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Affordable Care Act Tools

Affordable Care Act Tools. Overview. The Affordable Care Act, or ACA, includes new requirements for employer insurance coverage and for individuals to have health care coverage.

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Affordable Care Act Tools

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  1. Affordable Care Act Tools

  2. Overview • The Affordable Care Act, or ACA, includes new requirements for employer insurance coverage and for individuals to have health care coverage. • Employers that do not offer health care coverage that meets certain requirements will be subject to penalties which must be paid to the federal government. • The ACA is very complex and include a wide array of initiatives which are confusing in and of themselves but which also are changing as the Administration implements the law. • The Administration has repeatedly indicated that these provisions and related changes will go in force on January 1, 2014 – no delays.

  3. AHCA/NCAL Support • AHCA/NCAL has formed an team with representation from every department to ensure the membership is prepared. • The work of the AHCA/NCAL team is guided and overseen by the State Executives.

  4. Resources • Our major 2013 work areas based on member guidance include: • Research on what would be needed for Medicaid Rate Add-Ons to help cover new or expanded employee health care coverage • A user-friendly website which includes ACA implementation timelines, issue briefs, a webinar library • Webinar series on various aspects of the ACA • Development of an online calculator to allow members to estimate a penalty figure should they choose not to offer coverage • An email alert series which provides succinct and timely information on ACA implementation updates • Frequently Asked Questions online and a monthly “just the facts” audio files with experts answering member submitted questions • ACA dedicated email address, insurancecoverage@ahca.org, which members may use to email questions to Association staff

  5. ACA Team

  6. Employer Penalty Calculator • Beginning in 2014, employers with 50 or more full-time employee equivalents (FTEEs) will either have to offer health insurance coverage to their full-time employees or face penalties. • AHCA/NCAL has developed a calculator designed to give arough estimate of potential penalties based on company size. • Available online in May

  7. Medicaid Rate Add-On Analysis • Purpose is to develop • State-specific Medicaid rate add-ons needed to aid members with providing affordable health care coverage that meets federal Qualifying Coverage requirements • And to provide a national average Medicaid rate add-on for federal advocacy • Partnering with The Center for Research to conduct the survey and analysis • Web-based survey with state affiliate technical assistance and survey support included in work plan

  8. Compliance & Ethics Program • Statutory language requires SNFs and NFs to implement an effective Compliance & Ethics program (deadline was 3/23/13) • CMS is drafting a proposed rule that has not been released yet. • The rule will likely look like OIG guidance released in 2000 and 2008 at https://oig.hhs.gov/authorities/docs/cpgnf.pdf and https://oig.hhs.gov/compliance/compliance-guidance/docs/complianceguidance/nhg_fr.pdf • Whether or not the rule is released, SNFs and NFs without a program should design and implement a Compliance & Ethics program by the 3/23/13 deadline.

  9. Compliance & Ethics Program • Listen to a webinar on Deconstructing Corporate Compliance & Ethics for Single Facilities and Small Regional Chainsathttp://webinars.ahcancal.org/session.php?id=10512 . • Read about how to design and implement a Compliance & Ethics program at http://www.ahcancal.org/facility_operations/integrity/Pages/Compliance-Programs.aspx.

  10. AHCABenefits • AHCA has been developing a program for our members to address the requirements of ACA and achieve compliance. • Through Compass Total Benefits, insurance carrier partners will offer AHCA members traditional benefit programs, as well as defined contribution plans. • This program is open to AHCA/NCAL members and Associate Business Members. • A key member service is the comprehensive analysis EVERY employer must do. We are providing it to member as a free service. • Visit www.ahcabenefits.com for more information.

  11. Use Our ACA Tools • Visit the new website at www.ahcancal.org • Look under the Facility Resources tab in the top menu bar • Send questions & sign up for alerts at insurancecoverage@ahca.org

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