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 Resource Type: Report
 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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Medicare: Part B Premium Penalty

Medicare: Part B Premium Penalty

Date: June 29, 2005
Creator: O'Sullivan, Jennifer
Description: None
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How Medicaid Works - Program Basics

How Medicaid Works - Program Basics

Date: March 16, 2005
Creator: Herz, Elicia J; Hearne, Jean P; Stone-Axelrad, Julie; Tritz, Karen; Baumrucker, Evelyne P; Scott, Christine et al.
Description: None
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Medicare: Financing the Part A Hospital Insurance Program

Medicare: Financing the Part A Hospital Insurance Program

Date: April 11, 2005
Creator: O'Sullivan, Jennifer
Description: None
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Medicaid: A Fact Sheet

Medicaid: A Fact Sheet

Date: July 7, 2003
Creator: Hearne, Jean P
Description: None
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Health Insurance:  A Primer

Health Insurance: A Primer

Date: February 3, 2005
Creator: Fernandez, Bernadette
Description: None
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Medicare Payment Policies

Medicare Payment Policies

Date: February 23, 2005
Creator: Tilson, Sibyl L; Chaikind, Hinda Ripps; O'Sullivan, Jennifer; Morgan, Paulette C; Justice, Diane; Stone-Axelrad, Julie et al.
Description: None
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How Medicaid Works: Program Basics

How Medicaid Works: Program Basics

Date: February 7, 2004
Creator: Herz, Elicia J; Hearne, Jean P; Stone-Axelrad, Julie; Tritz, Karen; Baumrucker, Evelyne P; Scott, Christine et al.
Description: None
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Health Insurance: Uninsured by State, 2000

Health Insurance: Uninsured by State, 2000

Date: January 11, 2002
Creator: Morgan, Paulette C
Description: None
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Health Insurance: Uninsured by State, 2001

Health Insurance: Uninsured by State, 2001

Date: November 19, 2002
Creator: Morgan, Paulette C
Description: None
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Managed Health Care: A Primer

Managed Health Care: A Primer

Date: September 30, 1997
Creator: Lee, Jason S
Description: None
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Medicaid: 105th Congress

Medicaid: 105th Congress

Date: February 4, 1998
Creator: Ford, Melvina; Price, Richard J & Neisner, Jennifer A
Description: None
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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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