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 589DFHJKMNPQRSTUVWXY_`abcdefghijklmO№А№$џ№$џ№$џR№$uь%* Ÿ`aЖ sqOF—џЧEƒ №0ƒ†AПРХAџ€ё џ3џ3ЬfЬџџџ™3fџџЬ@ёџџџџї№ѓ €аЂџ њgў§4ddddАТv —яF0жќџџкўџџpћppћ@ <§4BdBd<—@0pЉшПv њgў§44d4dєрv —яF0љџџ”џџџpћq pћŸOШg Ъš;э>-Ъš;<§4dddd<—@0<—<§4!d!d<—@0<—ˆАŠnК___PPT10‹N РРф.6КMelissa Jenkinsх.Š2К___PPT9‹/Ш 0в?й2к КOctober 5, 2003Oй к=№0ѓ wŸЈ3Federal and Washington State Healthcare LegislationЁ44 ŸЊ ѓu ŒŸ  Stealth Care?ŸЊ ѓ Ÿ ”Children s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) ЁKK ŸЈ ѓP yŸЈ&American Recovery and Reinvestment ActЁ'' ŸЊ ѓ` €ŸЈAppropriationsŸЈТDepartment of Health and Human Services $3 billion appropriated for construction grants and projects Renovation and equipment, acquisition of health IT systems, and health professions workforce shortages $1.3 billion appropriated for research resources Grants to construct, renovate, or repair existing research facilities and for shared instrumentation $2 billion to supplement state general funds for child care assistance for low income families Ё„(=g1f_(=g1f`ѓb ‚ŸЈAppropriationsŸ @Department of Health and Human Services (con t) $1.1 billion for comparative effectiveness research Funding for existing and new programs through the National Institutes of Health $1 billion for Prevention and Wellness Fund Funding to CDC immunization program and infection reduction strategies Funding to carry out evidence based clinical and community prevention and wellness strategies $2 billion for Health IT ЁЂ04Q,Ѕ 04Q,Ѕ   Њ)sѓg ‡ŸЈHealth Information TechnologyŸЈbGrants and Loans Funding Funding could be as much as $19 billion over the next 4 years Secretary of HHS to invest in infrastructure as necessary to promote the electronic exchange of HIT State grants made available to promote HIT in states Required match from states FY 2011 $1 for every $10 fed, FY2012 $1 for every $7 fed, FY 2013 $1 for every $3 Ёр> d 6 R> d 6   Rѓd „ŸЈHealth Information TechnologyŸЈ’Promotion of Health IT Creation of the Office of the National Coordinator for Health Information Technology Works to promote the electronic use and exchange of Electronic Health Records (EHR) Strategic Plan Utilize EHR for each person in the United States by 2014 Develop website to increase public education Requires reports on a number of funding, implementation, and assessment of impacts of HITЁŽUT ТET  Т ѓf †ŸЈHealth Information TechnologyŸЈd HIT Policy Committee will make recommendations on infrastructure and development 20 Member Committee 3 members appointed by Secretary of HHS 4 appointed from Legislative Branch -1 from each chamber caucus 13 members appointed by Executive Branch HIT Standards and Implementation Committee will make specific recommendations on implementation proceduresЁ~ Q“k Q’   jѓi ‰ŸЈPremium Assistance for COBRAЁ ŸЈЬ65% subsidy for COBRA coverage Subsidy available for 9 months Assistance eligible for individuals who are involuntarily terminated between 9/1/08 and 12/31/09 Reduced or no subsidy for high income individuals No subsidy for individuals with Adjusted Gross Income exceeding $145K ($290K joint filing) Phase in subsidy for individuals between $125K and $145K ($250K and $290K joint) Entity that fronts subsidy will be reimbursed via a reduction in payroll taxes ЁrбЌPa  2ЋPѓj ŠŸЈDMedicare and Medicaid Health IT & Miscellaneous Medicare Provisions Ё EC  Ÿ рMedicare & Medicaid HIT Incentives Physicians Incentives for adoption of electronic health record technology Payments based at $15,000-1st year ($18,000 for 2011 or 2012), $12,000-2nd year, $8,000-3rd year, $4,000-4th year, $2,000-5th year If in a  shortage area incentives jump up 10% Hospitals $2 million per hospital incentive (plus additional incentives) $200 for every discharge between the 1,150th and 23,000th discharge Includes $87 billion to states to cover Medicaid funding shortagesЁ# ?