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Home Care Heroes Blog

Health Care Reform Update from Home Care Expert Stephen Tweed

Today's post is reprinted with permission from Home Health Care Today. Copyright 2010 Stephen C. Tweed. To receive a FREE subscription to this newsletter, log on to www.leadinghomecare.com.

Well, it's official. After five months of discussion, questions, stephen tweeddebate, seminars, workshops and webinars, the bottom line is that Health Care Reform is here, it's huge, and it will have a major impact on all of health care in America. We've continued to study the law and monitor the development of regulations needed to implement the law. Here are a few things that have happened that may affect your home health agency, hospice, or private duty home care business.

The 1099 Rule
A little-noticed provision in the Patient Protection and Affordable Care Act is suddenly generating a lot of attention. The new rule requires all businesses to file 1099 forms if they purchase $600 or more in goods or services from another business during a year. While the rule was largely overlooked in the early analysis of the health-care law, a recent uproar has put it in the spotlight, and efforts are now under way in Congress to repeal the measure.
Formerly, only unincorporated businesses that purchased services greater than $600 in a year were required to file a 1099 with the Internal Revenue Service and with the provider. The new rule extends the requirement to all companies, charities, and state and local governments. It also expands the provision to include purchases of goods or products.

For example, if a business buys more than $600 in office supplies from Staples over the course of a year, it will now have to send a 1099 to Staples and file another one with the IRS. Or, if you buy an airplane ticket to fly to the NAHC convention and it costs more than $600, you'll need to get the taxpayer ID number for your airline, figure out where to send the 1099, and file a copy with the IRS.

We suspect that this provision of the law will be revised, as neither the Congress or the IRS fully understood the unintended consequences of this tiny provision in the law. I'm sure we'll find other provisions like this that have major unintended consequences.

American confidence in ability to pay for Healthcare declines.
Americans' confidence in their ability to pay for and access health care has fallen by 5 percent since December 2009, according to a Thomson Reuters poll of consumer confidence released Monday, (8/23/10).

The monthly survey questions 3,000 consumers about their ability to pay for health care. According to Reuters, "On every survey question, responses were more pessimistic in July than they were in December."

New York state now has an active Pre-existing Condition Insurance Plan (PCIP), the NY Bridge Plan.
In July, New York officials said they were hoping the New York PCIP program premiums would be less than $600 per month. The actual premiums will be just $362 per month in upstate counties and $421 per month in downstate counties, including counties in New York City, officials say.

The initial plan design includes a $20 office visit co-payment, a $500 co-payment per inpatient stay and a $100 emergency room co-payment, officials say. The package also includes pharmacy benefits and vision care benefits.

The NY Bridge Plan administrators will process applications on a first-come, first-service basis, officials say. The earliest coverage can take effect is October 1. Once the NY Bridge Plan reaches capacity, administrators will set up a waiting list.

The federal Affordable Care Act (ACA) - the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act - allocated $5 billion to the PCIP to fill in coverage gaps that will exist before a ban on medical underwriting takes effect in 2014.
The PCIP program is supposed to provide "uninsurable" individuals access to coverage at rates comparable to individual rates in the commercial market. The program is open to individuals with serious pre-existing conditions who have been uninsured for at least 6 months. Some states are letting the new federal Office of Consumer Information and Insurance Oversight run their PCIP programs, but a majority will be running their own risk plans. New York is expecting to use $297 million in PCIP funding to provide temporary coverage for about.

Only two people enroll in New Jersey Plan.
New health plans for the sick and uninsured that became available as a result of federal health care reform have been slow to enroll patients: just two people in New Jersey will begin receiving coverage today, the first day the plans take effect.
Called NJ Protect, the health plans are available to people who have been without insurance for at least six months and submit evidence of pre-existing health conditions, such as diabetes, hypertension or cancer. New Jersey is to receive $141 million in federal subsidies to cover claims that exceed the premiums paid by the beneficiaries.

Most small businesses in California qualify for Tax Credit.
Garnering little to no press attention when released in July, a report undertaken by Families USA and the Small Business Majority found that 80 percent of California's small businesses with 25 or fewer employees will qualify for federal tax credits under the Patient Protection and Affordable Care Act starting this year.

This means that of the state's 571,200 small businesses, 465,500 are eligible for the tax credits in 2010. Of those, 30 percent - or 135,900 - qualify for the maximum tax credit amount.
Stay tuned to Home Health Care Today and Private Duty Today for more new developments in the implementation of the Patient Protection and Affordable Care Act.

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