NHC UPDATE
<< Return to June 2010 Council Currents
Health Care Reform Implementation -June 2010
In March, President Obama signed into law the Patient Protection and Affordable Care Act, better known as health care reform. Some of the provisions of this legislation become law immediately, while others will be phased in over the next ten years. Working with member organizations represented on the Government Relations Affinity Group and Health Care Reform Issue Teams, the National Health Council (NHC) has reached agreement on three major policy areas in which the NHC will be active during implementation of this landmark legislation.
The first area is the creation of the Qualified Health Benefit Plans and the essential benefits that they will be required to cover. The Secretary of Health and Human Services is required to define and update at least annually the categories of covered treatments, items, and services within benefit classes for individual plans, and in doing so must “conduct a transparent process that allows for public comment.” There may also be a rulemaking process for defining essential health benefits and an opportunity to limit cost sharing for some services.
Second, delivery system reform has long been a critical policy area for the NHC, and the new legislation provides many opportunities for input. The law requires the creation of the Center for Medicare and Medicaid Innovation to test innovative payment and service delivery models, and also establishes the Independent Payment Advisory Board (IPAB) to propose changes to Medicare to limit spending growth. The IPAB, in particular, consists of 15 members appointed by the President and must include “representatives of consumers and the elderly.”
Third, the new law establishes the Patient-Centered Outcomes Research Institute (PCORI) to design and fund comparative effectiveness research (CER). Specifically, the NHC plans to present candidates for the Board of Governors, participate in expert advisory panels, submit nominations for the Methodology Committee, and provide comments as a process for dissemination of CER is established at the Office of Communication and Knowledge Transfer within the Agency for Health Care Research and Quality (AHRQ).
These are only a few of the potential points of engagement during implementation of health care reform, and the NHC will be monitoring other opportunities.
