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Type Responsibility Statute Section Due Date Status Responsible Entity
Type Responsibility Statute Section Due Date Status Responsible Entity
Insurance Reform Establishes grants to states for ombudsman or consumer assistance offices to receive and respond to inquiries and complaints about health insurance coverage under federal and state requirements. 03/25/2010 Completed
Insurance Reform Requires plans to justify unreasonable premium increases to HHS and the states; authorizes grants to states to strengthen provisions for rate review. PPACA Sec. 1003, p. 21 , adds Sec. 2794 to the PHS Act 03/25/2010 Completed
Insurance Reform Temporary high risk pool for people with pre? existing conditions (sunsets in 2014). PPACA Sec. 1101, p. 23 06/23/2010 Effective 90 days after enactment
Insurance Reform Temporary reinsurance pool for retired employees 55 and older who do not qualify for Medicare (sunsets in 2014). PPACA Sec 1102, p. 25 06/23/2010 Effective 90 days after enactment
Insurance Reform HHS to establish a website to help customers identify affordable health insurance coverage options, including information on co?payments and Medical Loss Ratio. PPACA Sec. 1103, p. 28 07/1/2010
Insurance Reform Requires health plans to have an effective coverage and claims appeals process. PPACA Sec. 1001, p. 19, adds Sec. 2719 to the PHS Act 09/25/2010 (Effective six months after enactment)
Insurance Reform Prohibits denial of coverage for children with preexisting conditions. PPACA Sec. 10103(e), p 777, adds Sec. 2709 to the PHS Act 09/25/2010 (Effective six months after enactment)
Insurance Reform Prohibits rescissions except in the case of fraud. PPACA Sec. 1001, p. 13, adds Sec. 7212 to the PHS Act; HCERA Sec. 2301, p. 53 09/25/2010 (Effective six months after enactment)
Insurance Reform Health plans to begin reporting MLR to the Secretary. PPACA Sec. 10101(f), p. 767, adds Sec. 2718 to the PHS Act 09/25/2010 (Effective six months after enactment) Secretary
Insurance Reform Extension of coverage of children to 26th birthday on family policy. PPACA Sec. 1001, p. 14, adds Sec. 2714 to PHS Act; HCERA Sec. 2301(a), p. 53 09/25/2010 (Effective six months after enactment)
Insurance Reform Insurers may not establish lifetime limits or unreasonable annual limits on the value of benefits. Prior to January 1, 2014, HHS must approve any limits established by insurers. PPACA Sec. 10101(a), p. 765; HCERA Sec. 2301, p. 53 09/25/2010 (Effective six months after enactment)
Medicare Creates Medicare hospital value?based purchasing program. PPACA Sec. 3001, p. 235 10/1/2012 (for fiscal year 2013)
Delivery System Reforms Establishes the Patient Centered Outcomes Research Institute as a non?profit entity and sets requirements and limitations on the use of comparative effectiveness research PPACA 1002, p. 20, adds Sec. 2793 to the PSH Act 2010
Medicare Beneficiaries who reach the Part D doughnut hole receive a $250 subsidy; first step in closing the gap by 2020 HCERA Sec. 1011, p.9 2010
Medicare Medicare Advantage benchmarks frozen at 2010 level (HCERA Sec. 1102(b), p. 12, repeals PPACA Sec. 3201 and 3203). Coding intensity adjustments required HCERA Sec. 1102(e), p. 18 2011
Delivery System Reforms HHS to develop national quality strategy based on delivery, outcomes and population health PPACA Sec. 3011, p.260 2011
Revenue New tax on pharmaceutical manufacturers and importers () PPACA Sec. 9008, p. 741; HCERA Sec. 1404, p. 36 2011
Insurance Reform Requires a rebate for MLR less than 80% in individual and small group market and 85% in large group market. PPACA Sec. 1001, p. 19, adds Sec. 2718 to the PHS Act 2011
Medicare Provides coverage of comprehensive health risk assessment and personalized prevention incentives. Increases Medicare coverage to 100% for certain preventive services and wellness coverage . PPACA Sec. 4103, p. 435; Sec. 4104, p. 439 2011
