What is the Medicare Modernization Act (MMA)?
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. The MMA's most touted feature is the introduction of an entitlement benefit for prescription drugs, through tax breaks and subsidies.
What is the Medicare Modernization Act of 2003?
Medicare Prescription Drug, Improvement, and Modernization Act. 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.
What is the Original Medicare program called?
Medicare & Medicaid On July 30, 1965, President Lyndon B. Johnson signed into law the bill that led to the Medicare and Medicaid. The original Medicare program included Part A (Hospital Insurance) and Part B (Medical Insurance). Today these 2 parts are called “Original Medicare.”
What does the Medicare Prescription Drug Improvement and Modernization Act do?
Medicare Prescription Drug, Improvement, and Modernization Act. Long title. An act to amend title XVIII of the Social Security Act to provide for a voluntary prescription drug benefit under the medicare program and to strengthen and improve the medicare program, and for other purposes.
What program was created through the Medicare Modernization Act of 2003?
Medicare Advantage programThe 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 important addition Did the Medicare Modernization Act in 2003 provide to the Medicare program?
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.
When was Medicare Part D formed?
January 1, 2006Introduction. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) became law in December 2003. Among other provisions, the MMA created the Part D drug benefit, which became available to Medicare beneficiaries on January 1, 2006.
Who created Medicare Part D?
President BushRather than demand that the plan be budget neutral, President Bush supported up to $400 billion in new spending for the program. In 2003, President Bush signed the Medicare Modernization Act, which authorized the creation of the Medicare Part D program. The program was implemented in 2006.
What was the biggest change to Medicare brought about by the 2003 Medicare Modernization Act quizlet?
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was enacted in November 2003 and became effective on January 1, 2006. Two major changes occurred. A prescription drug benefit is now available for seniors and younger persons with disabilities who are covered by Medicare.
What is included in Medicare Part A?
In general, Part A covers:Inpatient care in a hospital.Skilled nursing facility care.Nursing home care (inpatient care in a skilled nursing facility that's not custodial or long-term care)Hospice care.Home health care.
When was Medicare Part D added to the Medicare benefit package what services did it add?
Medicare did not cover outpatient prescription drugs until January 1, 2006, when it implemented the Medicare Part D prescription drug benefit, authorized by Congress under the “Medicare Prescription Drug, Improvement, and Modernization Act of 2003.”[1] This Act is generally known as the “MMA.”
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.
Which of the following does Medicare Part D cover 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.
Which Medicare Part provides the Medicare Advantage program quizlet?
Medicare Part C offers plans provided by private health insurance companies called Medicare Advantage, as an option to coverage under the Original Medicare Plan.
Which legislation created Medicare risk programs?
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.
Why did Medicare Part D pass?
Overall, Part D has improved access to prescription drugs for Medicare beneficiaries. Better use of prescription drugs has improved the health of many beneficiaries as well as avoided the need for a number of other health care services, both of which reduced health care costs elsewhere in Medicare.
When was Medicare Modernization Act enacted?
Signed into law by President George W. Bush on December 8, 2003. 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 did Medicare Advantage start?
Medicare Advantage plans. With the passage of the Balanced Budget Act of 1997, Medicare beneficiaries were given the option to receive their Medicare benefits through private health insurance plans, instead of through the Original Medicare plan (Parts A and B).
What is Medicare Part D?
Main article: Medicare Part D. The MMA's most touted feature is the introduction of an entitlement benefit for prescription drugs, through tax breaks and subsidies. In the years since Medicare's creation in 1965, the role of prescription drugs in patient care has significantly increased.
What is the "donut hole" in Medicare?
The "donut hole" provision of the Patient Protection and Affordable Care Act was an attempt to correct the issue.
How many Americans were enrolled in HSAs in the first 10 years?
After the first 10 years over 12 million Americans were enrolled in HSAs (AHIP;EBRI).
How much did the stimulus program cost?
Initially, the net cost of the program was projected at $400 billion for the ten-year period between 2004 and 2013. Administration official Thomas Scully instructed analyst Richard Foster not to tell Congress of Foster's finding that the cost would actually be over $500 billion. One month after passage, the administration estimated that the net cost of the program over the period between 2006 (the first year the program started paying benefits) and 2015 would be $534 billion. As of February 2009, the projected net cost of the program over the 2006 to 2015 period was $549.2 billion.
When was the MMA signed?
The MMA was signed by President George W. Bush on December 8, 2003, after passing in Congress by a close margin.
What Is the Medicare Modernization Act of 2003?
The Medicare Prescription Drug, Improvement and Modernization Act of 2003 — also known simply as the Medicare Modernization Act (MMA) — is a sweeping piece of legislation that created a prescription drug benefit for millions of Medicare beneficiaries.
