Ili ndi yankho lalitali lomwe Maggie Mahar adandiyankha "N'chifukwa Chiyani Maggie Mahar Akunama Zokhudza Kusintha Kwaumoyo?" ku TPCafe. Tsopano ndadutsamo ndikupereka mayankho ku mawu ake. Sindikhala ndi nthawi yoyankhanso, koma ndikhulupilira kuti izi zikhala zokwanira. Ndikupangira kuti anthu aziwonetsa salon ya Firedoglake pa Novembara 9 ndikumufunsa kuti asiye Kunena kuti "njira" yapagulu ndi chilichonse ngati "Medicare E (kwa aliyense)."
Ine, ndithudi, sindikunama za kusintha kwa Health Care.
Mukawerenga kalata ya mkulu wa CBO Elmendorf kwa Charles Rangel komwe akuwonetsa kuti anthu aku America 30 miliyoni okha ndi omwe adzakhale mu h Exchange mu 2019 (zaka zisanu ndi chimodzi pambuyo pa kukonzanso) ndikuti 20% yokha ya anthu omwe ali oyenera Kusinthanitsa Inshuwaransi adzasankha anthu onse. konzekerani, mudzapeza kuti alibe maziko onenera izi. Palibe manambala. Palibe kusanthula kwenikweni.
Pamene Elmendorf akufotokoza chifukwa chake, m'malingaliro ake 1/5 okha mwa anthu mu Kusinthanitsa adzasankha ndondomeko ya boma, ndimeyi imadzazidwa ndi "mwinamwake." (Ndikhala ndikusindikiza positi yotchula ndimeyi posachedwa.)
CMS Akuti 40% poyerekeza ndi CBO's 1/3 pomwe njira yapagulu idalipira pamitengo ya Medicare. Izi zimandipangitsa kuganiza kuti ngakhale kuyerekezera kwa CBO sikungakhale kwangwiro, mwina sikupenganso.
Chowonadi ndichakuti Palibe amene angaganize kuti ndi anthu mamiliyoni ambiri aku America omwe angasankhe mapulani apagulu zaka zitatu kuchokera pano. Sitikudziwa chilichonse chokhudza tsatanetsatane wa dongosolo la anthu. Kapena mtengo. Sitikudziwa pang'ono za mapulani achinsinsi omwe adzakhale akupikisana.
Elmendorf akuchita masewera olimbitsa thupi powerenga malingaliro-kulingalira zomwe mamiliyoni aku America angasankhe zaka zitatu kuchokera pano.
Ndipo nditamva kuti Elmendorf adanena kuti 30 miliyoni yokha idzakhala mu Kusinthanitsa mu 2019, komanso kuti ndondomeko ya anthu idzakhala yaying'ono komanso yokwera mtengo kuposa mapulani achinsinsi, ndinadzifunsa kuti: adapeza bwanji manambala amenewo?
Chifukwa chake ndidapita komwe adalemba ziwerengerozi, kalata yomwe adalembera Rangel kumapeto kwa Okutobala. Kumeneko ndidapeza zonse "mwina" -
ndipo palibe mfundo zotsimikizira mfundo yake.Amangoganiza kuti chifukwa dongosolo la anthu ndi dongosolo la boma, "mwina" silingayesetse kuwongolera ndalama kapena kugwiritsa ntchito - zomwe zilibe tanthauzo. Medicare imayesetsa kuwongolera ndalama (onani pansipa) ndikupita patsogolo, Medicare ikukonzekera kuchepetsa ndalama zina kuyambira chaka chamawa (onani kuwombera). Ndondomeko ya anthu onse idzateronso.
CMS adafika mfundo yofanana kwambiri ndi CBO pakugwiritsa ntchito. Si Elmendorf yekha apa.
Kuphatikiza apo, zomwe tikudziwa motsimikiza ndikuti dongosolo labanja la anthu onse likhala lotsika mtengo $2000 chifukwa silikhala ndi ndalama zoyendetsera mabungwe aboma. (Nambala iyi ikuchokera ku Commonwealth.) Dongosolo la anthu silidzafunika kukopa anthu. Sichidzawononga ndalama zambiri (ngati chilipo) pakutsatsa ndi kutsatsa. Aliyense adziwa kuti ilipo, ndipo ipeza zotsatsa zaulere m'nkhani zambiri, zambiri zomwe zidzalembedwe m'manyuzipepala, m'mabulogu, komanso nkhani zapa TV.
Commonwealth Fund ikukamba za vuto losiyana kwambiri ndi dongosolo lalikulu la anthu lomwe limatenga pafupifupi theka la msika wa inshuwaransi yazaumoyo. Mu positi yanga yoyambirira ndidawonetsa zomwe Karen Davis adanena za momwe malingaliro awo amasiyanirana ndi mabilu omwe ali ku Congress. Inu munanyalanyaza izo.
(Mahar adalemba nkhani pa lipoti la Commonwealth Fund Pano. Zodabwitsa kwambiri chifukwa zikutsutsana mwachindunji ndi mfundo zake zomwe zili pansipa, nthawi ina akuti: "...nthawi zambiri, madokotala omwe amawathandiza amapatsidwa malipiro ochepa. zovuta kupeza madokotala okonzeka kutenga inshuwaransiโฆMapulani achinsinsi angakhale ndi ndalama zolipirira opereka ndalama zambiri ndikupanga "ma network ophatikizika," kuthana ndi kugawanika komwe kumabweretsa zolakwika m'dongosolo lathu laumoyo.Mwachidule, akanatha kupereka chisamaliro chabwinoko."Kutsindika ndi kwanga.)
Dongosolo la anthu silidzafunika kulipira otsogolera malipiro a madola mamiliyoni ambiri.
