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  • Wellness & Healthcare Mandates Part of Health Reform

    Wellness & Healthcare Mandates Part of Health Reform

    Health experts agree that one of the most difficult trends in the American health care system is the development of health conditions that could have been prevented or managed at the beginning, resulting in more costly methods of treatment.

     In order to promote wellness and decrease the costs associated with preventable illness, Congress has enacted the following legislation as part of the Health Reform Legislation: 

    • Starting in September of 2010, Medicare, employer‐sponsored (and other) group health  plans and  health insurance issuers are prohibited from requiring co‐pays for certain  preventive services, such as cancer and mental health screenings and immunizations; 
    • Beginning in 2014, certain most individual, employer and health insurance Exchange plans must cover “essential heath benefits”.  The Secretary of Health and Human Services (HHS) is to define the essential health benefits, however such benefits are required to include certain general categories, including: emergency services, hospitalization, maternity and newborn care, prescription drugs, laboratory services, mental health services, preventive and wellness services and chronic disease management(PPACA, Sec. 1302) 
    • Previous legislation allowed employers to reward workers who maintained a healthy lifestyle via participation in wellness programs, such as smoking cessation and fitness programs, with reductions in premium.    Starting January 1, 2014, group health plans may give reductions of up to 30% of the cost of premiums to employees who voluntarily participate in wellness programs. This may be expanded to 50% subject to the discretion of the Secretary of Health and Human Services

      For additional information on this legislation,  please refer to the Democratic Policy Committee Senate website at http://dpc.senate.gov/healthreformbill/healthbill75.pdf

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