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 Medicare Modernization Act?
Medicare Part D System On December 8, 2003, the President signed into law Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003.
What is the history of Medicare?
· Today's Presidential Action. Today the President signed into law the historic Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which will help to create a modern Medicare system, allow for the biggest improvements in senior health care in nearly 40 years, and provide seniors with prescription drug benefits and more choices in …
What would a modernized Medicare look like?
· The Medicare Prescription Drug Improvement and Modernization Act of 2003 received an odd compliment from Senator Chuck Schumer (D-NY) “This is not a perfect bill but America cannot wait for perfect.”. The assigned readings address not just aspects of the prescription drug act itself but the pressures that mounted beginning at the state ...
What is the SGR repeal and Medicare Provider payment Modernization Act?
The Kaiser Family Foundation website provides in-depth information on key health policy issues including Medicaid, Medicare, health reform, global health, HIV/AIDS, health insurance, the …
What was the impact of the Medicare Prescription Drug Improvement and Modernization Act quizlet?
What was the impact of the Medicare Prescription Drug Improvement and Modernization Act? The Act created Medicare Part D, the drug prescription program.
What was the impact of the Medicare prescription drug Improvement?
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.
When was the Medicare Modernization Act implemented?
On December 8, 2003, the President signed into law Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003.
Why was Medicare Prescription Drug Improvement and Modernization Act passed?
In an attempt to relieve patients of some of the financial burden of prescription drugs, the government has enacted a law that provides new prescription drug coverage under Medicare: the Medicare Prescription Drug, Improvement and Modernization Act (MMA) of 2003.
What came out of the Medicare Prescription Drug Improvement and Modernization Act?
Since the enactment of Medicare Prescription Drug, Improvement, and Modernization Act in 2003, only insurance companies administering Medicare prescription drug program, not Medicare, have the legal right to negotiate drug prices directly from drug manufacturers.
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.
What was notable about the Medicare Modernization Act of 2003 quizlet?
5. What was notable about the Medicare Modernization Act of 2003? The revision included a prescription drug benefit.
Why are handwriting tests done on drug names?
They do handwriting tests to catch names that might look alike when scribbled out on a prescription pad. They also reject any names that could be seen as a boast about the drug's power or efficacy, which is why you won't see any drugs named Cholesterol Busters, or Angina-B-Gone.
Why did Medicare Part D pass?
Medicare Part D dramatically lowered the number of beneficiaries spending more than one-fifth of their income on prescription drugs from 14% in 2003 to 7% in 2010. Part D coverage has made seniors' finances more stable and less prone to bankruptcy due to drug costs.
Which Medicare plan covers prescription medications quizlet?
Medicare Part D help cover the cost of prescription drugs, is run by medicare approved insurance companies, may help lower prescription drug costs, and may protect against higher costs in the future.
What President started Medicare Part D?
President George W. BushPresident George W. Bush signed into law the Medicare Prescription Drug Improvement and Modernization Act of 2003, adding an optional prescription drug benefit known as Part D, which is provided only by private insurers.
When was Medicare Part D established?
2006The MMA also expanded Medicare to include an optional prescription drug benefit, “Part D,” which went into effect in 2006.
When was Medicare Part D enacted?
Medicare Part D System. On December 8, 2003, the President signed into law Public Law 108-173, the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) of 2003. This new law amended section 1144 of the Social Security Act to require the Commissioner of Social Security to conduct additional outreach efforts to identify ...
When was Medicare Part D and Part D Subsidy File established?
A new system of records was established on December 28, 2004 (69 F.R. 77816), entitled Medicare Part D and Part D Subsidy File (60-0321) and routine uses applicable to the system of records. We will alter that system to include information applicable to the new Medicare Part B System.
What is the new Medicare Part D system?
The new Medicare Part D System will maintain only that information that is necessary for the efficient and effective control and processing of Medicare Part D subsidy applications from the initial application through the appeals process. The proposed new Medicare Part B System will maintain only information that is necessary for the efficient, timely and accurate imposition of Medicare Part B premium IRMAA. Security measures will be employed that protect access to and preclude unauthorized disclosure of records in the proposed system.