Ndipo ndondomeko ya anthu sidzayenera kupereka phindu kwa osunga ndalama. Choncho ndalama zake zoyendetsera ntchito zidzakhala zambiri, zotsika kwambiri.
CMS ziwerengero 10 peresenti yokha yochepetsera ndalama zoyendetsera ntchito. Izi sizili pafupi ndi Medicare.
Commonwealth Fund imapereka kusanthula kwabwino pamfundoyi.
Pomaliza, dongosolo la anthu silikhala lotolera. Mosiyana ndi zimenezi, ma inshuwaransi achinsinsi adzapitirizabe kuwononga ndalama zambiri kuti apeze momwe angapewere odwala. Chimodzi mwa zinthu zomwe tiyenera kuziganizira pazaka zitatu zikubwerazi ndi momwe tingawalamulire kotero kuti zikhale zovuta kwambiri kuti azichita zimenezo.
Zingatheke. Ndipo tili ndi chidaliro cha ubongo ku White House (wotsogolera bajeti ya White House Peter Orszag ndi mlangizi wake wa zaumoyo, Zeke Emanuel, omwe) mosakayikira, adzaika maganizo awo pa vutoli.
Chifukwa sizachilendo kukhala ndi chidaliro chaubongo ku White House,, akatswiri ambiri amaiwala kuti tili ndi anthu omwe ali muulamuliro omwe amadziwa zochuluka zachipatala, ndipo, kunena zoona, ndi anzeru kuposa onse koma anzeru kwambiri. atolankhani ndi akatswiri.
Kusintha kokwanira kwa chiwopsezo kungakhale kusintha kofunikira ku dongosolo ndipo anthu ngati Orszag alibe ulamuliro wochita izi. Mwachitsanzo, Netherlands amaika kwenikweni theka la ndalama za dongosolo kusintha ngozi zomwe zimaperekedwa ndi misonkho.
Tikudziwanso kuti ndondomeko ya anthu idzakhazikitsidwa pa Medicare, komanso kuti idzaphatikizapo kusintha kwa Medicare komwe kwayamba kale ndipo kudzapitirira kwa zaka zitatu zotsatira-kuchepetsa ndalama pamene akukweza khalidwe, Bwereraninso ku gwero loyamba. Werengani malamulowo. Musawerenge zomwe anthu amanena zokhudza malamulo (ambiri sanawerenge ndipo akubwereza ena omwe sanawerenge) .
Werengani nokha malamulowo. Onani magawo pakusintha kwa Medicare ndi magawo pazosankha za anthu.
Tiyeni titengeko malamulo. Nayi mndandanda wazomwe zili m'magawo ofunikira. Zina zonse zitha kuwonedwa Pano.
Dongosolo la anthu silimatsatiridwa ndi Medicare. Ukungonama. Pali zodutsana zing'onozing'ono pakati pa ziwirizi, monga momwe zimakhalira zachinyengo ndi nkhanza, koma zoyambira ndizosiyana kotheratu.
Mutu BโPublic Health Insurance Option
Sec. 321. Kukhazikitsa ndi kuyang'anira njira ya inshuwaransi ya umoyo wa anthu
monga ndondomeko ya mapindu a umoyo wa Exchange-qualified.
Sec. 322. Malipiro ndi ndalama.
Sec. 323. Malipiro a zinthu ndi ntchito.
Sec. 324. Njira zamakono zolipirira ndi kukonzanso kachitidwe kakatundu.
Sec. 325. Kutengapo mbali kwa opereka chithandizo.
Sec. 326. Kugwiritsa ntchito malamulo achinyengo ndi nkhanza.
Sec. 327. Kugwiritsa ntchito zofunikira za inshuwaransi za HIPAA.
Sec. 328. Kugwiritsa ntchito zachinsinsi zazaumoyo, chitetezo, ndi zamagetsi
zofunikira zamalonda.
Sec. 329. Kulembetsa mu njira ya inshuwaransi yaumoyo wa anthu ndizodzifunira.
Sec. 330. Kulembetsa mu njira ya inshuwaransi yaumoyo wa anthu ndi mamembala a Congress.
Sec. 331. Kubwezeredwa kwa Mlembi wa Zankhondo Zankhondo.
DIVISION B-MEDICARE NDI MEDICAID IMPROVEMENTS
MUTU IโKUKONZA KUKONZEDWA KWA NTCHITO YA NTCHITO
Subtitle A-Zopereka Zogwirizana ndi Medicare Part A
GAWO 1โKONDWERETSA BASKET YAMUSIKA
Sec. 1101. Kusintha kolipira kwa malo osamalira anamwino.
Sec. 1102. Kusintha kwa malipiro a malo okonzanso odwala.
Sec. 1103. Kuphatikiza zowongolera zokolola muzosintha zamabasiketi amsika
zomwe sizikuphatikizira kale kuwongolera kotere.
GAWO 2โMANKHWALA ENA GAWO A MALANGIZO
Sec. 1111. Malipiro kumalo osungirako anamwino aluso.
Sec. 1112. Lipoti la Medicare DSH ndi kusintha kwa malipiro poyankha kufalitsa
kukula.
Sec. 1113. Kuwonjezedwa kwa lamulo loletsa kuletsa anthu odwala matendawa.
Sec. 1114. Kulola othandizira adotolo kuyitanitsa chithandizo chotalikirapo pambuyo pa chipatala
chithandizo ndi kupereka kuzindikira kwa dokotala
othandizira ngati madotolo omwe amapita kukatumikira odwala hospice.
Mutu B-Zomwe Zikugwirizana ndi Gawo B
GAWO 1-ZINTHU ZOTHANDIZA AMADONGWALA
Sec. 1121. Dongosolo lothandizira othandizira madokotala ku Medicare.
