What was the impact of the Medicare Prescription Drug Improvement and Modernization Act?
Summary: Implementation of MMA has affected the entire healthcare continuum by reducing pharmaceutical reimbursement rates and health system revenues and increasing prescription drug copayments, emergency department visits, and hospital admissions.
What are the implications of the Medicare Modernization Act of 2003?
The 2003 Medicare Modernization Act (MMA) is considered one of the biggest overhauls of the Medicare program. It established prescription drug coverage and the modern Medicare Advantage program, among other provisions. It also created premium adjustments for low-income and wealthy beneficiaries.
What is the purpose of the Medicare prescription drug Improvement Act of 2003?
Provides for: (1) Federal phase-in of the costs of premiums and cost-sharing and cost-sharing subsidies for dually eligible individuals; and (2) coordination of Medicaid with Medicare prescription drug benefits to provide that Medicare is the primary payer for covered drugs for dual eligibles.
Which was created by the Medicare Prescription Drug Improvement and Modernization Act to identify and recover?
The Medicare Prescription Drug Improvement and Modernization Act of 2003 (MMA) made the biggest changes to the Medicare in the program in 38 years. Under the MMA, private health plans approved by Medicare became known as Medicare Advantage Plans. These plans are sometimes called "Part C" or "MA Plans.”Dec 1, 2021
When did the the Medicare Prescription Drug Improvement and Modernization Act?
2003The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was enacted in November 2003 and became effective on January 1, 2006.
What was notable about the Medicare Modernization Act of 2003 quizlet?
What was notable about the Medicare Modernization Act of 2003? The revision included a prescription drug benefit.
What was the purpose of the Prescription Drug Marketing Act of 1987?
Prescription Drug Marketing Act of 1987 - Amends the Federal Food, Drug, and Cosmetic Act to permit only the U.S. manufacturer of a drug to reimport such drug into the United States, except for emergency medical care. Prohibits the selling, purchasing, or trading of prescription drug samples or coupons.
What was the impact of the Durham Humphrey Amendment?
This amendment established the distinction between so-called legend (prescription) drugs and over the counter (nonprescription) drugs. The amendment also authorized the taking of prescriptions verbally, rather than in writing, and the refilling of prescriptions.Mar 29, 2016
What is the Modernization Act?
Introduced in House (04/15/2021) To amend the Federal Food, Drug, and Cosmetic Act to allow manufacturers and sponsors of a drug to use alternative testing methods to animal testing to investigate the safety and effectiveness of a drug, and for other purposes.
Which of the following provides the Medicare prescription drug benefit?
Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare, provided through private plans approved by the federal government.Oct 13, 2021
What did the Medicare Act of 1965 do?
On July 30, 1965, President Lyndon B. Johnson signed the Medicare and Medicaid Act, also known as the Social Security Amendments of 1965, into law. It established Medicare, a health insurance program for the elderly, and Medicaid, a health insurance program for people with limited income.Feb 8, 2022
What did Medicare do?
Medicare was enacted in July 1965 and implemented essentially nationwide in July 1966. It provided virtually universal public health insurance to individuals aged 65 and older (coverage for the disabled was added in 1973).
Why is autonomy important in health care?
Autonomy, which is defined as self-rule, is an important concept to health care because it is applied to "informed consent," which requires a provider to obtain the approval of a patient who has been provided adequate information to make a decision regarding intervention. True. False. True.
What is group insurance?
Group insurance is a type of public insurance that anticipates that a large group of individuals will purchase insurance through their employer and the risk is spread among those paying individuals. -True. -False. False.
What is the Lilly Ledbetter Fair Pay Act?
The Lilly Ledbetter Fair Pay Act of 2009 (FPA), an amendment to Title VII of the Civil Rights Act of 1964, which also applies to claims under the Age Discrimination Act of 1967 and the Americans with Disabilities Act of 1990, provides protection for unlawful employment practices related to compensation discrimination.
What is Medicare Part D?
Medicare Part D helps the elderly, and others, afford prescriptions. Use medicare.gov to help the patient pick an appropriate plan. Financial help is available for patients if needed. The donut hole is challenging for patients and providers. Pharmacists are a great resource - utilize them.
What is the late enrollment penalty for Medicare Part D?
Late enrollment penalty (also called the "LEP" or "penalty") -Added to the person's monthly Part D premium for as long as he or she has Medicare prescription drug coverage.
What is a PDP plan?
Prescription Drug Plans (PDP's) -Adds drug coverage for drugs other than in Part B. -Can have Part A and/or Part B to be eligible. Medicare Advantage Plans (Part C) -Encompass all parts of Medicare (A, B and D) -Eligibility requires both Part A and Part B. -Not eligible for gap coverage. --> Likely not needed.
What is a SHIP program?
State Health Insurance Assistance Program (SHIP) A group of federal and state funded programs working together to provide assistance with public and private health insurance issues and options to Medicare beneficiaries or those soon to be Medicare beneficiaries, their families and caregivers.
What is the role of Social Security Administration?
Determines eligibility for Medicare A, B, and low income subsidy (SSI) Centers for Medicare and Medicaid Services (CMS) Policies and procedures. Oversees Medicare and Medicaid plans, billing and rules.
When is open enrollment for Medicare Part D?
Medicare Part D: Enrollment. Open Enrollment Period occurs from October 15th through December 7th. -Individuals who sign up late may be penalized.
Does Medicare Advantage Plan include a prescription drug?
Medicare Advantage Plan (like an HMO) -Must provide all of Part A and Part B, but could provide more benefits. --> Most include a prescription drug benefit that substitutes for part D. Medicare Part D. Prescription Drug Plan. -Covers prescription medications.
What items were reduced in the 2005 Medicare payment?
Provides that for 2005 the payment amount for certain items, oxygen and oxygen equipment, standard wheelchairs, nebulizers, diabetic lancets and testing strips, hospital beds and air mattresses, will be reduced.
What is a FEHBP?
Requires the Secretary to apply such coordination requirements to described Rx plans, which include Medicaid programs and group health plans and the Federal Employees Health Benefit Program (FEHBP), in the same manner as such requirements apply to a State Pharmaceutical Assistance Program.
What is the federal income tax rate for 2004?
Provides that starting April 1, 2004 through September 30, 2004, payment will be based on a 62.5 percent Federal amount and a 37.5 percent local amount, and that starting October 1, 2004, payment will be based on a 75 percent Federal amount and a 25 percent local amount.