What to expect of PPACA/ACA: Provisions of the Affordable Care Act That Take Effect in 2012, 2013 and 2014

2012 • Medicare hospital value-based purchasing program • Increase in physician quality reporting requirements in Medicare • Additional Medicare pilot programs on alternative payment methodologies, e.g., accountable care organizations • Increased requirements for hospitals to maintain not-for-profit status • Fees from insured (including self-insured) plans transferred to the Patient-Centered Outcomes Research Trust Fund
2013
• Increase Medicare payroll tax by 0.9% on high-income earners • Impose a 3.8% tax on net investment income of high-income individuals • $500,000 cap on health insurers’ deduction for executive compensation • Eliminate employer deduction for Medicare Part D subsidy • FSA limitations • Excise tax on medical device manufacturers and importers • Medical expense deduction floor increases to 10% • Nationwide bundled payment pilot begins in Medicare • Increased Medicaid reimbursement for primary care • Medicare physician comparison data available to the public • Reductions in Medicare payments for select hospital readmissions • Expanded coverage of preventive services by Medicaid
2014 • Employer mandate and individual mandate • Employer and insurer reporting requirements • New health insurance market reforms take effect • State health insurance Exchanges established • Premium tax credits and cost-sharing subsidies available to certain individuals in Exchange insurance products • Medicaid expansion to new populations (100% federal match to states for newly-eligible populations through 2016) • Annual fee on health insurers • Medicare/Medicaid DSH payment cuts begin • Independent Payment Advisory Board (IPAB) issues first report to Congress if Medicare spending exceeds growth target
Also, as a reminder, all forms of birth control will be covered at 100% effective August 1, 2012. You will no longer be required to pay copays or meet deductibles.

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