Sec. 1122. Ma code olakwika pansi pa ndondomeko ya malipiro a dokotala.
Sec. 1123. Malipiro a madera ogwira ntchito.
Sec. 1124. Zosintha kwa Physician Quality Reporting Initiative (PQRI).
Sec. 1125. Kusintha kwa malo olipira a Medicare.
GAWO 2โKONDWERETSA BASKET YAMUSIKA
Sec. 1131. Kuphatikiza zowongolera zokolola muzosintha zamabasiketi amsika
zomwe sizikuphatikizira kale kuwongolera kotere.
GAWO 3โZINTHU ZINA
Sec. 1141. Kubwereketsa ndi kugula mipando ya olumala yoyendetsedwa ndi mphamvu.
Sec. 1141A. Kusankhidwa kutenga umwini, kapena kukana umwini, wa zinazake
chida chamankhwala cholimba cholimba pakatha miyezi 13
nthawi yobwereketsa yokhazikika ikutha.
Sec. 1142. Kuwonjezera kwa lamulo la malipiro a brachytherapy.
Sec. 1143. Lipoti la kulowetsedwa kunyumba ku Congress.
Sec. 1144. Amafuna malo opangira opaleshoni (ASCs) kuti apereke deta yamtengo wapatali ndi
deta zina.
Sec. 1145. Chithandizo cha zipatala zina za khansa.
Sec. 1146. Malipiro a mautumiki ojambula zithunzi.
Sec. 1147. Kupititsa patsogolo pulogalamu yokhazikika yazida zamankhwala.
Sec. 1148. Phunziro la MedPAC ndi lipoti la kuyeza kwa mafupa.
Sec. 1149. Kupeza zinthu zapanthawi yake pambuyo pa mastectomy.
Sec. 1149A. Kulipira kwazinthu zachilengedwe za biosimilar.
Sec. 1149B. Phunzirani ndikupereka lipoti za mpikisano wa DME.
Subtitle C-Zomwe Zimagwirizana ndi Medicare Part A ndi B
Sec. 1151. Kuchepetsa kubwezeredwa kuchipatala komwe kungathe kupewedwa.
Sec. 1152. Ndondomeko yosinthira malipiro a ntchito za chisamaliro cha postacute ndi woyendetsa ma bundling
pulogalamu.
Sec. 1153. Kusintha kwamalipiro azaumoyo wakunyumba kwa 2010.
Sec. 1154. Kusintha kwa malipiro a chisamaliro chaumoyo chapakhomo.
Sec. 1155. Kuphatikizira kuwongolera zokolola mukusintha mabasiketi amsika
za chithandizo chamankhwala kunyumba.
Sec. 1155A. Kafukufuku wa MedPAC pamitundu yosiyanasiyana yazaumoyo wam'nyumba.
Sec. 1155B. Kulola mabungwe azaumoyo kuti apereke zoyenera kwambiri
ntchito zaluso kupanga ulendo woyamba wowunika pansi a
Medicare Home Health Plan yosamalira milandu yokonzanso.
Sec. 1156. Kuchepetsa kwa Medicare kupatula kuletsa kwa dokotala wina
zotumizidwa kuzipatala.
Sec. 1157. Institute of Medicine kuphunzira za kusintha kwa malo zinthu pansi
Medicare.
Sec. 1158. Kukonzanso kachitidwe kamalipiro amankhwala kuti athetse kusalingana kwa malo.
Sec. 1159. Institute of Medicine kuphunzira za kusiyana kwa malo mu chisamaliro chaumoyo
kuwononga ndalama ndi kulimbikitsa chithandizo chamankhwala chamtengo wapatali.
Sec. 1160. Kukhazikitsa, ndi kubwereza Congress, za ndondomeko yokonzanso
Malipiro a Medicare kulimbikitsa chisamaliro chaumoyo chamtengo wapatali.
Subtitle D-Medicare Advantage Reforms
GAWO 1โKULIPITSA NDI KUYAMIKIRA
Sec. 1161. Gawo-pamalipiro potengera ndalama zolipirira ntchito; bonasi yabwino
malipiro.
Sec. 1162. Ulamuliro wa Secretarial coding intensity adjustment authority.
Sec. 1163. Kufewetsa nthawi ya chisankho cha opindula pachaka.
Sec. 1164. Kuwonjezedwa kwa mapangano okwera mtengo.
Sec. 1165. Kuchepetsa kwaulamuliro wochotsa pamagulu a olemba anzawo ntchito.
Sec. 1166. Kupititsa patsogolo kusintha kwa ngozi kwa malipiro.
Sec. 1167. Kuchotsa MA Regional Plan Stabilization Fund.
Sec. 1168. Phunzirani za zotsatira za kuwerengera malipiro a Medicare Advantage
mitengo pa avareji ya chigawo cha chindapusa cha Medicare pamitengo yantchito.
GAWO LACHIWIRIโKUTETEZA OPINDULIRA NDIPONSO POTSANA NDI chinyengo
Sec. 1171. Kuchepetsa kugawana mtengo kwa ntchito zachipatala payekha.
Sec. 1172. Kulembetsa momasuka mosalekeza kwa olembetsa mu mapulani ndi kulembetsa
kuyimitsidwa.
Sec. 1173. Chidziwitso kwa opindula pa ndalama zoyendetsera ndondomeko ya MA.
Sec. 1174 Kulimbikitsa maulamuliro owerengera ndalama.
Sec. 1175. Ulamuliro wokana mapulani.
Sec. 1175A. Ulamuliro wa boma kuti ukwaniritse zofunikira zamalonda.
