HEALTH CARE REFORM PASSES!
Key Provisions in H.R. 3590
CLASS Program
This new, voluntary long-term care insurance program represents a significant step forward in how future older adults and people with disabilities will be able to afford and access home and community-based services. According to the congressional Budget Office, the CLASS plan will reduce Medicaid spending and will be solvent and sustainable for the long term. And it will help individuals and families struggling to maintain their independence and financial stability by providing a much-needed daily benefit to help purchase the care they need to stay healthy and at home.
Aging and Disability Resource Centers
The bill provides $10 million a year over five years (FY2010-2014) for continuation of Aging and Disability Resource Centers (ADRCs) through the demonstrations developed by the Administration on Aging and the Centers for Medicare and Medicaid Services.
Medicare Part D Improvements
The bill makes improvements to the annual enrollment process for beneficiaries; in particular, changes the timing of the Part C and D enrollment period to begin October 15 and end December 7, starting in 2012. Includes an annual 45 period of disenrollment from Medicare Advantage plans to allow beneficiaries to change their election to the original Medicare fee-for-services program under Part A and B, beginning in 2011.
Additional Outreach and Assistance Funds for Part D
The bill provides additional funding to support outreach and assistance for Part D and low-income prescription drug programs by State health Insurance Assistance Programs (SHIPs), AAAs, ADRCs and the national Center for Benefits and Outreach Enrollment including a total of $45 million to these entities between FY2010 and 2012. In addition to these efforts, the funded entities would support outreach activities aimed at preventing disease and promoting wellness
Prevention and Wellness
It expands coverage of preventive health services under the Medicare and Medicaid programs. The provision will implement a national strategy and grant programs to support community-based prevention and wellness programs including a “Healthy Aging, Living Well” program that will provide more preventive health services and help to achieve the goal of reducing chronic diseases and addressing health disparities.
Elder Justice Act
The bill includes the Elder Justice Act provisions that would implement a comprehensive national strategy to address elder abuse, neglect and exploitation. These provisions would enhance the training, recruitment and staffing in long-term care and enhance state adult protective service systems, long-term care ombudsman programs, and law enforcement practices. The bill also provides for new nursing home transparency and criminal background check requirements.
Empowered At Home
Empowered at Home provisions will remove certain barriers to providing Medicaid HCBS by offering states more flexibility in state plan amendments for HCBS and modify the spousal impoverishment statute to mandate that states include the spousal impoverishment protections in their waiver programs.
Community First Choice
The bill includes a new option which offers states a financial incentive to further rebalance the provision of LTSS in Medicaid. Individuals in participating states would gain guaranteed access to community-based attendant services – currently, only institutional care is guaranteed.
Money Follows the Person
Reauthorizes the MFP program, originally authorized under the Deficit Reduction Act of 2005, and continues federal support through 2016 for grants to states to transition Medicaid enrolled nursing facility residents to their homes or other community settings, while making some positive changes to the minimum residency requirement (from six months to 90 days).