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 Country: United States
 Collection: Congressional Research Service Reports
Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief

Medicare Advantage (MA)--Proposed Benchmark Update and Other Adjustments for CY2016: In Brief

Date: February 25, 2015
Creator: Morgan, Paulette C.
Description: This report provides a brief background on how Medicare Advantage (Part C or MA) payments are determined through a comparison of a plan's estimated cost (bid) and the maximum amount Medicare will pay a plan (benchmark).
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The Independent Payment Advisory Board

The Independent Payment Advisory Board

Date: April 17, 2013
Creator: Hahn, Jim & Davis, Christopher M.
Description: This report, which provides an overview of the Payment Advisory Board, begins with a discussion of the rationale behind the creation of an independent Medicare board and briefly reviews prior proposals for similar boards and commissions. The report then describes the structure of the Board, the calculations and determinations required to be made by the Office of the Chief Actuary (the Chief Actuary) in the Centers for Medicare & Medicaid Services (CMS) that trigger a Board proposal, and the content of and constraints on Board proposals--including the Medicare productivity exemptions under Section 3401 of the The Patient Protection and Affordable Care Act (PPACA).
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The Independent Payment Advisory Board

The Independent Payment Advisory Board

Date: March 12, 2012
Creator: Hahn, Jim & Davis, Christopher M.
Description: In response, in part, to overall growth in Medicare program expenditures and growth in expenditures per Medicare beneficiary, the Patient Protection and Affordable Care Act created the Independent Payment Advisory Board (IPAB, or the Board) and charged the Board with developing proposals to "reduce the per capita rate of growth in Medicare spending." This report discusses the responsibilities and duties.
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NFIB v. Sebelius: Constitutionality of the Individual Mandate

NFIB v. Sebelius: Constitutionality of the Individual Mandate

Date: September 3, 2012
Creator: Lunder, Erika K. & Staman, Jennifer
Description: Report that provides an overview of the Court's holding with respect to the individual mandate of the Patient Protection and Affordable Care Act (ACA) under the Commerce Clause and the Taxing Power. It also addresses possible implications of the decision on existing federal law and future legislation.
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Health Insurance: Small is the New Large

Health Insurance: Small is the New Large

Date: August 26, 2015
Creator: Mach, Annie L.
Description: This report discusses aspects of the Patient Protection and Affordable Care Act that expand the definition of small employer to include employers with 100 or fewer employees. States must implement the expanded definition for plan years beginning in 2016, but have the option of implementing the expanded definition prior to the deadline.
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The Independent Payment Advisory Board (IPAB): Frequently Asked Questions

The Independent Payment Advisory Board (IPAB): Frequently Asked Questions

Date: October 30, 2015
Creator: Hahn, Jim; Davis, Christopher M. & Liu, Edward C.
Description: This report responds to frequently asked questions about the Independent Payment Advisory Board (IPAB), including the board's background, current status, controversial issues including legal challenges, and recent legislative efforts to repeal the IPAB.
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Medicare Advantage

Medicare Advantage

Date: March 3, 2009
Creator: Morgan, Paulette C.
Description: This report is an overview of the Medicare Advantage (MA) program, an alternative way for Medicare beneficiaries to receive covered benefits, and includes legislative history and analysis of recent trends.
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Medicare: Private Contracts

Medicare: Private Contracts

Date: October 21, 1997
Creator: O'Sullivan, Jennifer & Echeverria, Cecilia O
Description: This report discusses private contracting for medicare,which is the term used to describe situations where a physician and a patient agree not to submit a claim for a service which would otherwise be covered and paid for by Medicare.
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Medicaid Issues for the 109th Congress

Medicaid Issues for the 109th Congress

Date: October 20, 2005
Creator: Hearne, Jean P
Description: This report provides background information for medicaid reforms and discuses proposals for reform.
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Medicaid: A Primer

Medicaid: A Primer

Date: December 19, 2005
Creator: Herz, Elicia J
Description: This report describes the basic elements of Medicaid, focusing on federal rules governing who is eligible, what services are covered, how the program is financed and how beneficiaries share in the cost, how providers are paid, and the role of special waivers in expanding eligibility and modifying benefits.
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Medicare Structural Reform: Background and Options

Medicare Structural Reform: Background and Options

Date: January 28, 2003
Creator: Chaikind, Hinda R.; O'Sullivan, Jennifer & Boulanger, Jennifer
Description: THis report provides a brief overview of major issues underlying the debate about possible structural reforms or improvements to the current Medicare system. Medicare is a nationwide health insurance program for the aged and certain disabled persons.
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The ACA Medicaid Expansion

The ACA Medicaid Expansion

Date: December 30, 2014
Creator: Mitchell, Alison
Description: This report provides an overview of the ACA Medicaid expansion, and the impact of the Supreme Court decision on the ACA Medicaid expansion. Then, the report describes who is covered under the expansion, the expansion rules, and how the expansion is financed. In addition, enrollment and expenditure estimates for the ACA Medicaid expansion are provided. Finally, the report reviews state decisions whether or not to implement the ACA Medicaid expansion, and the implications of those decisions on certain individuals, employers, and hospitals.
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Medicare Primer