GAWO 3-KUCHITA MALANGIZO A ZOSOWA ZAPADERA
Sec. 1176. Kuchepetsa kulembetsa kunja kwa nthawi yotseguka ya anthu
m'mapulani apadera a MA pazosowa zapadera
anthu.
Sec. 1177. Kuwonjezeredwa kwaulamuliro wa mapulani a zosowa zapadera kuti aletse kulembetsa;
kuimitsidwa kwa ntchito kwa ma SNP ena.
Sec. 1178. Kukula kwa mapulani a nyumba za akuluakulu a Medicare.
Subtitle E-Kupititsa patsogolo kwa Medicare Part D
Sec. 1181. Kuchotsa kusiyana kwa kufalitsa.
Sec. 1182. Kuchotsera kwa gawo lina la mankhwala la D mu kusiyana koyambirira.
Sec. 1183. Kuthetsedwa kwa chilolezo chokhudzana ndi kutumiza zodandaula ndi ma pharmacies
zopezeka kapena kuchita mgwirizano ndi malo osamalirako nthawi yayitali.
Sec. 1184. Kuphatikizira ndalama zomwe zidabwera chifukwa cha mapologalamu othandizira mankhwala a Edzi ndi amwenye
Health Service popereka mankhwala operekedwa kwa odwala
Kutuluka kwa mthumba kwapachaka pansi pa gawo D.
Sec. 1185. Palibe kusintha kwa formulary kwapakati pa chaka komwe kuloledwa.
Sec. 1186. Kukambitsirana kwa magawo otsika a D mitengo yamankhwala m'malo mwa Medicare
opindula.
Sec. 1187. Kupereka kolondola m'malo osamalirako nthawi yayitali.
Sec. 1188. Kudzaza kwa generic kwaulere.
Sec. 1189. State certification isanachotsedwe zofunika chilolezo pansi
Pulogalamu ya mankhwala a Medicare.
Subtitle F-Medicare Rural Access Protections
Sec. 1191. Kukula kwa telefoni ndi zowonjezera.
Sec. 1192. Kuonjezeredwa kwa odwala ogonekedwa kunja kukhala osavulaza.
Sec. 1193. Kuwonjezedwa kwa magawo 508 a zipatala.
Sec. 1194. Kukulitsa malo ogwirira ntchito.
Sec. 1195. Kuwonjezeka kwa malipiro a gawo laumisiri la dokotala wina
ntchito za pathology.
Sec. 1196. Kuwonjezedwa kwa ma ambulansi owonjezera.
MUTU IIโMEDICARE BENEFICIARY IMPROVEMENTS
Subtitle AโKupititsa patsogolo ndi Kufewetsa Thandizo Lazachuma Kuti Tipeze Ndalama Zochepa
Othandizira Medicare
Sec. 1201. Kupititsa patsogolo mayeso a katundu wa Medicare Savings Program ndi ndalama zochepa
pulogalamu yothandizira.
Sec. 1202. Kuchotsa gawo D kugawana mtengo kwa ena omwe sanakhazikitsidwe
opindula mokwanira anthu awiri oyenerera.
Sec. 1203. Kuchotsa zolepheretsa kulembetsa.
Sec. 1204. Kuyang'anira kopitilira muyeso kokhudzana ndi kubweza kwa retroactive low
kulembetsa ndalama zothandizira.
Sec. 1205. Ntchito yanzeru pakulembetsa.
Sec. 1206. Nthawi yolembetsa mwapadera ndi ndondomeko yolembetsa yokhayokha
perekani anthu oyenerera.
Sec. 1207. Kugwiritsa ntchito malipiro a MA kusanabwezedwe ndi malipiro a bonasi abwino
powerengetsera benchmark ya subsidy ya ndalama zochepa.
Mutu BโKuchepetsa Kusiyana Kwaumoyo
Sec. 1221. Kuonetsetsa kuti kulumikizana kwabwino mu Medicare.
Sec. 1222. Chiwonetsero cholimbikitsa mwayi kwa opindula ndi Medicare ndi
odziwa Chingelezi ochepa popereka ndalama zothandizira chikhalidwe
ndi mautumiki oyenerera mwachiyankhulo.
Sec. 1223. Lipoti la IOM lokhudza kukhudzidwa kwa mautumiki a chinenero.
Sec. 1224. Matanthauzo.
Mutu CโZowonjezera Zosiyanasiyana
Sec. 1231. Kuwonjezera njira mankhwala zisoti kupatulapo.
Sec. 1232. Anawonjezera miyezi Kuphunzira immunosuppressive mankhwala impso
kumuika odwala ndi zinthu zina aimpso dialysis.
Sec. 1233. Kukambilana modzifunira zokonzekera chisamaliro.
Sec. 1234. Gawo B nthawi yapadera yolembera ndi kuchotsedwa kwa chiwerengero chochepa
chilango kwa opindula a TRICARE.
Sec. 1235. Kupatulapo kugwiritsa ntchito chaka cha msonkho chaposachedwa ngati mutapindula pogulitsa
wokhala m'malo oyamba pamakompyuta gawo B lokhudzana ndi ndalama.
Sec. 1236. Pulogalamu yowonetsera kugwiritsa ntchito zothandizira zisankho za odwala.
MUTU WACHITATUโKULIMBIKITSA CHISADALIRO CHOYAMBA, UTHENGA WA MTIMA
NTCHITO, NDI CHISANALIRO CHONONGEKA
Sec. 1301. Pulogalamu yoyeserera ya Accountable Care Organisation.
Sec. 1302. Pulogalamu yoyendetsa nyumba yachipatala.
Sec. 1303. Chilimbikitso chamalipiro cha ntchito zosankhidwa za chisamaliro choyambirira.