В ADC# ?   +            5 ?DCѓk ‹ŸЈ!Trade Adjusted Assistance ProgramЁ"" Ÿ тTrade Adjusted Assistance (TAA) Program Law passed in 1962 to provide government assistance for workers that lose their job due to outsourcing as a result of trade agreements Rule changes in the TAA Program 80% (up from 65%) of healthcare premiums paid Expanded to include workers in the service sector Previously was limited only to firms that  produce an article Ёz(‰ a?(‰ a? ѓ ™Ÿ >President Barack Obama s BudgetЁ  Ÿ ьReleased February 26, 2009 Includes 10 year, $634 billion  reserve fund to pay for expansion of healthcare system Large pot of money is intentionally short on details Hopes to signal willingness to negotiate on eventual plan Funding to be covered by decreasing tax breaks for individuals making more than $250,000 Also include cuts to Medicare including Medicare Advantage ЁPXXѓŒ ˜ŸЈ Recent QuotesŸ p So let there be no doubt: health care reform cannot wait, it must not wait, and it will not wait another year. President Barack Obama Address to Joint Session of Congress February 24, 2009  We cannot afford to delay health care reform& If we delay, millions more Americans will lose coverage. If we delay, premiums will grow even farther out of reach. And if we delay, federal health spending will absorb an even greater share of the nation's economy." Senate Finance Chairman Max Baucus Opening Remarks at Senate Finance Committee Meeting February 25, 2009 ЁшrPPP9 PPP#PH PPr9  #H  ѓ€ ‘ѓ ’ŸЈ#Association Health Plans (SHB 1714)Ё$ ŸЈdWould require carriers to submit information on associations annually to the insurance commissioner Ёe`eѓ‚ “ŸЈ-Neurodevelopmental Therapy Mandate (SHB 1412)Ё.# ŸЈнRequires group plans and the state employee plan to cover neurodevelopmental therapies for children under age 18 Allows Department of Health to review and determine regulation of certain providers and identify therapies Ёооѓƒ ”ŸЈOrgan TransplantsŸЈGCrediting the Waiting Period (SHB 1308) Credits prior group or individual creditable coverage towards the organ transplant benefit waiting period Current transplant waiting periods: Individual: 12 months Group coverage: 6 months Lifetime Limits (SSB 5725) No separate lifetime limits less than $350,000 for organ transplants ЁЌ(`Ž`0``F`` Ž0 Gѓ„ •ŸЈYoung Adult Plan (SB 5052)Ё ŸЈ‰Permits carriers to offer an individual health plan for young adults, age 19-34 Plan may exclude mandated benefits and some requirements Ё ‰Šѓ… –ŸЈHealthcare Reform BillsŸ кExchange/Connector  Sen. 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McRae, Senior Vice President March 4, 2009Ё3(3Іј‡Sпgя№H №œ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Лру33™™™™Ьˆ‘ЉК___PPT10‹iы.21Ш№‰ŸЉ+Dё='ё : џџџџ=ё @Bё +юХя €0љ АN0 Ф№М…№ф#№T№( № №ф#№r №ф# S №€“; Пџ№№` €р№У  ;  № ž№ЂВ №ф# C №zAСBУ ED-AI941_pw0130_D_20090129162855[Potomac Watch]№Q№”` №H №ф# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы.И–ЩVГ+Dё='ё : џџџџ=ё @Bё +юня €†0љ АN0 м№д№…№$№l№( № №$№x №$ c №$€hџ: Пџ№ˆ№` Pа№У  :  № ž№x №$ c №$€; Пџ№ˆ№0P`@№У :  № ž№4 №$ ƒ №0€; ƒПРџ №РP`  №дŸЈ†Signed into law February 4, 2009 Costs $32 billion over 4.5 years Funded by increased tobacco product taxes Allows states to increase eligibility to children with family incomes of 300% of federal poverty level Simplifies state premium assistance option for employer sponsored coverage Provides states with option to enroll legal immigrant children and pregnant women without waiting periodЁ‡‡ІјИˆаЄ`0ь№H №$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.fkЩ0/-+Dё='ё : џџџџ=ё @Bё +юƒя €y0љ АN0 ‚№z€ƒ№\#№№( № №\#№` №\# ƒ №0€ Ј; ƒПРџ "ёП`№pP а №ђŸ ^ Signed into law on February 17th Provides $787 billion of economic  stimulus in the form of project funding and tax cuts Total estimated healthcare funding is $140 billion ЁbЎ Z ZZ ŒІј‡Sпgя№r №\# S №€Р›; Пџ№№` €р№У  ;  № ž№H №\# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Лру33™™™™Ьˆ‘ЉК___PPT10‹iы.21Ш№‰ŸЉ+Dё='ё : џџџџ=ё @Bё +ю•я €|0љ АN0 ”№Œ@„№#№$№( № №#№r №# S №€0.: Пџ№№` €р№У  ;  № ž№r №# S №€1: Пџ№№р№p№У :  № ž№H №# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЁя €}0љ АN0  №˜`„№˜#№0№( № №˜#№x №˜# c №$€dД; Пџ№ˆ№` €р№У  ;  № ž№x №˜# c №$€мИ; Пџ№ˆ№@№p№У ;  № ž№H №˜# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЗя €€0љ АN0 Ж№ЎА„№Ќ#№F№( № №Ќ#№x №Ќ# c №$€Т; Пџ№ˆ№` €р№У  ;  № ž№Ž №Ќ# c №$€tШ; Пџ№ˆ№а№p№У ;  №"žІрќ„@Ь№H №Ќ# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЗя €~0љ АN0 Ж№Ў€„№ #№F№( № № #№x № # c №$€Ао; Пџ№ˆ№` €р№У  ;  № ž№Ž № # c №$€pх; Пџ№ˆ№@№p№У ;  №"žІр$Ќh8є№H № # ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юГя €0љ АN0 В№Њ „№Ј#№B№( № №Ј#№x №Ј# c №$€ы; Пџ№ˆ№` €р№У  ;  № ž№Š №Ј# c №$€ї; Пџ№ˆ№а№p№У ;  №žІ РД<ј№H №Ј# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЁя €0љ АN0  №˜а„№Д#№0№( № №Д#№x №Д# c №$€B Пџ№ˆ№` €р№У  B  № ž№x №Д# c №$€АB Пџ№ˆ№а№p№У B  № ž№H №Д# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЗя €‚0љ АN0 Ж№Ўр„№И#№F№( № №И#№x №И# c №$€,B Пџ№ˆ№№ €p№У  B  № ž№Ž №И# c №$€B Пџ№ˆ№0№а№У B  №"žІрќ„@Ь№H №И# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +юЛя €ƒ0љ АN0 К№В…№Р#№J№( № №Р#№x №Р# c №$€0,B Пџ№ˆ№` €р№У  B  № ž№’ №Р# c №$€P6B Пџ№ˆ№а№p№У B  №&žІ№l=АЩ…U№H №Р# ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы. –ЩЬћt+Dё='ё : џџџџ=ё @Bё +ю•я €0љ АN0 ”№Œа†№<$№$№( № №<$№r №<$ S №€DDB Пџ№№` €р№У  B  № ž№r №<$ S №€ EB Пџ№№ №а№У B  № ž№H №<$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы.–—Щр~ƒЋ+Dё='ё : џџџџ=ё @Bё +ю•я €0љ АN0 ”№ŒР†№8$№$№( № №8$№r №8$ S №€„LB Пџ№№№ €p№У  B  № ž№r №8$ S №€\MB Пџ№№а№0№У B  № ž№H №8$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы.”—Щ№oŒ+Dё='ё : џџџџ=ё @Bё +юaя€0љ АN0 `№X†№ $№№№( № № $№ИЂ № $ “ №6€ќЃ: ‡ПƒПРџ"ёП`№ра №DŸЈWashington StateЁ(2(№H № $ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы.е–Щ`&Š+Dё='ё : џџџџ=ё @Bё +юЗя €‡0љ АN0 Ж№Ў †№$№F№( № №$№x №$ c №$€ИЗ: Пџ№ˆ№P№№У B  № ž№x №$ c №$€(Ћ: Пџ№ˆ№` €р№У  :  № ž№о №$ “ №6€ќ`B ‡ƒПРџ №рР №  №xŸЈ>School District Benefit Plans (HB 1940 and SB 5491 / HB 2177)Ё? №( №$ ƒ №0€cB ƒПРџ №р Pа №ШŸЈ’Requires school districts and educational service districts to purchase healthcare benefits through the Health Care Authority by September 1, 2011Ё“`“№H №$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.hzЩРJУ8+Dё='ё : џџџџ=ё @Bё +юЁя €ˆ0љ АN0  №˜@†№$№0№( № №$№x №$ c №$€(tB Пџ№ˆ№0P`№У B  № ž№x №$ c №$€uB Пџ№ˆ№@№У  B  № ž№H №$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.hzЩРJУ8+Dё='ё : џџџџ=ё @Bё +юЁя €‰0љ АN0  №˜`†№ $№0№( № № $№x № $ c №$€HƒB Пџ№ˆ№` €р№У  B  № ž№x № $ c №$€ „B Пџ№ˆ№ €`№У B  № ž№H № $ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.hzЩ`XЋC+Dё='ё : џџџџ=ё @Bё +ю…я €0љ АN0 „№|€†№($№№( № №($№x №($ c №$€а’B Пџ№ˆ№` €р№У  B  № ž№x №($ c №$€Ј“B Пџ№ˆ№а Рp№У B  № ž№М №($ “ №6€•B ‡ƒПРџ №0 €А  №VŸЈWellness Programs (SHB 2160)Ё № №($ ƒ №0€а˜B ƒПРџ №@ P0 №ИŸЈ‚Permits carriers to offer wellness programs for individual and group plans that meet federal HIPAA nondiscrimination requirements Ёƒ`ƒ№H №($ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ№№№ќўЙ‘‘‘кккˆ‘Š‰К___PPT10‹iы.