Medicare Provides a 10% Medicare bonus for primary care services in all areas and for procedures performed by general surgeons in shortage areas PPACA Section 5501, p. 534 2011
Delivery System Reforms Establishes center for Medicare and Medicaid Innovation within CMS to test payment and service delivery models. PPACA Sec. 3021, p. 271 2011
Mandates and Subsidies Provides tax credits to subsidize employer coverage by companies with no more than 25 employees with average annual wages per employee of less than $50,000 PPACA Sec 1421, p. 119 2011
Delivery System Reforms Reduces Medicare payments to hospitals for preventable readmissions PPACA Sec. 3025, p. 290; Sec. 10309, p. 824 2011
Delivery System Reforms Establishes community collaborative care networks PPACA Sec. 10333, p. 852 2011
Delivery System Reforms Creates a community?based transitions of care program PPACA Sec. 3026, p. 295 2011
Medicare Establishes an open enrollment period from Oct. 15 to Dec. 7, starting with 2012 plan year. PPACA Sec. 3204(b), p. 338 2011
Delivery System Reforms Establishes shared savings program to promote Accountable Care Organizations PPACA Sec. 3022, p. 277 2012
Delivery System Reforms Creates an Independence at Home demonstration program PPACA Sec. 3024, p. 286 2012
Revenue Imposes a fee of $1 per insured life for policy years after October 1, 2012 and $2 for subsequent years to fund Patient?Centered Outcomes Research Trust Fund PPACA Sec. 1183, p. 626, adds Sec. 4375 to the IRC 2012
Medicare Medicare Advantage ? begin phase?in of new benchmarks, quality bonus payments, and rebate calculation HCERA Sec. 1102(b), p. 12, 1102(c), p. 15, & 1102(d), p. 17) 2012
Insurance Reform Establishes electronic funds payment requirements for health care payment and remittance PPACA Sec. 1104, p. 28 2012
Medicaid Requires Medicaid payment for primary service to be paid at Medicare rates; applicable for 2013 and 2014 only HCERA Sec. 1202, p. 24 2013
Delivery System Reforms Creates pilot program for bundled payments PPACA Sec. 3023, p. 281; Sec. 10308, p. 823 2013
Revenue Eliminates employer deduction of expenses allocable to Medicare Part D PPACA Sec. 9012, p. 750; HCERA Sec. 1407, p. 39 2013
Revenue Increases Medicare payroll tax on incomes over $200K for individuals and $250K for couples PPACA Sec. 9015, p. 752; HCERA Sec. 1402, p.32 2013
Medicare Establishes Medicare Part D coverage gap discount program PPACA Sec. 3301, p. 343; HCERA Sec. 1101, p. 8 2013
Revenue Establishes new Medicare tax on investment income for high?income individuals HCERA Sec. 1402, p. 32 2013
Revenue Limits the deductibility of executive compensation of health insurance providers to $500,000 for 2013 income or payments of deferred compensation for services rendered after January 1, 2010 PPACA Sec. 9014, p. 750 2013
Exchanges, Qualified Health Plans, and Markets Limits annual salary reduction contributions by an employee to a flexible health spending arrangement under a cafeteria plan to $2,500. Allows an annual inflation adjustment to such amount after 2013. PPACA Sec. 9005, p. 736; Sec. 10902, p. 898; HCERA Sec. 1403, p. 35 2013
Exchanges, Qualified Health Plans, and Markets Establishes grant and loan program to support creation of Co?ops PPACA Sec. 1322, p. 69; Sec. 10104, p. 778 2013
Revenue Increases threshold for deduction of unreimbursed medical expenses to 10%; waives the increase for people 65 and older PPACA Sec. 9013, p. 750 2013
Revenue Establishes 2.3% tax on medical device manufacturers and importers HCERA Sec. 1405, p. 36 2013
Revenue Phase?in of annual fee on health insurers begins PPACA Sec. 9010, p. 747; Sec. 10905, p. 899; HCERA Sec. 1406, p. 37 2014
Medicaid Medicaid expansion for adults up to 133% of the poverty level, including those without children PPACA Sec. 2001, p. 153; Sec, 10201, 799; HCERA Sec. 1201, p. 23 2014
Medicare Medicare Advantage plans required to have an 85% MLR HCERA Sec. 1103, p. 19 2014