Sec. 1304. Kuwonjezeka kwa malipiro a anamwino-anamwino ovomerezeka.
Sec. 1305. Kuphimba ndi kuchotserapo kugawana mtengo kwa ntchito zodzitetezera.
Sec. 1306. Kuchotsedwa kwa deductible pakuyezetsa khansa ya colorectal mosasamala kanthu
Kulemba zolemba, kuzindikira kotsatira, kapena kuchotsa minofu yowonjezera.
Sec. 1307. Kupatulapo ntchito zachipatala za anthu ogwira nawo ntchito pazachipatala
medicare luso la unamwino woyembekezera dongosolo malipiro
ndi malipiro ophatikizidwa.
Sec. 1308. Kufotokozera za maukwati ndi mabanja othandizira ndi malingaliro
ntchito za alangizi azaumoyo.
Sec. 1309. Kuwonjezeka kwa ndondomeko ya malipiro a dokotala owonjezera thanzi la maganizo.
Sec. 1310. Kukulitsa mwayi wopeza katemera.
Sec. 1311. Kukula kwa Medicare-Covered Preventive Services ku Federally
Malo Oyenerera a Zaumoyo.
Sec. 1312. Pulogalamu yowonetsera zodziyimira pawokha kunyumba.
Sec. 1313. Kuzindikirika kwa aphunzitsi ovomerezeka a shuga ngati opereka ziphaso zovomerezeka za
Zolinga za Medicare Diabetes Medicare Outpatient Management
ntchito zophunzitsira.
MUTU IVโQUALITY
Subtitle A-Comparative Effectiveness Research
Sec. 1401. Kafukufuku wofananira bwino.
Subtitle BโKuwonekera Panyumba Ya Okalamba
GAWO 1-KUKONZEKERA KUBVIRITSIDWA KWA ZINTHU ZOKHUDZA UNAMENE WOPHUNZIRA
ZINTHU ZOTHANDIZA, ZOTHANDIZA ZINTHU ZOTHANDIZA, NDI ZINTHU ZINA ZOTHANDIZA NTCHITO.
Sec. 1411. Kuwulula kofunikira kwa umwini ndi maphwando owonjezera omwe angatulutsidwe
Zambiri.
Sec. 1412. Zofunikira pakuyankha.
Sec. 1413. Nyumba yosungirako anthu okalamba yerekezerani ndi webusaiti ya Medicare.
Sec. 1414. Lipoti la ndalama.
Sec. 1415. Fomu yodandaulira yokhazikika.
Sec. 1416. Kuonetsetsa kuti ogwira ntchito ali ndi udindo.
Sec. 1417. Pulogalamu yapadziko lonse yoyang'anira mbiri ya dziko ndi boma ikuyendera
kulunjika kwa odwala ogwira ntchito kumalo osamalirako nthawi yayitali ndi
operekera.
GAWO 2-KUKHALA ZOCHITA
Sec. 1421. Zilango zandalama za boma.
Sec. 1422. Pulogalamu yoyeserera yodziyimira payokha.
Sec. 1423. Chidziwitso cha kutsekedwa kwa malo.
GAWO 3โKUKONZA MAPHUNZIRO A NTCHITO
Sec. 1431. Maphunziro a kupewa matenda a dementia ndi nkhanza.
Sec. 1432. Phunzirani ndi lipoti la maphunziro ofunikira kwa othandizira ovomerezeka a namwino ndi
ogwira ntchito oyang'anira.
Sec. 1433. Kuyenerera kwa mkulu wa ntchito za chakudya kumalo osungirako anamwino aluso
kapena malo osungirako anamwino.
Kamutu CโMiyezo Yakhalidwe
Sec. 1441. Kukhazikitsa zofunikira za dziko pofuna kupititsa patsogolo ubwino.
Sec. 1442. Kupititsa patsogolo njira zatsopano za khalidwe; Kuwunika kwa GAO pakusonkhanitsa deta
njira yoyezera bwino.
Sec. 1443. Kuyikapo malamulo kwa anthu ambiri posankha mtundu
miyeso.
Sec. 1444. Kugwiritsa ntchito miyeso yabwino.
Sec. 1445. Kugwirizana kwa ndalama za bungwe.
Subtitle DโDokotala Payments Sunshine Provision
Sec. 1451. Malipoti okhudza maubwenzi azachuma pakati pa opanga ndi ogulitsa
za mankhwala ophimbidwa, zida, biologicals, kapena mankhwala
pansi pa Medicare, Medicaid, kapena CHIP ndi madokotala ndi
mabungwe ena azaumoyo komanso pakati pa madokotala ndi ena
mabungwe azaumoyo.
Subtitle EโPublic Reporting on Health Care-Associated Infections
Sec. 1461. Chofunikira pakudziwitsa anthu zipatala ndi ma ambulatory opaleshoni
malo okhudzana ndi matenda okhudzana ndi chithandizo chamankhwala.
MUTU VโMEDICARE OGWIRITSA NTCHITO MAPHUNZIRO A MEDICARE
Sec. 1501. Kugawa malo okhala osagwiritsidwa ntchito.
Sec. 1502. Kuchulukitsa maphunziro m'makonzedwe osapereka.
Sec. 1503. Malamulo owerengera nthawi yokhalamo pazochitika za didactic ndi maphunziro
ndi ntchito zina.
Sec. 1504. Kusungidwa kwa zipatala zotsekedwa.
Sec. 1505. Kupititsa patsogolo kuyankha pa maphunziro ovomerezeka a udokotala.
MUTU VIโPROGRAM INTERGRITY
Mutu AโKuwonjezeka kwa Ndalama Zolimbana ndi Zinyalala, Chinyengo, ndi Nkhanza
Sec. 1601. Kuchulukitsa kwandalama ndi kusinthasintha polimbana ndi chinyengo ndi nkhanza.
