Health reform benefits that went into effect Jan. 1 2011

Republicans want to repeal the following health reform benefits:

For people who are overcharged for insurance premiums:
What Will Be New: Insurers will be required to send rebates to consumers if they do not spend at least 85% (large-group insurers) or 80% (small-group insurers) of premium money on health care.
What to Do: Rebate checks should be coming in the mail automatically. 

For seniors struggling to pay for brand-name drugs:
What Will Be New: Medicare Part D recipients who are in the donut hole will get a 50% discount on covered brand-name drugs and a 7% discount on covered generic drugs if Part D is the primary payer.
What to Do: The discount will apply immediately at the pharmacy.

For seniors struggling to pay for preventive care:
What Will Be New: Medicare will now cover preventive care with no copays or deductibles 
What to Do: See the list of covered services or See details on the USPSTF recommendations

For primary care providers:
What Will Be New: Medicare will pay 10% more to eligible primary care providers.  Primary care is defined as those in family medicine, internal medicine, geriatrics, and pediatrics; this includes PA's, NP's, and clinical nurse specialists.  
What to Do: To qualify for the bonus, 60% of Medicare charges must be for primary care services.  (Note: Doctors for America does not have at present have a position on these provisions, there has been some discussion that the 60% threshold needs to be adjusted as it will leave out many primary care providers.)

For general surgeons practicing in rural areas:
What Will Be New: Medicare will pay 10% more to eligible rural general surgeons who perform major surgical procedures.  
What to Do:  To be eligible for the incentive payment, you must be enrolled in Medicare as a general surgeon and practice in a Health Professional Shortage Area (HPSA).  Read more and find links to get more information.

For those who are concerned about Medicare staying sustainable:
What Will Be New: Medicare will stop paying private insurance companies extra to provide the same level of care that traditional Medicare provides. 
What to Do: Nothing. 

For those who think we need innovative ways to deliver care:
What Will Be New: The Center for Medicare and Medicaid Services is launching a website for its new CMS Innovation Center that will work with the private sector to improve quality and lower costs.
What to Do: Stay tuned for upcoming opportunities to get involved.

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