е–Щ€ѓ8ю+Dё='ё : џџџџ=ё @Bё +юЇя €0љ АN0 І№ž†№,$№6№( № №,$№x №,$ c №$€\ЊB Пџ№ˆ№` €р№У  B  № ž№~ №,$ s №*€4ЋB Пџ№ˆ№№@№У B  № ž№H №,$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.I–Щ`Rэ‚+Dё='ё : џџџџ=ё @Bё +юIя €Š0љ АN0 H№@ †№0$№и№( № №0$№ Ђ №0$ ƒ №0€ЌИB ПƒПРџ№ р №@ŸЈ Questions?Ё (2 0№H №0$ ƒ №0ƒ“ŽŸ‹”оНhПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ‘ЉК___PPT10‹iы.hzЩ ўL+Dё='ё : џџџџ=ё @Bё +№ёw0 ˜№Pƒ№L#№(№( № №L#№^ №L# S №Пџ№ЗщYK №У  ; №Š №L# c №$€Јx; Пџ№н Mѓ)№У  ;  №ŸЊ №H №L# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы. qЩPQє6№Цёy0 F№>ƒ№`#№ж№( № №`#№d №`# c №$Пџˆ№ЗщYK №У  B №2 №`# s №*€,ФB Пџˆ№н Mѓ)№У  B  №РŸЈвHefty Health Spending in Stimulus Bill Law Signed by President Obama Includes Funds for Medicare, Research, and Insurance By Todd Zwillich WebMD Health News Reviewed by Louise Chang, MD Feb. 17, 2009 -- The economic stimulus bill signed by President Obama contains more than $140 billion in health care spending, designed mostly to ease the recession's effects on workers and also to boost long-held goals of improving the nation's health information infrastructure.ЁгyZЊN}     ђѓ`c0п}Šђѓac0пЉЙ№H №`# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы. qЩ .™5№јё€0 x№p…№Ф#№№( № №Ф#№^ №Ф# S №Пџ№ЗщYK №У  B №j №Ф# c №$€рЯB Пџ№н Mѓ)№У  B  №ўŸЈrDepartment of Health and Human Services $2.5 billion appropriated to Health Resources and Services Administration $500 million for grants for health centers that qualify under the Public Health Services Act $1.5 billion for grants for construction, renovation and equipment, and for the acquisition of health IT systems $500 million to address health professions workforce shortages (scholarships, loan repayment, training programs, etc.) $1.3 billion appropriated for the National Center for Research Resources $1 billion for grants or contracts to construct, renovate, or repair existing non-federal research facilities $300 million to provide shared instrumentation and research equipment to recipients of grants $2 billion to supplement State general funds for child care assistance for low income families $500 million for Buildings and Facilities to fund high priority repair ЁprEIЬІ’З№rEIЬЇ№H №Ф# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ђ–ЩрЧО№ˆ ё‚0  № …№Ш#№˜ №( № №Ш#№^ №Ш# S №Пџ№ЗщYK №У  B №њ  №Ш# c №$€pюB Пџ№н Mѓ)№У  B  №Ž Ÿ vNational Institutes of Health - con t $1.1 billion for comparative effectiveness research $700 million for comparative effectiveness research through Public Health Services Act, Social Security Act, and Medicare Prescription Drug, Improvement, and Modernization Act of 2003 $400 million to the Office of the Director to conduct comparative effectiveness research $400 million for comparative effectiveness research at the discretion of the Secretary of Health and Human Services assessing the effectiveness of health care treatments and strategies It s worth noting that there are many different provisions attached to this appropriation $50 million for Public Health and Social Services Emergency Fund $1 billion for Prevention and Wellness Fund $300 million to the CDC for their immunization program $650 million to carry out evidence based clinical and community prevention and wellness