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Reforms pending for providers.

A number of provisions in the Patient Protection and Affordable Health Care Act could affect hospitals and other health-care providers in New Hampshire in 2011.

Beginning July 1, 2011, Medicaid will no longer reimburse for care associated with conditions acquired in health-care settings, such as infections or injuries due to a fall.

This provision will probably "piggyback" on a similar law passed in 2008 prohibiting Medicare from reimbursing for health-care acquired conditions, said corporate and health-care attorney Hannah Zaitlin of the Manchester law firm of McLane, Graf, Raulerson & Middleton.

"Many private insurers have also followed suit," said Zaitlin.

Insurers also have new reform requirements to meet in 2011.

Beginning Jan. 1, insurers offering small-group health plans must spend at least 80 percent of premiums on care, known as the "medical loss ratio," or will have to send a rebate to subscribers. Those offering plans in the large-group market must spend at least 85 percent on care.

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Author:Kibbe, Cindy
Publication:New Hampshire Business Review
Article Type:Brief article
Geographic Code:1U1NH
Date:Dec 31, 2010
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