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Health Care Reform Timeline

2010
• $250 to every senior entering the donut hole (2010 only)
• Temporary high-risk insurance pool for early retirees
• Background checks on long-term care employees
• Nursing homes required to disclose ownership information
• Student loan programs to boost primary care workforce
Initiatives to root out waste, fraud, and abuse

2011
• Part D prescription drug discounts for seniors in donut hole (50 percent for brand-name drugs and 7 percent for generics)
• Free annual wellness visits and personalized prevention plans
• Preventive care deductibles and copayments eliminated
• Medicare Advantage plan reimbursements frozen
• Medicare Advantage plans prohibited from charging enrollees more than traditional Medicare for chemotherapy administration, skilled nursing home care, and other specialized services
• Creation of new Centers for Medicare and Medicaid Services (CMS) Innovation Center
• Means-tested Part D premiums begin; Part B means-tested income thresholds frozen for 10 years
• 10% bonus payments to Medicare primary care practitioners
• New, voluntary long-term care insurance program (CLASS ACT). Implementation of this program is on hold.

2012
• Phase-down of Medicare Advantage plan subsidies
• Bonus payments to high-quality Medicare Advantage plans
• Incentives for hospitals to reduce preventable readmissions
• Data collection and reporting improvements to CMS’ Nursing Home Compare (NHC) Website

Elder Justice Coordinating Council required to make recommendations to the Secretary of Health and Human Services on the coordination of federal, state, local and private agencies’/entities’ activities relating to elder abuse, neglect, and exploitation

2013
• Pilot program to test bundled payments for a single episode of care
• Double-deduction for employer Part D subsidies eliminated
• Additional hospital insurance tax for high-income workers
• Nursing homes required to have effective compliance and ethics programs

2014 and beyond
• Part D donut hole phases down to complete closure by 2020
• Medicare Advantage plans must limit profits and expenses to 15 percent of Medicare payments
• Independent Payment Advisory Board established

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