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Health System Reform Resource Center

This comprehensive resource center serves as the central repository for all information related to the Patient Protection and Affordable Care Act (ACA) of 2010. It contains documents that range from the Academy's position statements and communications to Congress during the legislative phase, to proposed regulations and comment letters sent to federal agencies. You can view all of these documents and more on the interactive timeline below.

Use this resource center to access a growing suite of resources that will guide you through the transitions that ACA and other legislation have set in motion. Resources range from our HIT-kit, which guides you through implementation and adoption of electronic health records, to coding and reimbursement information for new payment policies.

In addition, the Practice Management Essentials series provides compliance guidance materials and tools to help you make the most of new regulations in your practice. We hope you find the Health System Reform Resource Center helpful. Please email govtaffairs@aad.org with feedback about this resource center, and feel free to share your thoughts about the ACA provisions highlighted here.

2012 election: Strategies for moving ahead

As a result of the 2012 election, implementation of the Affordable Care Act will continue. However, AADA President Daniel M. Siegel, MD, says significant opportunities to influence its direction remain. Learn more about the AADA's strategies here.
2009
2010
2011
2012
2013
2014
2015
2016
2017
2009
  • May: AAD/A Responds to "Transforming the Health Care Delivery System."
    May: The Senate Finance Committee proposed "Transforming the Health Care Delivery System: Proposals to Improve Patient Care and Reduce Health Care Costs" (Reform Proposal). The AAD/A responded with letter to Chairman Max Baucus.
    May: AAD/A's Response to Transforming the Health Care Delivery System.
    May 2009
  • June: AAD/A Responds to "Expanding Health Care Coverage."
    June: The Senate Finance Committee proposed, "Expanding Health Care Coverage: Proposals to Provide Coverage to All Americans and Financing Comprehensive Health Care Reform: Proposed Health System Savings and Revenue Options." The AAD/A again responded with a letter to Chairman Baucus.
    June: AAD/A's Response to Expanding Health Care Coverage.
    June 2009
  • July: AAD/A Issues Letter about America's Affordable Health Choices Act of 2009.
    July: Rep. Dingell introduces HR 3200, "America's Affordable Health Choices Acts of 2009," in the House of Representatives. The AAD/A expressed its support through a letter to the committee chairmen.
    July: AADA issues letter on America's Affordable Health Choices Act of 2009.
    July 2009
  • August: AAD/A Introduces HSR Principles.
    August: The AAD/A introduces HSR Principles.
    August: AAD/A Introduces HSR Principles.
    August 2009
  • September: The AAD/A Expresses Concerns about the Independent Medicare Commission.
    September: The AAD/A addresses its concerns with the Independent Medicare Commission provision in the America's Healthy Future Act of 2009.
    September: AAD/A Expresses Concerns about the Independent Medicare Commission.
    September 2009
  • October: AAD/A Makes Known its Concerns about Provisions in the America's Healthy Future Act of 2009.
    October: America's Healthy Future Act of 2009, S. 1796, which was introduced by Sen. Baucus, caused the AAD/A to express concern about certain provisions in the bill.
    October: AAD/A Makes Know its Concerns about Provisions in Admerica's Healthy Future Act of 2009.
    October 2009
  • November: AAD/A Opposes the Patient Protection and Affordable Care Act.
    November: In a letter to Senate Leadership, the AAD/A opposes HR 3590, the Patient Protection and Affordable Care Act, as it is debated in the Senate.
    November: AAD/A Opposes the Patient Protection and Affordable Care Act.
    November 2009
2010
  • Jan. 1-Dec. 31: E-prescribing and PQRI Bonus of 2 Percent Take Effect.
    Jan. 1-Dec. 31: E-prescribing and PQRI bonus of 2 percent take effect.
    Jan. 1: E-prescribing and PQRI Bonus of 2 Percent Take Effect.
    Jan. 1, 2010
  • Jan. 1: Submission of Medicare Claims Changes.
    Medicare Part B Claims must be submitted no later than 12 months after the date of service.
    Jan. 1: Submission of Medicare Claims Changes
    Jan. 1, 2010
  • Jan. 1: Small Business Tax Credit Takes Effect.
    Employers receive a tax credit up to 35 percent of their contributions for health insurance premiums for their employees. To be eligible, a business must have fewer than 25 full-time-equivalent employees, have less than $50,000 in average wages, and the employer must cover at least 50 percent of the cost of health care coverage for employees. See eligibility, examples, and FAQs
    .
    Jan. 1: Small Business Tax Credit Takes Effect.
    Jan. 1, 2010
  • March: AAD/A Sends Letter to Speaker Pelosi in Opposition to the Patient Protection and Affordable Care Act.
    March: Leadership sends a letter to Speaker Pelosi detailing reasons why the AAD/A is opposed to the Patient Protection and Affordable Care Act.
    March: AAD/A Sends Letter to Speaker Pelosi Detailing Opposition to the Patient Protection and Affordable Care Act.
    March 2010
  • March: HR 3590, the Patient Protection and Affordable Care Act, Becomes Law.
    March: HR 3590, the Patient Protection and Affordable Care Act, becomes law. The following is the text of the bill as enrolled.
    March: HR 3590, the Patient Protection and Affordable Care Act, Becomes Law.
    March 2010
  • July: Establish a Temporary Pre-Existing Condition Insurance Plan.
    See the U.S. Goverment site, Healthcare.gov, to establish such a plan for your practice.
    July 1: Establish a Temporary Pre-Existing Condition Insurance Plan.
    July 1, 2010
  • July: Tanning Tax Goes into Effect.
    The AAD releases a statement that supports federal and state regulations on indoor tanning.
    July: Tanning Tax Goes into Effect
    July 1, 2010
  • September: Insurance Reform and Compliance Begins.
    Insurance Reform stipulates the following:
    • All insurance coverage must include preventive services and immunizations.
    • Children must be allowed to stay on a parent's insurance coverage up to age 26.
    • Children may not be dropped from insurance coverage due to a pre-existing condition.
    • Insurers may not rescind existing coverage except in cases of fraud.
    • Lifetime coverage limits are banned.
    • Annual coverage limits are restricted.
    • Insurers must allow an appeals process to consumers for coverage decisions.
    • The U.S. Department of Health and Human Services (HHS) must develop a protocol to allow providers to self-disclose violations to Stark laws.

