While Medicare provisions of the The Patient Protection and Affordable Care Act (PPACA) have received heightened attention in recent months, changes to Medicaid have been less prominently featured. However, they are also important both for patients and for heathcare providers who accept this government-sponsored plan.
In fact, changes brought about by the healthcare reform passed last March will affect all areas of medical care under that plan, including coverage, care administration and system oversight.
In terms of coverage, states will be allowed to expand eligibility to include non-pregnant adults under 65 years of age through an amendment plan. In 2014, the biggest expansion will take place as individuals under 65 who are not eligible for Medicare and whose income is the same or less than 133 percent of the poverty level will become eligible.
By then, the application process for Medicaid will also be simplified, with states establishing electronic systems to do so.
Quality standards are also key in the PPACA, and they include the requirement that plans provide essential coverage, including for mental health issues. The Department of Health and Human Services (HHS) will also be tasked with identifying health quality measures for eligible individuals, and, based on those, set up a Medicaid Quality Measurement Program.
In the future, HHS will also establish a Centers for Medicare and Medicaid Services innovation center to try out novel payment and care delivery methods in order to bring about cost reductions. It will also create systems to share data with the departments of Veterans Affairs, Defense, Social Security and Indian Health in order to identify and prevent fraud and abuse.
The Department will also team up with the Inspector General’s office to establish procedures for the screening of providers and suppliers participating in Medicare, Medicaid and Children’s Health Insurance Program (CHIP), another government-funded plan, the news provider further reported.
Medicaid was established on July 30, 1965, through Title XIX of the Social Security Act. It is administered at the state level and available to certain low-income individuals and families.
The PPACA was signed by President Obama on March 23, 2010, and some estimates suggest that the Medicaid expansion provisions will add as many as 20 million more people to the plan’s rolls. Currently, some 40 million Americans are covered by various Medicaid programs, according to National Resource Center for Human Service Transportation Coordination.