strategies $50 million to states to implement health associated infection reduction strategies $2 billion for Health IT .25% of those funds may be used for administration of Health IT programs ЁкZИYЙZmюIZ И Y Й Z  m ю  I  Њ №H №Ш# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ѓ–Щ ХЖm№| ё„0 ќ №є 0…№Ь#№Œ №( № №Ь#№^ №Ь# S №Пџ№ЗщYK №У  D №ю №Ь# c №$€ќ%D Пџ№н Mѓ)№У  D  №‚Ÿ аSubtitle A  Promotion of Health IT Creation of the Office of the National Coordinator for Health Information Technology Established within the Dept. of HHS Works to promote the electronic use and exchange of health information that protects PPI, improves healthcare quality, reduces healthcare costs, provides appropriate and helpful information, coordinates amongst healthcare interests (hospitals, physicians, labs, etc.) Strategic Plan Update the Federal Health IT Strategic Plan (developed as of 6/3/2008) Utilization of EHR for each person in the United States by 2014 Incorporation of privacy and security protections Specifying a framework for coordination and flow recommendations Recommendations to foster public understanding Collaboration Produce measurable goals Create a website to post information Reports are required on funding needed and/or used, implementation, assessment of impact of HIT, evaluation of cost/benefit, financial assistance granted, governance of national network Ё–y1G пy 1  G  п   №H №Ь# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ѕ–Щ€]й-№Z ё†0 к№в@…№а#№j№( № №а#№^ №а# S №Пџ№ЗщYK №У  D №Ь №а# c №$€@D Пџ№н Mѓ)№xУ  D ˆ`ŠXК___PPT9‹:Ќ2 №јŸ tSubtitle B  Testing of Health Information Technology Pilot Testing and Voluntary Testing Programs will take place on proposed standards and implementation specifications as coordinated by the HIT Standards Committee HIT Policy Committee will make recommendations on infrastructure and development 20 Member Committee 3 members appointed by Secretary of DHHS(1 of which to represent DHHS & 1 a public health official) 1 member appointed by majority leader of Senate, 1 member appointed by minority member of Senate, 1 member appointed by Speaker of the House, 1 member appointed by minority leader of the House 13 members appointed by Executive Branch (Office of the Comptroller General) HIT Standards and Implementation Committee formed as part of the program as well to make specific recommendations on HIT implementation ЁhйQˆˆ’oйQˆˆ №H №а# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ј–ЩpвЯП№~ ё‡0 ў №і P…№д#№Ž №( № №д#№^ №д# S №Пџ№ЗщYK №У  D №№ №д# c №$€Д`D Пџ№н Mѓ)№У  D  №„Ÿ мSubtitle C  Grants and Loans Funding $2 billion is seemingly a start-up fund for this program; there is authorized to be appropriated additional sums as may be necessary for each year 2009-2013. Could be as high as $19 billion over the next 4 years. Secretary will invest in the infrastructure necessary to allow and promote the electronic exchange of HIT consistent with the goals in the strategic plan State grants to promote HIT in the state that shall be used to conduct activities to facilitate and expand HIT This must be in required consultation with hc providers, health plans, etc. Required match from states FY 2011 $1 for every $10 fed, FY2012 $1 for every $7 fed, FY 2013 $1 for every $3 Subtitle D - Privacy Guidance on privacy provisions and security provisions will be issued annually from the Secretary of HHS HIPPA standards apply Many provisions laid out to regulate the information made available via HER including penalties, reporting requirements, and public awareness