Massive administrative work of expanded health coverage begins

The Centers for Medicare and Medicaid Services, the Internal Revenue Service, health information technology professionals, physicians, health plans, and individual states face hefty to-do lists now that the landmark healthcare reform legislation has passed. Despite the criticism some have expressed over health reform's major provisions not taking effect until 2019, the Congressional Budget Office has predicted that 19 million additional Americans will carry health insurance when the individual mandate becomes law on Jan. 1, 2014.

"It's an aggressive timeline," Genevieve Kenney, a health-policy analyst at the Urban Institute, told Newsweek. "But we're not going into it blind." Prior learning experiences include the passage of Medicare in 1965 and Massachusetts' individual health mandates in 2006.

"You can leave no stone unturned," Joan Fallon, communication director of the Massachusetts Health Connector, said before 42 states convened at a January conference to discuss how to make health coverage universal. The Connector, charged with the task of putting the Massachusetts' new health policy into action, spent $4 million on outreach alone, hosting 150 events across the state in the course of 21 months. The group ultimately developed a user-friendly online portal that handled 80 percent of the state's new enrollments.

UnitedHealthcare is also battening down the hatches by hiring an additional 175 employees for its call center in Maryland Heights, Mo., just to take calls from physicians and other providers regarding their questions about provided benefits, administration and claims processing. The customer calls previously handled through the Maryland Heights center will be routed to other company centers throughout the United States, according to the St. Louis Business Journal.

Finally, CMS has already implemented several provisions of the Patient Protection and Affordable Care Act, according to the Part B News Blog. So far, the agency has administered the expiration of therapy cap exceptions, extension of the outpatient hold-harmless provision, and more-with plenty of work to go, according to the post.

To learn more:
- read this Newsweek article
- check out this St. Louis Business Journal article
- here's the Part B News Blog post

Suggested Articles

The profit margins and management of Community Health Group raise questions about oversight of managed care insurers.

Financial experts are warning practices about the pitfalls of promoting medical credit cards to their patients.

A proposed rule issued by HHS on Tuesday would expand short-term coverage, a move Seema Verma said will have "virtually no impact" on ACA premiums.