Healthcare Legislation of the Senior Citizens

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6th Oct 2020 Nursing Essay Reference this

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There are variant laws and acts in the society which is geared towards improving people rights, lifestyles and standards of healthy living. On the same note, there are two essential acts which performs on protecting senior’s healthcare rights, laws and opportunities in the society which has been listed below:

1)     The Affordable Care Act

2)     The Health Insurance Portability and Protection Act

The Affordable Care Act (ACA) was signed into law on March 23, 2010, which aims to provide greater access to health care coverage, advances the quality of services delivered and condenses the rate of upsurge in health spending to the senior citizens. The ACA is a United States federal statute enacted by the 111th United States Congress and has been signed into law by President Barack Obama on March 23, 2010. The act largely recollects the prevailing edifice of Medicare, Medicaid, and the employer market, but individual markets were fundamentally overhauled around a three-legged sequencer. In these markets, insurers are made to accept all applicants and charge the similar charges irrespective of pre-existing circumstances or gender. The act mandates that individuals purchase insurance and insurers refuge a list of "essential health benefits" to combat subsequent adverse selection. The Tax Cuts and Jobs Act of 2017 zeroed out the federal tax penalty for violating the individual directive, starting in 2019. Even though, the order to pass the Senate under reconciliation rules with only 50 votes, the requirement itself is still in effect. The regulation delivers insurance premium appropriations, to help households between 100–400% of the Federal Poverty Line afford these obligatory policies. Simultaneously, other individual market changes include health marketplaces and risk modification programs. The ACA provides innovative ways to support hospitals, doctors and additional health care providers to synchronize care for beneficiaries so that health care quality is enhanced and unnecessary expenditure is concentrated. These assistances significantly benefits many seniors from necessities of the law such as receiving free preventive services and paying lower Medicare prescription drug costs. Beneath are some of the conducts that the Affordable Care Act is serving seniors citizen:

•The senior citizens can benefit from the Medicare-covered supports for instance, the seniors, are not abridged or taken away under the Affordable Care Act; rather, supports are expanded. According to a new report from the Department of Health and Human Services, Medicare beneficiaries are anticipated to save an average of $4,200 from 2011 to 2021 due to lower drug costs, free preventive services, and reductions in the growth of health expenditure.

•  The senior citizens can benefit from the Private Medicare Advantage plans which are not going away, and the additional assistances they deliver are not eradicated or reduced. In 2011, Medicare Advantage membership improved by about 10 percent, while premiums fell by an average of 7 percent.

• The senior citizens can benefit from the Medicare beneficiaries where they are eligible to receive numerous free preventive services with no out of pocket budgets. These include flu shots, mammograms, and tobacco use cessation counseling, as well as no-cost screenings for cancer, diabetes, and other enduring illnesses. Seniors can also get a free annual wellness appointment, so they can discuss to their doctor about any health apprehensions. More than 25 million seniors have already received at least one of these free preventive services.

•  The seniors can benefit from the Medicare Part D prescription drug program, Medicare recipients who fall into the coverage gap, automatically obtain a deduction on prescription medications. Respectively each year, the cost paid by recipients will be a reduced amount for brand name and generic medications in the coverage gap .

On the same note, I agree with the suggested rationales of the Affordable Care Act. There are numerous reasons why I support the regulations because it includes the new resources and tools to protect the senior taxpayer dollars by preventing fraud in Medicare and Medicaid. It also builds on the efforts of the Department of Health and Human Services and the Justice Department, which has already yield substantial savings for the seniors. Reports also has proved that nearly $4.1 billion was recovered in Fiscal Year 2011 from individuals and companies seeking fraudulent payments from Medicare and Medicaid. The strict rules and regulations comprise tougher consequences for individuals who steal from Medicare and there is additional law enforcement which is geared towards finding criminals abusing the law and beneficiaries. Simultaneously, they also use several measures via the technology to prevent fraud before it happens. For instance, they prevent fraudulent payments from going out in the first place vs. trying to recollect the money and working with the Senior Medicare Patrol program, which coach seniors and their friends and neighbors about how to halt Medicare fraud. They also eliminate the cap on how much senior citizens will pay for medical assistances over a lifetime. They also have specific programs where they providing greater insurance coverage for medical expenses – up to at least $750,000 per year. Essentially, they protect senior citizens against insurance cancellations when they become sick. They have worked really efficiently on improving health insurance for 50 to 64-year old’s, including limiting age rating and establishing a provision program to encourage employers to sustain retiree health care coverage.