What age can you be eligible for Medicare?
The initial selection of individuals will be from the population of current Medicare beneficiaries. Subsequent selection will be individuals who attain age 65 after initial selection and are eligible for Medicare. These individuals will be eligible by virtue of age or disability. This population also includes disabled individuals who file and receive expedited entitlement to Medicare due to Lou Gehrig’s disease (ALS) or End Stage Renal Disease (ESRD).
How does SSA safeguard the security of information?
We will safeguard the security of the information by requiring the use of access codes to enter the computer systems that will maintain the data and will store computerized records in secured areas that are accessible only to employees who require the information to perform their official duties. Any manually maintained records will be kept in locked cabinets or in otherwise secure areas. Furthermore, SSA employees having access to SSA databases maintaining personal information must sign a sanction document annually, acknowledging their accountability for making unauthorized access to or disclosure of such information.
What is the President's action on Medicare?
Today the President signed into law the historic Medicare Prescription Drug, Improvement, and Modernization Act of 2003, which will help to create a modern Medicare system, allow for the biggest improvements in senior health care in nearly 40 years, and provide seniors with prescription drug benefits ...
When did Medicare cut drug costs?
Beginning in 2006, seniors without coverage would be able to join a Medicare-approved plan that would cut their yearly drug costs roughly in half, in exchange for a $35 monthly premium. In many cases, the savings will be even greater.
How much money would a senior save with no drug coverage?
Seniors with no drug coverage and monthly drug costs of $200 would save more than $1,700 on drug costs each year. Seniors with no drug coverage and monthly drug costs of $800 would save nearly $5,900 on drug costs each year.
Will private employers continue to provide drug coverage to retirees?
Private employers will receive incentives to continue to provide drug coverage to their retirees. For the first time ever, the legislation will require the Medicare Trustees to analyze the combined fiscal status of the Medicare Trust Funds and warn Congress and the President when Medicare's general fund subsidy exceeds 45 percent.
How does private sector competition affect Medicare?
Private sector competition will result in more innovation and flexibility in coverage. This will be a significant improvement over the way benefits are provided in Medicare today -where politicians and bureaucrats, rather than health care markets, dictate what is covered and what is paid.
Is Medicare a modernized system?
Under a modernized Medicare, there will be better coverage for preventive care (e.g., a "welcome to Medicare" physical that would include screening for cancer, diabetes, and heart disease, as well as immunizations against pneumonia and the flu).
Can seniors stay in Medicare?
Seniors can choose to stay in traditional Medicare and still get prescription drug coverage. Or, they can choose a new Medicare-approved private plan where the drug benefit is integrated into broader medical coverage, including disease management programs and protections against high out-of-pocket medical spending. Or, seniors who like the lower cost sharing and extra benefits often available in managed care plans would be able to make that choice as well.
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 SSA Title 3?
Title III: Combatting Waste, Fraud, and Abuse - (Sec. 301) Amends SSA title XVIII to allow the Secretary to make a conditional Medicare payment if a primary plan has not made or cannot reasonably be expected to make prompt payment. Requires the payment to be contingent on reimbursement by the primary plan to the appropriate Medicare trust fund. Requires a primary plan as well as an entity that receives payment from a primary plan to reimburse the Medicare Trust Funds for any payment made by the Secretary if the primary plan was obligated to make payment. Makes other changes with regard to Medicare as a secondary payer to address the Secretary's authority to recover payment from any and all responsible entities and to bring action, including the collection of double damages, to recover payment under the Medicare secondary payer provisions.
Who conducts a study for a report to the Congress on the extent to which drug utilization and access to covered
Requires the Comptroller General to conduct a study for a report to the Congress on the extent to which drug utilization and access to covered part D drugs by subsidy eligible individuals differs from such utilization and access for individuals who would qualify as such subsidy eligible individuals except for application of the assets test.