of violationsЁjLR0 L  R 0 Њ1М№H №д# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Љ–Щдi4№ёё‰0 q№i`…№и#№№( № №и#№^ №и# S №Пџ№ЗщYK №У  D №c №и# c №$€мOD Пџ№н Mѓ)№У  D  №їŸЈяProvisions of Premium Assistance Reduction of premiums payable Individual eligible for COBRA coverage is responsible for paying 35% of the amount of such premium Limitation period of premium assistance 9 months after the first day that a person is eligible for COBRA Assistance eligible individual If at any time they become (or have become) eligible for COBRA between 9/1/08 and 12/31/09 Tax implications of reimbursement Employers will be reimbursed in their share of the premium costs as payroll taxes No subsidy for high income individuals No subsidy for individuals with AGI exceeding $145K ($290K joint filing) Phase in subsidy for individuals between $125K and $145K ($250K and $290K joint) Subsidy less than the 65% coverage otherwise offered Ёь?c(A["R'š5?c(A[" R 'š5№H №и# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Љ–ЩаГ„њ№ш ёŠ0 h №` p…№м#№ј №( № №м#№^ №м# S №Пџ№ЗщYK №У  D №Z  №м# c №$€8œD Пџ№н Mѓ)№У  D  №ю Ÿ МMedicare & Medicaid HIT Incentives Physicians Incentives for adoption of HER Technology Incentives up to75% of estimates for meaningful use of EHR by an eligible professional, for all covered professional services furnished No incentive payments after 2016 Payments for investments in HIT will begin next year (2010) Payments cannot exceed $15,000 for first year ($18,000 for 2011 or 2012), second year $12,000, third year $8,000, fourth $4,000, fifth $2,000 If in a  shortage area incentives jump up 10% Shortage area is determined by the Secretary of HHS taking into account (1) An urban or rural area (which need not conform to the geographic boundaries of a political subdivision and which is a rational area for the delivery of health services); (2) a population group; or (3) a public or nonprofit private medical facility Not applicable to hospital based professionals Hospitals Incentive is the sum of base amount of $2 million, $200 for every discharge between the 1,150th and 23,000th discharge, a Medicare share fraction, and a transition factor Added incentives also exist for critical access hospitals Ёє.Z*ZЂZEZ/Z Z4ZxZ:ZZ. * Ђ E /   2 x: Њ:№H №м# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ќ–Щ)‡№аё‹0 P№H€…№р#№р№( № №р#№^ №р# S №Пџ№ЗщYK №У  D №B №р# c №$€0ЦD Пџ№н Mѓ)№У  D  №жŸ lTrade Adjusted Assistance (TAA) Program Rule changes in the TAA Program 80% (up from 65%) of healthcare premiums paid through TAA Program for workers that lose their job due to outsourcing or jobs moving overseas Provision available for workers that qualify for TAA and are released by their employer before January 1, 2011 Expanded to include workers in the service sector Previously was limited only to firms that  produce an article ЁNH/?H/? №H №р# ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.Ж–Щ $MЩ№ ё0 † №~ †№$№ №( № №$№d №$ c №$Пџˆ№ЗщZL №У  D №r  №$ s №*€TэD Пџˆ№€ .І)№У  D  № Ÿ House 1/14 vote count: 289 - 139 Currently covers 6-7 million children and will total around 11M with new reauthorization 61cent per pack cigarette tax increase and additional tax on tobacco products Option to enroll legal immigrant children without waiting period. Currently, 5 year waiting period State option for premium assistance under CHIP - removes requirements of measuring cost effectiveness if employer plan meets criteria (makes it easier to use subsidy for ESI) employer coverage must be creditable coverage under