January 6, 2011

Twenty-one provisions of the health reform law are scheduled to go into effect in 2011. The following provisions are for Jan. 1 implementation.

• Medical-loss ratio requirements — Health plans must provide rebates to customers if they spend less than 80 percent of premiums on health care.
• Closing the donut hole — Medicare beneficiaries will receive a 50 percent discount on brand-name prescriptions as the government works to close the Medicare Part D “donut” hole.
• Doctors will get a 10 percent Medicare bonus for primary care services, while general surgeons in health professional shortage areas also will get a 10 percent bump.
• Medicare prevention benefits — Cost sharing for Medicare-covered preventive services earning an “A” or “B” grade from the U.S. Preventive Services Task Force will be eliminated.
• CLASS Act begins — This national, voluntary program will allow employees to purchase long-term care insurance.
• Premium threshold freeze — The income threshold for income-related Part B premiums will be frozen at 2010 levels for 2011 through 2019.
• Medicare Advantage changes — Payment rates to private Medicare Advantage plans will be gradually reduced in comparison to Medicare fee-for-service rates.
• Home health payments — States can allow Medicaid enrollees to designate a home health care service as their provider, and states can receive 90 percent federal matching payments for two years for home health-related care.
• Chronic disease prevention — States can receive three-year grants to develop comprehensive healthy lifestyle programs for Medicaid enrollees.
• Tax-free spending accounts — Costs for over-the-counter drugs will not be reimbursed through a health reimbursement account or flexible spending account, unless they are prescribed by a doctor.
• Quality strategy — The U.S. Department of Health and Human Services must report to Congress a strategy to improve health care service delivery, patient health outcomes and population health.

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