What is a Medigap guarantee?
Guarantees issuance of a substitute Medigap policy for persons, enrolling in part D during the initial part D enrollment period, who at the time of such enrollment were enrolled in and terminated enrollment in a Medigap policy H, I, or J or a pre-standard policy that included drug coverage. Guarantees the enrollment for any policies A, B, C, and F within the same carrier of issue. Prevents the issuer from discriminating in the pricing of such policy on the basis of such individual's health status, claims experience, receipt of health care or medical condition. Prohibits the issuer from imposing an exclusion of benefits based on a pre-existing condition under such policy. Provides that the guarantee applies for enrollments occurring in the new Medigap plan within 63 days of termination of enrollment in a Medigap plan H, I, or J.
When did the CCA program begin?
241) Directs the Secretary to establish a program for the application of comparative cost adjustment in CCA areas, to begin January 1, 2010, and last six years, and to test whether direct competition between private plans and the original Medicare fee-for-service program will enhance competition in Medicare.
What is MEDPAC report?
Requires a Medicare Payment Advisory Commission (MEDPAC) study and report to Congress with respect to authority regarding disapproval of unreasonable beneficiary cost-sharing.
When was Medicare Modernization Act enacted?
The Medicare Prescription Drug, Improvement, and Modernization Act, also called the Medicare Modernization Act or MMA, is a federal law of the United States, enacted in 2003. It produced the largest overhaul of Medicare in the public health program's 38-year history.
When was the MMA signed?
It produced the largest overhaul of Medicare in the public health program's 38-year history. The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin. This summary is from Wikipedia. Source: Wikipedia. Show More Summary Show Less Summary.
Who signed the Medicare Amendment?
Lyndon B. Johnson signing the Medicare amendment. Former President Harry S. Truman (seated) and his wife, Bess, are on the far right.
When did Medicare+Choice become Medicare Advantage?
These Part C plans were initially known in 1997 as "Medicare+Choice". As of the Medicare Modernization Act of 2003, most "Medicare+Choice" plans were re-branded as " Medicare Advantage " (MA) plans (though MA is a government term and might not even be "visible" to the Part C health plan beneficiary).
How long does Medicare cover hospital stays?
The maximum length of stay that Medicare Part A covers in a hospital admitted inpatient stay or series of stays is typically 90 days . The first 60 days would be paid by Medicare in full, except one copay (also and more commonly referred to as a "deductible") at the beginning of the 60 days of $1340 as of 2018.
What is Medicare Part A?
Part A covers inpatient hospital stays where the beneficiary has been formally admitted to the hospital, including semi-private room, food, and tests. As of January 1, 2020, Medicare Part A had an inpatient hospital deductible of $1408, coinsurance per day as $352 after 61 days' confinement within one "spell of illness", coinsurance for "lifetime reserve days" (essentially, days 91–150 of one or more stay of more than 60 days) of $704 per day. The structure of coinsurance in a Skilled Nursing Facility (following a medically necessary hospital confinement of three nights in row or more) is different: zero for days 1–20; $167.50 per day for days 21–100. Many medical services provided under Part A (e.g., some surgery in an acute care hospital, some physical therapy in a skilled nursing facility) is covered under Part B. These coverage amounts increase or decrease yearly on the first day of the year.
When will Medicare cards be mailed out?
A sample of the new Medicare cards mailed out in 2018 and 2019 depending on state of residence on a Social Security database.
How old do you have to be to get Medicare?
Eligibility. In general, all persons 65 years of age or older who have been legal residents of the United States for at least five years are eligible for Medicare. People with disabilities under 65 may also be eligible if they receive Social Security Disability Insurance (SSDI) benefits.
Who is responsible for Medicare eligibility?
The Social Security Administration (SSA) is responsible for determining Medicare eligibility, eligibility for and payment of Extra Help/Low Income Subsidy payments related to Parts C and D of Medicare, and collecting most premium payments for the Medicare program.