      September: Insurance Reform and Compliance Begins
      Sept. 23, 2010
    2011
    • Jan. 1-Dec. 31: E-Prescribing, EHR, PQRI, and MOC Bonuses Take Effect.
      Jan. 1-Dec. 31: Bonuses Go into Effect.
      2011
    • Jan. 1: Several Health System Reform Policies Take Effect:
      • Medicare beneficiaries will receive free preventive services.
      • The Center for Medicare and Medicaid Payment Innovation is established and will test new models of care including medical homes, accountable care organizations (ACOs), and value-based payments, among others.
      • Medical malpractice demonstration grants will be awarded to states to develop innovative programs aimed at reducing malpractice costs.
      • Medicare Advantage (MA) payments will be frozen to 2010 levels. Those with MA plans also will have to begin participating with Recover Audit Contractors (RACs).
      • Providers enrolling in Medicare or Medicaid must include NPI numbers on all enrollment applications.
      • Physician Compare website is established to compare physicians who are participating in Medicare to report on various quality measures.
      Jan. 1, 2011:
      Jan. 1, 2011
    • March 23: Medicare and Medicaid Providers Must Disclose Relationships Regarding Payment Suspension.
      • Providers who are enrolling in Medicare or Medicaid must disclose any relationship with other providers or suppliers who have been subject to payment suspension.
      March 23, 2011: Payment Suspension Relationships
      March 23, 2011
    • June: Patient-Centered Outcomes Research Institute (PCORI) is established and public comment is sought on definition and priorities.
    • July 1: Administrative Simplification Requirements to be Established.
      • Operating rules for the HIPAA eligibility verification transaction and the health claim status transaction will be established.
      July 1: Administrative Simplification Requirements to be Established.
      July 1, 2011
    • September: AADA joins 26 other specialty groups to comment on Patient-Centered Outcomes Research Institute definitions and priorities
    • Oct. 1: The Independent Payment Advisory Board (IPAB) will commence.
      July 1: Administrative Simplification Requirements to be Established.
      • The Patient Protection and Affordable Care Act calls for the establishment of an Independent Payment Advisory Board (IPAB).
      • The IPAB is charged with formulating comprehensive regulatory and legislative recommendations designed to slow the growth in national health spending while preserving or enhancing quality of care.
    2012
    • Jan. 1-Dec. 31: E-prescribing, EHR, PQRI, and MOC bonuses and penalties go into effect.
      Jan. 1-Dec. 31: Bonuses and penalties go into effect.
      Jan. 1-Dec. 31, 2012
    • Jan. 1: A Medicaid demonstration project will be conducted in eight states to evaluate the use of bundled payments for the provision of integrated care.
    • Jan. 1: Practice Expense Geographic Practice Cost Indices (GPCI) data methods will be analyzed and adjusted based on statutory provisions.
    • Jan. 1: Physicians May Begin Participation in Accountable Care Organizations (ACOs).
      April 1: Pharmaceutical Companies Must Disclose Who Receives Drug Samples.
      April 1, 2012
    • April 1: Pharmaceutical Companies Must Disclose Who Receives Drug Samples.
      • Pharmaceutical companies must disclose to HHS the names of providers who were given drug samples.
      • Sunshine Act
      April 1: Pharmaceutical Companies Must Disclose Who Receives Drug Samples.
      April 1, 2012
    • July 1: HHS Must Adopt Rules for Eletronic Funds Transfers
      • HHS must adopt a set of rules for electronic funds transfers (EFT) and the HIPAA transactions standards health care payment and remittance advice.
      July 1: HHS Must Adopt Rules for Eletronic Funds Transfers.
      July 1, 2012
    • July 9: The Centers for Medicare and Medicaid Services (CMS) announced the selection of 89 additional Accountable Care Organizations (ACOs) to participate in the Medicare Shared Saving Program.
    • Oct. 1: Administrative Simplification.
      • Administrative Simplification
        • HHS must set forth rules establishing a unique health plan identifier number.
      Oct. 1: Administrative Simplification.
      Oct. 1, 2012
    2013
    • Jan. 1-Dec. 31: E-Prescribing, EHR, PQRI and MOC Bonuses and Penalties Go into Effect.
      Jan. 1: E-Prescribing, EHR, PQRI and MOC Bonuses and Penalties Go into Effect.
