Post on 14-Jan-2016
description
State of NevadaOffice for Consumer Health
Assistance
HEALTHCARE REFORM
Marilyn G. Wills, DirectorMarilyn G. Wills, DirectorGovernor’s Consumer Health AdvocateGovernor’s Consumer Health Advocate
Office for Consumer Health Assistance
Workers Compensation Ombudsman
2001 Legislation Senate Bill 573 – Transferred Bureau for Hospital
Patients to GovCHA Hospital billing issues Jurisdiction: Final determination (NRS 223.575.4)
Office for Consumer Health Assistance
Assembly Bill 236 – Nevada Prescription Help Desk RxHelp4NV.org
Assembly Bill 79 – External Review◦Certified by Division of Insurance◦Final Determination
2005 Legislation Assembly Bill 155 – Requires all Nevada Hospitals to
have GovCHA contact information on all Admission and Discharge forms. (NRS 449.730)
Post discount policy for uninsured.
Office for Consumer Health Assistance
Senate Bill 126 – Requires the Division of Industrial Relations (DIR) to include GovCHA contact information on all notices or forms sent to an injured employee. These include:◦C1 – Notice of Injury or Occupational Disease◦C3 – Employer’s Report of Industrial Injury or
Occupational Disease◦C4 – Employee’s Claim for Compensation/Report of
Initial Treatment◦D1 – Workers’ Compensation Rights and Benefits Poster◦The DIR’s web-site
Office for Consumer Health Assistance
Five years Assist small employer and their employees in
resolving disputes with insurance companies relating to insurance coverage, claims, payments, and reimbursements
Small business employer education and advocacy Small group health plans Health Care Reform
Provision in the Patient Protection and Affordable Care Act of 2010 (Health Care Reform)
Strategic Collaborations ◦ Access to HealthCare Network◦ SHIP◦ RAGE◦ Salud En Accion
Goal is to expand the reach of the office and assist more individuals statewide
2011 – AB519
Moved GovCHA to DHHS, Director’s OfficeTransferred Office of Minority Health from the Health Division to GovCHA – remains as separate programNevada 211 moved under GovCHA umbrellaEstablished GovCHA Director as “Governor’s Consumer Health Advocate”
Office for Consumer Health Assistance
Expands rules for External Review
Establishes Silver State Exchange
HEALTH CARE REFORMPatient Protection and Affordable Care Act•Signed into Law March 23, 2010
Health Care and Education Affordability Reconciliation Act •Signed into Law March 30, 2010
Created to improve access to health insurance and improve overall quality and affordability for all Americans.
Office for Consumer Health Assistance
HEALTH CARE REFORM
Insurers that offer dependent coverage must offer coverage for adult children until age 26, EVEN IF...
no longer lives at home;Is not claimed as a dependent, or;Is no longer a student
Effective September 23, 2010
Office for Consumer Health Assistance
HEALTH CARE REFORMInsurance plans can no longer charge co-pays/deductibles for preventive care screenings (ex: cancer, cholesterol, diabetes)•Grandfathered plans are exempt
Insurers cannot deny coverage to children through age 18 that have pre-existing conditions.•Grandfathered “Individual” plans are exempt from this provision
Office for Consumer Health Assistance
HEALTH CARE REFORMInsurers cannot require higher co-payments/deductibles if the member seeks treatment at an out-of-network emergency room•Grandathered plans are exempt.
Insurers are prohibited from setting dollar limits on the lifetime of the policy; and annual limits on essential benefits are greatly restricted. All plans are affected.
Office for Consumer Health Assistance
Office for Consumer Health Assistance
HEALTH CARE REFORMEarly Retiree Insurance Plan• Provides continued health care
coverage to individuals who retire early but are not yet eligible for Medicare (ages 55-64)
• Apply through employer’s group plan
Small Business Tax Credit• 25 or less employees• If eligible, may receive up to 35% tax
credit Office for Consumer Health Assistance
HEALTH CARE REFORMWhat is a “Grandfathered” Plan?•If a plan was in existence before reform was enacted on March 23, 2010 it is considered to be a “grandfathered” plan.
•Plans are allowed to keep their grandfathered status as long as they do not make any significant changes in coverage. For example:
Significantly increases premiums; Increase medical costs to employees; Reduces the employer contribution; Significantly cuts or reduces benefits; Adding or tightening an annual limit
The plan loses its grandfathered status and is subject to the provisions in the Health Care Reform Act if any of the above take place. Office for Consumer Health
Assistance
7- Member Voting Board
Governor appoints 5 Senate Majority Leader Appoints 1 Speaker of Assembly Appoints 1
◦ Ex-officio Director of Department of Health and Human
Services Director of Department of Business and Industry Director of the Department of Administration
WEB SITE: govcha.state.nv.us/
E-mail address : cha@govcha.state.nv.us
Office of Consumer Health Assistance555 E. Washington Ave., Suite 4800
Las Vegas, NV 89101702-486-3587 1-888-333-1597
Fax: 702-486-3586
Office for Consumer Health Assistance
MORE INFORMATION ON HEALTH CARE REFORM:www.healthcare.gov