Mutu BโZilango Zowonjezereka za Chinyengo ndi Nkhanza
Sec. 1611. Zilango zowonjezera chifukwa chabodza pa olembetsa kapena ogulitsa
ntchito.
Sec. 1612. Zilango zokwezedwa popereka ziganizo zabodza
kunena zabodza.
Sec. 1613. Zilango zowonjezera chifukwa chochedwetsa kuyendera.
Sec. 1614. Chitetezo chowonjezereka cha pulogalamu ya hospice.
Sec. 1615. Zilango zowonjezera kwa anthu omwe sanalowe nawo pulogalamu.
Sec. 1616. Zilango zokwezedwa popereka zidziwitso zabodza ndi Medicare
Ubwino ndi mapulani a gawo D.
Sec. 1617. Zilango zowonjezera za Medicare Advantage ndi gawo D malonda
kuphwanya malamulo.
Sec. 1618. Zilango zowonjezera zolepheretsa kuwunika kwa pulogalamu.
Sec. 1619. Kuchotsedwa kwa anthu ena ndi mabungwe kuti asatenge nawo mbali
Mapulogalamu a Medicare ndi State Healthcare.
Sec. 1620. Ulamuliro wa OIG kuti usakhale ndi maofesala a Federal health care program
ndi eni mabungwe opezeka ndi milandu yachinyengo.
Sec. 1621. Ndondomeko yodziwonetsera yokha.
Mutu C-Pulogalamu Yowonjezereka ndi Chitetezo cha Wopereka
Sec. 1631. Kupititsa patsogolo chitetezo cha pulogalamu ya CMS.
Sec. 1632. Zofunikira pakuwulula pulogalamu ya Medicare, Medicaid, ndi CHIP
zogwirizana ndi zomwe zidachitika kale.
Sec. 1633. Kuphatikizidwa kwa zosintha zolipira pakuwunika kwina ndi
ntchito zowongolera.
Sec. 1634. Kuwunika ndi malipoti ofunikira pansi pa Medicare Integrity Program.
Sec. 1635. Amafuna opereka chithandizo ndi ogulitsa kuti agwiritse ntchito mapulogalamu ochepetsera zinyalala,
chinyengo, ndi nkhanza.
Sec. 1636. Nthawi yochuluka yoperekera zodandaula za Medicare yachepetsedwa mpaka ayi
zoposa miyezi iwiri.
Sec. 1637. Madokotala omwe amayitanitsa zida zamankhwala zokhazikika kapena thanzi lapakhomo
ntchito zomwe zimafunikira kuti mukhale madokotala olembetsa a Medicare kapena oyenerera
akatswiri.
Sec. 1638. Chofunikira kwa madokotala kuti apereke zolemba pa kutumiza
mapulogalamu omwe ali pachiwopsezo chachikulu chakuwonongeka komanso kuzunzidwa.
Sec. 1639. Kukumana maso ndi maso ndi wodwala kofunikira musanakhale ndi ziphaso zovomerezeka
zachipatala chapakhomo kapena zida zolimba zachipatala.
Sec. 1640. Kuonjezeredwa kwa umboni wa subpoena ulamuliro kuchotsedwa pulogalamu
kufufuza.
Sec. 1641. Kubwezera kofunikira kwa Medicare ndi Medicaid overpayments.
Sec. 1642. Kugwiritsa ntchito kowonjezereka kwa kuchotsedwa kwa zovuta kwa OIG kuchotsedwa kwa
opindula ndi pulogalamu iliyonse ya Federal Healthcare.
Sec. 1643. Kupeza zidziwitso zina pazida za aimpso dialysis.
Sec. 1644. Othandizira zolipirira, malo operekera chilolezo, kapena ena olipidwa ofunikira
kulembetsa pansi pa Medicare.
Sec. 1645. Kugwirizana ndi zilango zandalama za boma ku zosintha za False Claims Act.
Sec. 1646. Kufuna malipiro operekera ndi othandizira pansi pa Medicare kukhala
yopangidwa kudzera mu deposit mwachindunji kapena kutumiza ndalama zamagetsi (EFT)
m'mabungwe osungira inshuwaransi.
Sec. 1647. Inspector General wa Health Choices Administration.
Subtitle DโKupeza Chidziwitso Chofunikira Kuti Mupewe Chinyengo, Zinyalala, ndi
nkhanza
Sec. 1651. Kupeza Chidziwitso Chofunikira Kuzindikiritsa Zachinyengo, Zinyalala, ndi
Nkhanza.
Sec. 1652. Kuthetsa kubwerezabwereza pakati pa Healthcare Integrity ndi
Chitetezo cha Data Bank ndi National Practitioner Data
Banki.
Sec. 1653. Kutsatira mfundo zachinsinsi za HIPAA ndi chitetezo.
Onani zomwe Obama wanena za chisankho cha anthu.
Malinga ndi kuyerekezera kwa DRM Budget Office, tikukhulupirira kuti anthu osakwana 5% aku America angalembetse.
Onani zomwe White House Budget Direct Peter Orszag adalemba zakusintha kwa Medicare komanso kusintha kwaumoyo. (Adzakhala wofunikira kwambiri pa momwe kusintha ndi dongosolo la anthu likugwiritsidwira ntchito.)
Orszag ali ndi zambiri zoti anene pakusintha kwa Medicare, popeza monga mtsogoleri wakale wa CBO ku 2007 adaphunzira mwatsatanetsatane kukula kwa mtengo wake. Koma kusintha kwa Medicare kulibe kanthu kochita ndi chisankho cha anthu, kotero izi sizimatiuza zambiri za izo.
