; close the coverage gap, improving quality and efficiency, and decreasing hospital readmission rates

State the name of Title IV of the ACA.

Prevention of Chronic Disease and Improving Public Health

Title IV was for a tremendous push toward ___________________ as opposed to ___________________.

prevention; treatment

State the name of Title V of the ACA.

Health Care Workforce

What is the main purpose of Title V?

increase community health centers and primary care providers, and help relieve health students' debt in exchange for working with underserved people through the National Health Services Corps

State the name of Title VI of the ACA.

Transparency and Program Integrity

Title VI protects...

senior citizens and fraud/abuse of Medicaid and Medicare programs

Which year between 1991 and 2011 did the most criminal prosecutions for health care fraud occur? Relate this to when the ACA was signed into law.

2011; the ACA was signed into law on March 23, 2010

Describe Medicaid and Medicare fraud.

the intentional providing of false information to get Medicaid/Medicare to pay for medical care or services

List some examples of Medicaid and Medicare fraud.

billing for unnecessary services or items, billing for service or items not provided, unbundling, upcoding, card sharing, collusion, drug diversion, kickbacks, multiple cards, program eligibility

State the name of Title VII of the ACA.

Improving Access to Innovative Medical Therapies

What are some aspects of Title VII?

offers drug discounts to hospitals and communities the serve low-income patients; a pathway was directed for the FDA to approve the manufacturing, marketing, and sale of generic biotechnology drugs

State the name of Title VIII of the ACA.

Community Living Assistance Supports and Services (CLASS)

What is the purpose of Title VIII?

supports independent living for disabled needing services

Do we still have Title VIII?

no, in October 2011, the administration announced that it would not move forward with this title as it could not ensure financial viability in the future

State the name of Title IX of the ACA.

Revenue Provisions

What are some aspects of Title IX?

includes new Medicare taxes on high-income earners; included new assessments and taxes on insurance, drug, medical device companies as well as indoor tanning salons

State the name of Title X of the ACA.

Strengthening Quality, Affordable Health Care for All Americans

What is the purpose of Title X?

makes amendments to the previous titles

What is the most significant revision in Title X?

reauthorization of the Indian Health Care Improvement Act which provides health care to American Indians and Alaskan natives

Describe star ratings used for marketplace plans as per CMS.

used to measure the quality of health and drug services received by consumer enrolled in MA and PDPs