Medicare Medicare DSH payments are reduced PPACA Sec. 3133, p. 314, & Sec. 10316, p. 828; HCERA Sec. 1104, p. 19 2014
Medicaid Medicaid DSH payments are reduced PPACA Sec. 2551, p. 194; Amended by HCERA Sec. 1203 p. 25 2014
Exchanges, Qualified Health Plans, and Markets Permits states to create Basic Health Plan for uninsured individuals between 133% PPACA Sec. 1331, p. 81 2014
Insurance Reform Limits coverage waiting periods to 90 days PPACA Sec. 1201, p. 43, adds Sec. 2708 to PHS Act 2014
Insurance Reform Requires states to establish a transitional reinsurance program for high?risk individuals in the individual market; funded through assessment on insurers PPACA Sec. 1341, p.90 2014
Insurance Reform Allows limited rating variation based on age, premium rating area, family composition and tobacco use in the individual and small group markets PPACA Sec. 1201, p. 37, adds Sec. 2701 to PHS Act 2014
Insurance Reform Requires guaranteed issue and renewability PPACA Sec. 1201, p. 38, adds Sec. 2702 and 2703 to PHS Act 2014
Insurance Reform Prohibits annual and lifetime dollar coverage caps PPACA Sec. 10101(a), p.765, adds Sec. 2711 to the PHS Act; HCERA, Sec. 2301, p. 53 2014
Insurance Reform Prohibits denial of coverage for adults with pre?existing conditions PPACA Sec. 1201, p. 36, adds sec. 2704 to the PHS Act 2014
Mandates and Subsidies Phase?in of the individual mandate begins PPACA Sec. 1501(b), p. 126; Sec. 10106(b), p. 791; HCERA, Sec. 1002, p. 4 2014
Mandates and Subsidies Establishes cost sharing limits: 100?200% FPL ? 1/3 of the H.S.A. limits; 200?300% FPL ? 1/2 H.S.A. limits; 300?400% FPL ? 2/3 H.S.A. limits PPACA Sec. 1402, p. 102; HCERA, Sec. 1001, p. 3 2014
Mandates and Subsidies Provides premium assistance tax credits to families with household incomes between 133% and 400% FPL PPACA Sec. 1401, p. 95; Sec. 10105, p. 788; HCERA Sec. 1001, p. 2; Sec. 1004, p. 6 2014
Exchanges, Qualified Health Plans, and Markets Essential health benefits offered by Qualified Health Plans through the exchange. Requires four tiers of benefits based on actuarial value of benefits: Bronze 60%, Silver 70%, Gold 80%, Platinum 90%. All exchange plans must offer at least Silver and Gold options PPACA Sec. 1302, p. 45; Sec. 10104, p. 778. 2014
Exchanges, Qualified Health Plans, and Markets Allows employers to offer rewards to employees who participate in a wellness program PPACA Sec. 1201, p. 38, adds Sec. 2705 to PHS Act 2014
Exchanges, Qualified Health Plans, and Markets Qualified health plans (QHPs) begin to offer coverage in the exchange. PPACA Sec. 1301, p. 44 2014
Exchanges, Qualified Health Plans, and Markets State?based exchanges and SHOP exchanges begin to operate. PPACA Subtitle D, Part II, p. 55; Sec. 10104, p. 778; HCERA, Sec. 1204, p. 27 2014
Mandates and Subsidies Establishes penalties for employers not offering coverage and employers offering coverage with one or more employees receiving subsidized coverage. PPACA Sec. 1513, p. 135; Sec. 10106(e) & (f), p. 792, & (i), p. 796; HCERA Sec. 1003, p. 5 2014
Delivery System Reforms [2015] Reduces payments by 1% for excessive hospital acquired conditions PPACA Sec. 3008, p. 258 2015
Exchanges, Qualified Health Plans, and Markets States may limit small employer size to 50 employees in the small group market PPACA Sec. 1304, p. 54 2016
Mandates and Subsidies Individual mandate penalties increase to $695 or 2.5% of income PPACA Sec 1501(b), p. 126; Sec. 10106(b), p. 791; HCERA, Sec. 1002, p. 4 2016
Exchanges, Qualified Health Plans, and Markets States may form interstate compacts PPACA Sec. 1333, p. 88 2016
Exchanges, Qualified Health Plans, and Markets States may permit employers with more than 100 employees to obtain coverage through state exchanges 2017
Revenue Excise tax imposed on high?cost employer?sponsored health plans PPACA 9001, p. 729; Sec. 10901, p. 897; HCERA Sec. 1401, p. 31 2018
Type Responsibility Statute Section Due Date Status Responsible Entity