Ponena za omwe adzakhale mu dongosolo la anthu: 7% ya aku America tsopano amagula munthu payekha pamsika wachinsinsi. Iwo ndi olemera komanso athanzi (kupanda kutero sakanatha kupeza inshuwaransi payekha pamsika wamba. Theka limapanga $56,000 (Onani EBRI pa izi).
Chimodzimodzi.
Pakalipano, osauka kwambiri omwe sali otetezedwa adzapita ku Medicaid pamene ikukula mu 2013. (Elmendorf akuvomereza izi m'kalata yake kwa Rangel) Izi zikutanthauza kuti omwe kale anali osatetezedwa mu Kusinthanitsa (ndi mu ndondomeko ya anthu) sadzakhala osauka-ndipo. mokulira osati odwala kwambiri (Anthu aku America osauka kwambiri nthawi zambiri amadwala kuposa tonsefe.)
Zowona, koma siziyenera kutero chifukwa omwe amagula inshuwaransi yawoyawokha, monga mukunenera, ali bwino modabwitsa ndipo angakhale athanzi.
Ambiri mwa anthu azaka zapakati pa 25-34 pakali pano alibe inshuwalansi. Iwo adzatha kupita ku Exchange. Zina 20 zidzasankha dongosolo lachinsinsi la "achichepere osagonjetsedwa"
koma pamene afika kumapeto kwa zaka za mโma 20 ndi 30, achichepere ambiri amakhala anzeru mokwanira kuzindikira zimenezo
iwo sali osakhoza kufa. Ambiri amafuna kuyambitsa mabanja. Amazindikira kuti amafunikira inshuwaransi yeniyeni.
Opanda inshuwaransi ndi thanzi labwino kwambiri zonse kuposa inshuwaransi.
Nambala yoyenera idzasankha dongosolo la anthu onse. Palibe amene anganene kuti ndi angati. Koma, ngakhale atachuluka bwanji, ili lidzakhala gulu lathanzi lolowa nawo dziwe.
Omwe amapatsidwa chithandizo pakusinthana ayenera kukwaniritsa njira zitatu: sayenera kukhala ndi inshuwaransi yothandizidwa ndi owalemba ntchito, ayenera kukhala pansi pa 400% yaumphawi (63% chiwerengero cha anthu omwe ali ndi inshuwaransi ndi omwe alibe inshuwalansi), ndipo sayenera kukhala pansi pa 150% ya umphawi (22%). Poganizira mfundo zomwe zili pamwambazi n'zovuta kukayikira kuti pamlingo wotere adzakhala ndi thanzi labwino kusiyana ndi omwe sakuyenera kulandira chithandizo. Ndipo ngati ndi choncho, ndiye kuti omwe sali oyenerera akuwoneka kuti ndi bwino kugula inshuwaransi kwina. Ndikutsimikiza kuti pali zinthu zambiri zovuta, koma izi zikuwoneka ngati vuto.
Kuphatikiza apo, ogwira ntchito ndi eni mabizinesi ang'onoang'ono adzakhala oyenerera dongosolo la anthu.
Ena adzakhala olemera, ena adzakhala opeza ndalama zochepa.
Ena adzakhala achikulire, ena achichepere. Pofika chaka chachiwiri cha kusintha (2014) anthu ogwira ntchito m'mabizinesi omwe ali ndi antchito okwana 30 adzakhala oyenerera. Ndi anthu ambiri.Zambiri zapangidwa ponena kuti HHS iyenera kukambirana zamitengo ndi opereka chithandizo.
Palibe chifukwa chokayikira kuti dongosolo la anthu silidzaumirira pamitengo yoyenera. Ndizotheka kulipira zochepa kwambiri kuposa ma inshuwaransi achinsinsi-ngakhale, nthawi zina, amalipira pang'ono kuposa Medicare.
Izi zimatengera kukula kwa dongosolo la anthu.
Choyamba, Medicare yayamba kale kuchepetsa chindapusa. Chaka chamawa, ikukonzekera kuchepetsa malipiro a CT scans ndi MRIs ndi 38% - komanso chindapusa cha madotolo omwe amagula zidazo ndikuyesa m'maofesi awo. (Madotolo awa amalimbikitsa kuyesa kuwirikiza kawiri.)
Ndipo Medicare yakonza zochepetsera chindapusa kwa odwala matenda amtima ndi 6% chaka chamawa-kukweza chindapusa ku madotolo a chisamaliro choyambirira ndi 4% kuyambira Januware.
Congress ikhala ndi mwayi woganizira izi-koma masiku 60 okha -betwteen pano ndi Januware 1
Yembekezerani kusintha kwina kwa chindapusa cha teh pazaka zitatu zikubwerazi.
Ma inshuwaransi achinsinsi anena kuti atsatira chitsogozo cha Medicare. Amangofuna kuti Medicare ipereke chivundikiro cha ndale.
Ngakhale zitakhala zoona, chifukwa chiyani izi zingakhudze kuthekera kwa dongosolo la anthu kupikisana ndi ma inshuwaransi apadera?
Kotero mu 2013, pamene ndondomeko ya anthu ikukambirana za malipiro, idzakambirana m'malo omwe malipiro ambiri adzakhala otsika, pamene malipiro a ntchito zopewera ndi matenda aakulu adzakhala apamwamba. Net, net, Medicare ikupulumutsa ndalama.
Ndipo, mu 2013, ndondomeko ya anthu idzakambirana m'malo omwe ndalama zimakhala zochepa komanso zobwezera zimakhala zomveka.
Ndiye?