What Was the Impact of the Medicare Prescription Drug Improvement and Modernization Act?
The Medicare Modernization Act has impacted the program and its beneficiaries in significant ways. Perhaps the greatest impact is a massive enrollment shift to Medicare Advantage plans.
Medicare Modernization Act Pros and Cons
The Medicare Modernization Act expanded prescription drug coverage to millions of older and disabled Americans.
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.
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 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.
Which title directs the Secretary to request the Institute of Medicine of the National Academy of Sciences to conduct an evaluation of the?
Directs the Secretary to request the Institute of Medicine of the National Academy of Sciences to conduct an evaluation of the peer review program under SSA title XI.
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 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 created?
When Medicare was created in 1965 , its purpose was to protect seniors from the catastrophic costs of long hospital stays and expensive medical procedures (1–3). Since then, Medicare has expanded the scope of its benefits, the populations it covers, and, consequently, its costs.
What is Medicare Modernization?
Medicare modernization: the new prescription drug benefit and redesigned Part B and Part C
What is CMS in healthcare?
The Centers for Medicare and Medicaid Services (CMS) administers all aspects of the Medicare program, including making decisions about covered services, determining payment rates and policies, administering claims, educating beneficiaries and health care providers, and conducting research on alternative health care delivery systems.
How do MA-PDs and PDPs get funding?
The MA-PDs and PDPs receive funding through monthly premium subsidies from the government that are risk adjusted to reflect variation in drug costs among beneficiaries, monthly premiums, prescription copayments, reinsurance payments for high-cost beneficiaries, and risk-sharing payments from the government if a plan's total drug cost is unexpectedly high in a given year.
How much does Medicare pay for a drug?
For drug costs exceeding $5100, Medicare will pay 80%, the plan will pay 15%, and the beneficiary will pay 5%.
Why do Medicare Advantage plans have to bid?
The competitive bidding system is intended to encourage plans to compete to offer the best benefits at the lowest prices for beneficiaries.
How many parts are there in Medicare?
There are four distinct parts to the Medicare program: Parts A, B, C, and D. CMS organizes, funds, and administers each part separately.
When did Medicare expand?
Over the years, Congress has made changes to Medicare: More people have become eligible. For example, in 1972 , Medicare was expanded to cover the disabled, people with end-stage renal disease (ESRD) requiring dialysis or kidney transplant, and people 65 or older that select Medicare coverage.
How long has Medicare and Medicaid been around?
Medicare & Medicaid: keeping us healthy for 50 years. On July 30, 1965, President Lyndon B. Johnson signed into law legislation that established the Medicare and Medicaid programs. For 50 years, these programs have been protecting the health and well-being of millions of American families, saving lives, and improving the economic security ...
What is Medicare Part D?
Medicare Part D Prescription Drug benefit. 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.
What is the Affordable Care Act?
The 2010 Affordable Care Act (ACA) brought the Health Insurance Marketplace, a single place where consumers can apply for and enroll in private health insurance plans. It also made new ways for us to design and test how to pay for and deliver health care.
When was the Children's Health Insurance Program created?
The Children’s Health Insurance Program (CHIP) was created in 1997 to give health insurance and preventive care to nearly 11 million, or 1 in 7, uninsured American children. Many of these children came from uninsured working families that earned too much to be eligible for Medicaid.
Does Medicaid cover cash assistance?
At first, Medicaid gave medical insurance to people getting cash assistance. Today, a much larger group is covered: States can tailor their Medicaid programs to best serve the people in their state, so there’s a wide variation in the services offered.
What is Medicare Part C?
also known as Medicare Advantage, this is a managed care option that includes services under Parts A, B, C, and D, and additional services that are not typically covered by Medicare; Medicare Part C requires an additional premium; plan known formerly as Medicare1Choice. Medicare Part D.
What is the ACA?
Known as the ACA. a division of the Department of Health and Human Services (DHHS) that is responsible for administering the Medicare program and the federal portion of the Medicaid program; responsible for maintaining the procedure portion of the International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM).
What is a CMS?
Before 2001, CMS was named the Health Care Financing Administration (HCFA) Civili an Health and Medical Program: Veterans Administration (CHAMPVA) a benefits program administered by the Department of Veterans Affairs for the spouse or widow (er) and for the children of a veteran who meets specified criteria.
What is an optional managed care plan?
optional managed care plan for Medicare beneficiaries who are entitled to Part A, are enrolled in Part B, and live in an area with a plan. Types of plans available include health maintenance organizations, point-of-service plan, preferred provider organization, and provider-sponsored organization (formerly Medicare1Choice)