Public Health Service Act, contribute at least 40% of premium, and be nondiscriminatory If coverage does not meet criteria, then plan needs to be evaluated for cost effectiveness to get subsidy New quality measures for children s health care under SCHIP and Medicaid- new pediatric quality measures program and more outreach and enrollment funding House bill contains provision on specialty hospitals: Would halt building of any new doctor-owned hospitals and hamper plans of existing ones to expand ЁМміš7d Њф(і›!dІ8H"јj№H №$ ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.czЩРVR*№Tё’0 д№Ь0†№$№d№( № №$№d №$ c №$Пџˆ№ЗщZL №У  D №Р №$ s №*€<ћD Пџˆ№о §D)№У  D  №NŸЈ SHB 1714 -Ё  І8H"јj№H №$ ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.г|ЩАK,№фё“0 d№\P†№$№є№( № №$№d №$ c №$Пџˆ№ЗщZL №У  D №P №$ s №*€ ц Пџˆ№о M)№У  D  №оŸ NHB 1412  expands existing neurodev mandate for group plans Implementation timing: plans issued or renewed 1/1/2011 Includes coverage for occupational, speech, and physical therapies, applied behavioral analysis (ABA) and otther therapies for treatment of developmental delays and disabilities Ё*(t Г  Њ,ЛDІ8H"јj№H №$ ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.wzЩ№ПŽ№yё”0 љ№ёp†№$$№‰№( № №$$№d №$$ c №$Пџˆ№ЗщZL №У  ц №х №$$ s №*€dц Пџˆ№о MD)№У  ц  №sŸЈCredit the waiting period: Ё(І шјв№H №$$ ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.д|Щ№Jн №$ё—0 Є№œА†№4$№4№( № №4$№d №4$ c №$Пџˆ№ЗщZL №У  ц № №4$ s №*€дц Пџˆ№о Mѓ)№У  ц  №ŸЊ №H №4$ ƒ №0ƒ“.k”ођПџ ?№ џџџ€€€Ь™33ЬЬЬџВВВˆ8Š0К___PPT10‹ы.д|Щ№3Jђrд ЌђА `‚ jЖL ЅіP /СХј` КХb WШd ПЭf ~аЫi А9гтеЁи“§“#Ї #-ˆ3x?u }Й №JМžруЦчoъэЅёTєPE^PКRІW'Zоdлѕw# S\ Х1ўџр…ŸђљOhЋ‘+'Гй0­ pxЄА МШ ш є   фNo Slide Title John Cakecf757Microsoft PowerPoint@p‡МAZ@pхљ‘‡У@@RћЏр{У@рHЬXЉ—Щ) GhЌџџџџ‰g  ,VЁ'&" WMFC1I <8?@ABCDEFGHIJKLMNOPQRSTUVWXYZ[\]^_`abcdefghijklmnopqrstuvwxyz{|}~€‚ƒ„…†‡ˆ‰Š‹ŒŽ‘’“”•–—˜™š›œžŸ ЁЂЃЄЅІЇЈЉЊЋЌ­ЎЏАБВГДЕЖЗИЙКЛМНОПРСТУФХЦЧШЩЪЫЬЭЮЯабўџџџгдежзийклмнопрстуфхцчшщъыьэюя№ёђѓєѕіїјљњћќ§ўџ      !"#$%&'(ўџџџ*+,-./0ўџџџ2345678ўџџџ§џџџ§џџџ§џџџ=ўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџRoot Entryџџџџџџџџd›OЯ†ъЊЙ)шўџџџPicturesџџџџџџџџџџџџЧECurrent Userџџџџџџџџ1SummaryInformation(џџџџвР­PowerPoint Document(џџџџџџџџџџџџ#S]DocumentSummaryInformation8џџџџџџџџ)џџџџџџџџџџџџџџџџџџџџџџџџRoot Entryџџџџџџџџd›OЯ†ъЊЙ)шƒЏ8™ЩўџџџPicturesџџџџџџџџџџџџЧECurrent Userџџџџџџџџ1SummaryInformation(џџџџвР­      !"#$%&'(ўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџ2345678ўџџџ§џџџ§џџџџџџџџџџџџџџџH§џџџABCDEFGўџџџўџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџџўџеЭеœ.“—+,љЎDеЭеœ.“—+,љЎф ˆЈИРШа и рш №ј  @фOn-screen ShowPremeraЃѓ' ArialTimes New RomanSymbol Courier NewPlan Language4Federal and Washington State Healthcare Legislation‘Stealth’ Care?KChildren’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA) 'American Recovery and Reinvestment ActAppropriationsAppropriationsHealth Information TechnologyHealth Information TechnologyHealth Information TechnologyPremium Assistance for COBRAEMedicare and Medicaid Health IT & Miscellaneous Medicare Provisions "Trade Adjusted Assistance Program President Barack Obama’s BudgetRecent Quotes Slide 15$Association Health Plans (SHB 1714).Neurodevelopmental Therapy Mandate (SHB 1412)Organ TransplantsYoung Adult Plan (SB 5052)Healthcare Reform Bills Slide 21  Fonts UsedDesign Template Slide Titles@ 8@ _PID_HLINKSфAј #http://www.webmd.com/todd-zwillich"http://www.webmd.com/louise-changPowerPoint Document(џџџџџџџџџџџџ#S]DocumentSummaryInformation8џџџџџџџџ@џџџџџџџџџџџџџџџџџџџџџџџџ