Medicare Primer

Date: March 31, 2016
Creator: Davis, Patricia A.; Talaga, Scott R.; Binder, Cliff; Hahn, Jim; Kirchhoff, Suzanne M. & Morgan, Paulette C.
Description: This report provides a general overview of the Medicare program including descriptions of the program's history, eligibility criteria, covered services, provider payment systems, and program administration and financing.
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Medicare: Enrollment in Medicare Drug Plans

Medicare: Enrollment in Medicare Drug Plans

Date: October 20, 2006
Creator: O'Sullivan, Jennifer
Description: This report discusses the enrollment process for private prescription drug plans (PDPs) or Medicare Advantage prescription drug (MA-PD) plans. At a minimum, these plans offer "standard coverage" or alternative coverage with actuarially equivalent benefits. Beneficiaries are required to enroll in one of these private plans in order to obtain coverage.
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Medicare: FY2008 Budget Issues

Medicare: FY2008 Budget Issues

Date: February 6, 2007
Creator: Chaikind, Hinda; Jacobson, Gretchen A.; Hahn, Jim; Morgan, Paulette C.; O’Sullivan, Jennifer & Stockdale, Holly Sue
Description: This report discusses President's budget request to Congress for Medicare, for the following federal fiscal year, along with projections for the five-year budget window. The President’s 2008 budget includes Medicare legislative proposals with estimated savings of $4.3 billion in 2008 and $65.6 billion over the five-year budget window.
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Medicaid Citizenship Documentation

Medicaid Citizenship Documentation

Date: April 15, 2008
Creator: Grady, April
Description: Due to recent changes in federal law, individuals who declare that they are citizens for Medicaid eligibility purposes must present documentation that proves citizenship and documents personal identity. This report discusses issues related to Medicaid citizenship documentation that have received considerable media and interest group attention, as well as proposed legislation that would affect the requirement.
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Medicare: FY2007 Budget Issues

Medicare: FY2007 Budget Issues

Date: March 31, 2006
Creator: Chaikind, Hinda; Morgan, Paulette C.; O’Shaughnessy, Carol; O’Sullivan, Jennifer; Stone, Julie & Tilson, Sibyl
Description: This report discusses President's budget request to Congress for Medicare, for the following federal fiscal year, along with projections for the five-year budget window. The President’s 2007 budget includes Medicare legislative proposals for Part A (Hospital Insurance) and Part B (Supplementary Medical Insurance) spending with estimated savings of $2.5 billion in 2007 and $35.9 billion over the five-year budget window.
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Discretionary Spending Under the Affordable Care Act (ACA)

Discretionary Spending Under the Affordable Care Act (ACA)

Date: October 28, 2014
Creator: Redhead, C. Stephen; Colello, Kirsten J.; Heisler, Elayne J.; Lister, Sarah A. & Sarata, Amanda K.
Description: The Patient Protection and Affordable Care Act (Affordable Care Act, or ACA) reauthorized funding for numerous existing discretionary grant programs administered by the Department of Health and Human Services (HHS). The ACA also created many new discretionary grant programs and provided for each an authorization of appropriations. Generally, the law authorized (or reauthorized) appropriations through FY2014 or FY2015. This report summarizes all the discretionary spending provisions in the ACA.
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A Federal Pause in Potentially Risky Influenza Research

A Federal Pause in Potentially Risky Influenza Research

Date: November 24, 2014
Creator: Shea, Dana A.
Description: This report briefly discusses a recently implemented federal research moratorium that has highlighted concerns about the general appropriateness of research on biological pathogens and the sufficiency of certain biosecurity efforts.
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Appropriations and Fund Transfers in the Affordable Care Act (ACA)

Appropriations and Fund Transfers in the Affordable Care Act (ACA)

Date: August 1, 2014
Creator: Redhead, C. S.
Description: This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the Affordable Care Act (ACA) and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending.
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Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2011

Centers for Disease Control and Prevention Global Health Programs: FY2001-FY2011

Date: April 7, 2010
Creator: Salaam-Blyther, Tiaji
Description: This report explains the role the Centers for Disease Control and Prevention (CDC) plays in U.S. global health assistance, highlights how much the agency has spent on global health efforts from FY2001 to FY2010, and discusses how funding to each of its programs has changed during this period.
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Tax Options for Financing Health Care Reform

Tax Options for Financing Health Care Reform

Date: March 2, 2010
Creator: Gravelle, Jane G.
Description: This report reviews the revenue raisers proposed to fund health care reform. Other financing proposals are presented including those made by the Obama Administration and those introduced in earlier congressional work. The final sections discuss other proposals suggested by the round-table discussion participants.
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The Community Health Center Fund: In Brief

The Community Health Center Fund: In Brief

Date: February 12, 2015
Creator: Heisler, Elayne J.
Description: This report provides information on the Community Health Center Fund (CHCF) that may be useful for discussions about the fund's future. Specifically, it includes information on: the types of grants awarded, total funds disbursed, and the amount of CHCF funds that facilities in each state and territory received.
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Appropriations and Fund Transfers in the Affordable Care Act (ACA)

Appropriations and Fund Transfers in the Affordable Care Act (ACA)

Date: March 6, 2015
Creator: Redhead, C. Stephen
Description: This report summarizes all the mandatory appropriations and Medicare trust fund transfers in the ACA and provides details on the status of obligation of these funds. The information is presented in two tables. The report also includes a brief discussion of the impact that sequestration is having on ACA mandatory spending. This report is periodically revised and updated to reflect important legislative and other developments.
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