Masiku ano, ma inshuwaransi apadera amalipira zipatala zodziwika bwino 15% mpaka 25% kuposa momwe zimawawonongera (kapena ziyenera kuwalipirira) kusamalira odwala. Pafupifupi, Medicare amalipira 98% ya ndalama zachipatala. A
zipatala zambiri (zoposa 40% ngati kukumbukira kumagwira ntchito) kumapanga phindu pamalipiro a Medicare. Onani post excelletn pa blog wanga ndi Pat S. atagona manambala outthe.Chifukwa chake ngati dongosolo la anthu limalipira chipatala china 7% kuposa Medicare, ikhala ikulipirabe zochepa kwambiri kuposa ma inshuwaransi apadera - zomwe zikutanthauza kuti malipiro ake adzakhala apamwamba.
Chifukwa chiyani zipatala zidzavomereza mapulani a boma kuti achepetse mitengo? Chifukwa dongosolo la anthu silidzakhala laling'ono ndipo anthu omwe ali mu ndondomekoyi sadzakhala odwala osauka kwambiri (omwe ali okwera mtengo kwambiri kuwasamalira. (Odwalawo adzakhala mu Medicaid yowonjezera)
Mukuganiza kuti sichikhala chaching'ono. Koma palibe chomwe chimayambitsa malingaliro anu. Dongosolo likayamba, palibe amene angadziwe kuti ndi anthu angati omwe adzakhalemo. Kodi opereka adzavomereza zimenezo?
Dongosolo la anthu onse lidzakhala lalikulu kwambiri kotero kuti ochepa - ngati alipo - zipatala zitha kuwona "sitifunika kukhala pagulu la anthu."
Madokotala ena amakana dongosolo la anthu - koma ochepa kuposa momwe mukuganizira. Ku Manhattan, ndikupeza kuti akatswiri a Park Avenue ali pa intaneti ya inshuwaransi yanga ndipo amatenga malipiro a inshuwaransi - zomwe ndi zabwino, koma osati monga akatswiri aku NY omwe satenga inshuwaransi.
Komanso, nditha kupeza nthawi yokumana ndi katswiri ngakhale sindinamuwonepo - nthawi zambiri m'masiku 2-5.Izi zikuwonetsa kuti akatswiri aku NY amafunikira odwala. Ambiri amatenga Medicare - ngakhale amalipira ndalama zochepa kuposa ma inshuwaransi omwe ali ndi inshuwaransi.
Medicare ndi wamkulu.
Kafukufuku wanga akusonyeza, kuti conservaitvely, 17-18% ya anthu adzakhala mu Kusinthanitsa pa zaka ziwiri zoyambirira za kukonzanso. Kuyerekeza kocheperako kunganene mpaka 25%. Sindikudziwa kwenikweni. Koma ndikudziwa kuti Kusinthana kukukonzekera kutsegulira anthu aku America ambiri chaka chilichonse,
Ndani adzakhala mu Te Exchange? Olemera odzilemba okha omwe tsopano amagula inshuwaransi yawoyawo, ndipo ambiri mwa ogwira ntchito ndi eni mabizinesi ang'onoang'ono adzapanga dziwe mu Kusinthanitsa kukhala gawo lalikulu la anthu omwe amapeza ndalama zapakatikati komanso apamwamba apakati aku America -ambiri. achichepere ndi athanzi.
Ziwerengero za Elmendorf (kuchokera ku kalata yopita kwa Rangel) zikusonyeza kuti mu 2013-2014 ena a 49 miliyoni aku America sadzakhala oyenera Kusinthanitsa koma mu Kusinthanitsa. (Iye amavomereza kuti amene tsopano kugula inshuwaransi awo (21 miliyoni American) adzakhala mu Kusinthanitsa ndi zikusonyeza kuti 7 miliyoni ogwira ntchito ndi ngongole ku mabizinesi ang'onoang'ono adzakhala mmenemo. - ena adzakhala ku Medicaid ndipo ena mwa omwe alibe inshuwalansi adzasankha kulipira chilango osati kugula inshuwalansi.
Izi ndi zolakwika. Elmendorf akutero osati nenani kuti amene agula inshuwaransi yawo adzakhala pakusinthana. Mu kalata wa Okutobala 29, chiyembekezero chomaliza ndi 21 miliyoni kupeza inshuwaransi pawokha kudzera mukusinthana ndi ena 9 miliyoni, zomwe zikubweretsa 30 miliyoni.
Izi zimatifikitsa ku 49 miliyoni aku America- pafupifupi 17% mpaka 18% ya anthu, ndipo ziwerengero zonse zovuta zomwe ndingapeze zikusonyeza kuti adzakhala mu Kusinthanitsa kumayambiriro kwa 2013-2014.
Osalondola.
Panthawiyi, Elmendorf akukamba za 30 miliyoni mu Kusinthanitsa 5 kwa zaka 6 pambuyo pake-mu 2019. Izi sizikutanthauza.
Lamuloli limafotokoza momveka bwino kuti "m'zaka zotsatila" Kusinthanitsa kudzakhala kotseguka kwa anthu ambiri aku America mpaka kutsegulidwa kwa anthu onse aku America. Ogwira ntchito mu komiti ya Nyumba ina anandiuza kuti kt zikutheka kuti ogwira ntchito m'mabungwe akuluakulu omwe tsopano ali ndi inshuwaransi yotengera olemba anzawo ntchito atha kulowa nawo "muzaka 4 kapena 5."
Palibe mwamtheradi chilichonse m'malamulo ofotokozera kuti mabwana akulu awonjezedwe. Sindisamala zomwe wantchito wina wakuuzani. Mwinamwake muyenera kutsata ndondomeko yanu ndikuyang'ana pa biluyo.
ZNetwork imalandira ndalama kudzera mu kuwolowa manja kwa owerenga ake.
Ndalama