Similarly, they work on providing resources for finding affordable insurance and increasing access to specialty care, expanding constitutional rights of appeal seniors denied an insurance claim, strengthening protections for nursing home residents.

According to a recent report, 3.6 million beneficiaries(seniors) who reached the coverage gap saved more than $2.1 billion on their prescription drugs, which averages $604 in savings for seniors and people with disabilities.

 Secondly, the Health Insurance Portability and Accountability Act (HIPAA) was engaged into law in the year 1996, by President Bill Clinton. It is a legislation which delivers safekeeping requirements and data confidentiality, in order to keep patients’ medical information safe. It is one of the essential parts of the healthcare system. Its’ main objective is to provide the individual as well as the seniors greater control over their medical information and disclosures. Generally, the act encompasses five titles, or sections in total, which affects the elderly population in an effective manner, which are listed below:

1) HIPAA Title I aims to guard coverage of health insurance for individuals who have transformed or misplaced their occupations. It prevents group health plans from declining to cover individual seniors and other populations who have pre-existing illnesses or circumstances, and proscribes them from setting restrictions for lifetime coverage.

2) HIPAA Title II aims to direct the United States Department Of Human Services and Health in command to regiment the processing of electronic healthcare communications nation-wide. It necessitates the system of government to implement harmless electronic entree to the patients’ health statistics, remaining in agreement with the confidentiality regulations which were set by the HHS.

3) HIPAA Title III is associated to provisions which are tax-related, as well as wide-ranging medical care strategies.

4) HIPAA Title IV designates a supplementary improvement in health insurance, including provisions for those who have pre-existing illnesses or circumstances, and individuals or seniors who are on the lookout for continual coverage.

5) HIPAA Title V includes necessities accompanying with company-owned insurance, and treatment of those who misplaced their citizenship for income tax motives.

On the same note, I agree with the provided rationales because I believe that human privacy is one of the integral parts of life. It offers the seniors over what happens to their medical information. It provides the seniors an option to correct their health information. Simultaneously, it provides senior citizens the opportunity to verify who has accessed their healthcare information. It also holds the offenders accountable if the senior rights are violated.

HIPAA desecrations can be very costly for a health care association. First of all, the Breach Notification Rule, set in the compilation, necessitates that the entities which are enclosed as well as any of their business associates notify seniors that they are following a data breach. In addition to these costs, the administrations may encounter fines after the audits get directed by the Office of Civil Rights (OCR). Providers may even face unlawful custodies for defilement of such rules. Therefore, their ultimate goal is to protect the privacy of the seniors and provide them full control over their healthcare information.

References

  • Hughes Beverly. (1995) Older people and Community Care: Critical Theory and Practice. Open University Press.
  • Johnson Fusco Tanya. (1999) Handbook On Ethical Issues In Aging. Greenwood Press.
  • Milstead A. Jeri. (1998) Health Policy and Politics. Jones and Bartlett Publishers
  • Emanuel Ezekiel. (2014) Reinventing American Healthcare: How the Affordable Care Act will    Improve Error Prone System. Public Affairs, New York.
  • Showalter J. Stuart. (2004) The Law of Healthcare Administration. Waterston Happiness Press
  • Busch Saltiel Rebecca. (2008) Healthcare Fraud: auditing and Detection Guide. Blue Sky Press

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