Health Care Reform Implementation

About Health Care Reform

The Patient Protection and Affordable Care Act (PPACA) offers the opportunity to greatly expand access to HIV prevention, care and treatment. Enrollment for the major component of PPACA that significantly expands access to health care coverage begins Oct. 1, 2013 for coverage effective Jan. 1, 2014.

HIVMA responses to key PPACA implementing regulations are available under “Comments.” PPACA information for HIV providers is available under “Resources.

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The Latest Updates & Resources on Health Care Reform Implementation

4/19/2013

Essential Community Providers Fact Sheet

The Patient Protection and Affordable Care Act (ACA) requires Marketplace (or Exchange) plans to contract with some Essential Community Providers (ECP) – providers with experience caring for medically underserved populations.

4/4/2013

New Coverage Options and Health Care Reform Fact Sheet

Enrollment will begin in October 2013 for coverage beginning January 2014. At this time, uninsured or underinsured individuals and families will have more health coverage options. This fact sheet provides information for HIV providers on how their patients may be affected.

3/15/2013

Preparing for Health Coverage Expansion Fact Sheet

In 2014, many uninsured patients with HIV will have health insurance for the first time, and others will transfer to new health coverage. For patients to continue to see their HIV medical providers, their providers will need to contract with the plan offering this coverage.

2/6/2013

Medicaid Primary Care Payment Rate Increase Fact Sheet

The Patient Protection and Affordable Care Act (ACA) increased Medicaid payment rates to Medicare levels for primary care services for 2013 and 2014. Many HIV physicians that provide primary care services will be eligible for the enhanced payment rates.

More Resources

12/19/2012

HIVMA Urges Essential Health Benefits Support HIV Care Standards

HHS should set a higher national benefits standard that protects people with HIV from discriminatory practices. HIVMA’s recommendations focus on prescription drugs, chronic disease management and mental health and substance use services.

12/19/2012

HIVMA Comments on CMS RFI Regarding Health Plan Quality in Insurance Exchanges

HIVMA commented on CMS’s request for information regarding health plan quality in health insurance exchanges, highlighting existing HIV-related measure sets and emphasizing the importance of ensuring effective clinical quality measurement while minimizing the burden of data collection by aligning measures across programs.

12/19/2012

HIVMA Comments on USPSTF Updated HCV Screening Recommendation

HIVMA weighed in with the U.S. Preventive Services Task Force (USPSTF) in support of the panel’s draft recommendation to upgrade the rating for HCV screening of persons with risk factors from a grade “I” to a grade “B,” but urging that patients with an HIV diagnosis be specifically named among the high risk populations that should be screened for HCV infection. The comments also strongly urge the Task Force to reconsider the “C” grade level recommended for the 1945 to 1965 birth cohort, and revisit the considerable evidence to support strengthening this rating.

11/1/2012

HIVMA’s Public Comments on the National Quality Forum’s NQF’s Draft 2012 ID Measures Report

HIVMA Board of Directors Chair Michael Horberg, MD, MAS, FIDSA, submitted public comments on behalf of HIVMA on the National Quality Forum’s (NQF’s) Draft Report on “Infectious Disease Consensus Standards Endorsement Maintenance 2012.” HIVMA’s comments urge NQF to play an active role in ensuring that the final endorsed HIV and related clinical quality measures are harmonized and streamlined across federal government agencies and programs, as well as between public and private payors and practice settings.

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Health Care Reform Implementation

About Health Care Reform

The Latest Updates & Resources on Health Care Reform Implementation

Essential Community Providers Fact Sheet

New Coverage Options and Health Care Reform Fact Sheet

Preparing for Health Coverage Expansion Fact Sheet

Medicaid Primary Care Payment Rate Increase Fact Sheet

HIVMA Urges Essential Health Benefits Support HIV Care Standards

HIVMA Comments on CMS RFI Regarding Health Plan Quality in Insurance Exchanges

HIVMA Comments on USPSTF Updated HCV Screening Recommendation

HIVMA’s Public Comments on the National Quality Forum’s NQF’s Draft 2012 ID Measures Report

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