Having trouble keeping up with the looming medical billing deadlines associated with the ACA? You’re not alone. This fall, we saw the insurance marketplace open, the disproportionate share hospital payment kick in, and the two-midnight inpatient admission policy put in place. Now it’s time to look at 2014 and 2015 using this timeline created by FierceHealthPayer.
January 1, 2014
- Medicaid will be expanded to all individuals not eligible for Medicare under age 65 with incomes up to 138% of the federal poverty level.
- Insurers are prohibited from charging more or denying coverage to anyone with a pre-existing condition.
- Consumers in every state can get coverage through health insurance exchanges (federal or state, depending where they live).
- Physicians, hospitals, and health plans must follow new rules for electronic fund transfer and remittance advice transactions.
- Providers participating in the EHR Incentive Program who have met Meaningful Use Stage 1 for two or three years will need to meet Stage 2 criteria during 2014.
March 1, 2014
- Physician-owned hospitals must report ownership and investment information.
October 1, 2014
- Healthcare organizations must submit all claims using the ICD-10 coding system.
- Federally qualified health centers will begin receiving higher Medicare payments (about 30% higher).
January 1, 2015
- Employers with at least 50 full-time employees must offer health benefits for pay a penalty.
- CMS will apply a value modifier under the Medicare Physician Fee Schedule so payments to physicians emphasize quality of care instead of volume of services.
January 1, 2017
- Meaningful Use Stage 3 begins for providers who have completed at least two years in Stage 2.
January 1, 2018
- A 40% excise tax will be charged on the cost of health plans that exceed these thresholds: $10,200 for individual coverage and $27,500 for family coverage.
Last Updated on December 19, 2013