+1 862 207 3288 What kind of adjusmnets hospital CEO must make to meet helath reform ( ACA) requirements
In this white paper we summarize the prospective impact of recent US. health
care reform legislation on hospitals, as seen in four major areas: changes
in funding and reimbursement, changes in clinical operations, transparency
requirements, and additional oversight measures. The specific eflects include
increased reporting requirements, increased fundin g for Medicaid and primary
care, and increased taxes on medical devices.
On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act
of 2010.1 The accompanying Health Care and Education Reconciliation Act of 20102 (the “Reconciliation
Act”) was signed one week later on March 30, 2010. We refer to the two acts collectively as “PPACA”
unless othenNise noted. Though many of the legislative changes do not take effect until 2014 or later,
several provisions are self-implementing and took effect immediately.
When discussions on health reform began in earnest, the hospital industry believed that cuts in Medicare
reimbursement were inevitable. Rather than opposing reform entirely, the industry worked with members
of Congress to receive some offsetting benefits. By virtue of their involvement, the hospital associations
believe they achieved several successes, such as: (1) inclusion of insurance coverage mandates,
(2) expanded eligibility through enrollment in exchanges, and (3) defeat of the single-payor and public
option proposals.
Despite these successes, various concerns remain for hospitals. Many do not believe PPACA will provide
coverage to an adequate number of individuals in order to significantly increase insurance coverage for
hospital patients. For example, the exclusion of illegal immigrants from the mandates and exchanges
leaves a significant population uncovered. In addition, meaningful tort reform is not included in the legis-
lation. Further, many provisions within PPACA call for expanded reporting requirements. Though the
stated purpose of increased reporting is to promote quality of care, there likely will be further reimburse-
ment consequences.
H.R. 3590, Pub. L. No. 111-148.
2 H.R. 4872, Pub. L. No. 111-152.
Pillsbury Winthrop Shaw Pittman LLP www.pillsburylaw.com 1
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