      Jan. 1, 2013
    • Jan. 1: A five-year national voluntary pilot program will be established to test bundled Medicare payments around an episode of care for 10 different medical conditions selected by the Secretary.
    • Jan. 1: Operating Rules for HIPAA Eligibility Verification Transaction and Health Claim Status Transaction will be Implemented.
      • Operating rules for the HIPAA eligibility verification transaction and the health claim status transaction will be implemented by providers.
      Jan. 1, 2013: Operating Rules for HIPAA Eligibility Verification Transaction and Health Claim Status Transaction will be Implemented.
      Jan. 1, 2013
    • March 31: Drug and Device Manufacturers Must Report Any Payment Made to a Provider in Excess of $10.
      • Drug and device manufacturers must report to HHS any payment made to a provider in excess of $10.
      March 31: Drug and Device Manufacturers Must Report Any Payment Made to a Provider in Excess of $10.
      March 31, 2013
    • Oct. 1: ICD-10 Must Be Implemented (DELAYED until Oct. 1, 2014).
      Oct. 1, 2013: IDC-10 Must Be Implemented.
      Oct. 1, 2013
    2014
    • Jan. 1-Dec. 31: Bonuses and Penalties Go into Effect.
      Jan. 1-Dec. 31: Bonuses and Penalties Go into Effect.
      2014
    • Jan. 1: Insurer and Employer Laws Go into Effect.
      • Health insurance exchanges will be available for individuals to purchase. Individuals will face a fine if they do not have acceptable health insurance coverage.
      • Insurance companies will not be allowed to prohibit individuals from enrolling in a plan based on a pre-existing condition.
      • Insurance companies will no longer be allowed to set annual limits on coverage.
      • Small Business Tax Credit: Employers receive a greater tax credit up to 50 percent of their contributions for health insurance premiums for their employees.
      • Employers with up to 100 employees may enroll in their state-based Small Business Health Options Program (SHOP).
      • A unique health plan identifier must be implemented.
      • Final rules must be established for EFT, health care payment and remittance advice, and health claims attachments.
      Jan. 1: Insurer and Employer Laws Go into Effect.
      Jan. 1, 2014
    • Jan. 15: IPAB May Begin Making Recommendations to Congress on the Medicare Program.
      • IPAB may begin making recommendations to Congress on the Medicare program.
      Jan. 15: IPAB May Begin Making Recommendations to Congress on the Medicare Program.
      Jan. 15, 2014
    • July 1: IPAB Must Submit an Annual Report on Health Care Costs, Utilization Rates, and Quality of Care.
      • IPAB must submit an annual report on health care costs, utilization rates, and quality of care.
      July 1: IPAB Must Submit an Annual Report on Health Care Costs, Utilization Rates, and Quality of Care.
      July 1, 2014
    2015
    • Jan. 1-Dec. 31: Bonuses and Penalties Go into Effect.
      Jan. 1-Dec. 31: Bonuses and Penalties Go into Effect.
      2015
    • Jan. 1: Value-based modifier goes into effect.
      • Value-based modifier goes into effect in the Medicare physician fee schedule for select physicians.
      • An individual will face a larger fine if he or she does not have acceptable health insurance coverage.
      Jan. 1: Value-Based Modifier Goes into Effect.
      Jan. 1, 2015
    • Jan. 15: IPAB Has the Authority to Make Medicare Cost-Reduction Recommendations.
      • IPAB has the authority to make Medicare cost-reduction recommendations.
      Jan. 15: IPAB has the authority to make Medicare cost-reduction recommendations.
      Jan. 15, 2015
    2016
    • Jan. 1-Dec. 31: Penalties go into Effect.
      Jan. 1-Dec. 31: Penalties Go into Effect.
      2016
    • Jan. 1: Health Claims Attachments Standards and Referral Standards Should be Implemented by All Providers.
      • Health claims attachments standards and referral standards should be implemented by all providers.
      Jan. 1: Health Claims Attachments Standards and Referral Standards Should be Implemented by All Providers.
      Jan. 1, 2016
    • Jan. 15: IPAB has the Authority to Make Medicare Cost-Reduction Recommendations.
      • IPAB has the authority to make Medicare cost-reduction recommendations.
      Jan. 15: IPAB has the Authority to Make Medicare Cost-Reduction Recommendations.
      Jan. 15, 2016
    2017

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