Provisions of the Patient Protection and Affordable Care Act (PPACA) will take effect over the next eight years. Here are some of the newest protections, opportunities, programs and regulations created by PPACA.

NEW IN NOVEMBER!

• CMS Launches the Center for Medicare and Medicaid Innovation: CMS launched the Center for Medicare and Medicaid Innovation (CMMI) on November 16. The CMMI is a creation of the Patient Protection and Affordable Care Act that will test various payment and health care delivery strategies. CMS has the authority to implement successful strategies throughout the Medicare program. The goal of the CMMI is to find payment and delivery strategies that enhance the quality of care, improve the health of the population and lower costs. Richard Gilfillan, MD, will serve as acting director. The CMMI will likely consider innovative models for the delivery of care such as the Patient Centered Medical Home (PCMH) and approaches to payment that include the Accountable Care Organization model and bundled payment. CAFP will monitor the CMMI closely and seek opportunities to improve the payment of family physicians and promote the PCMH model. For more information on the CMMI, click here. 
• CMS Selects States to Participate in the Multi-Payer Advanced Primary Care Practice Demonstration: On November 16, CMS announced the eight states selected to participate in the Multi-Payer Advanced Primary Care Practice Demonstration Project. The Advanced Primary Care Practice is another name for the Patient Centered Medical Home (PCMH). States selected include Maine, Vermont, Rhode Island, New York, Pennsylvania, North Carolina, Michigan and Minnesota. AAFP has reached out to chapters in these states and offered its support and assistance for the demonstration project. This project will combine payment and data from Medicare, Medicaid and private payors in the most comprehensive demonstration of PCMH to date.  CAFP spearheaded submission of a letter to Toby Douglas, head of the Medi-Cal program, urging the State of California to submit a proposal to participate in the demonstration project.  The Academy rounded up a coalition of 20 individuals and organizations supportive of participation, but the state declined.

Already in Place:

• PPACA created a high risk pool program to help provide affordable health insurance coverage to people denied insurance because of pre-existing medical conditions. California launched its high risk pool program, the Pre-Existing Condition Insurance Plan (PCIP), in September 2010 and is currently accepting applications. Click here for more information. 
• As part of PPACA's step-by-step effort to close the Medicare Part D prescription drug coverage gap, eligible beneficiaries who hit the Part D coverage gap will receive a one-time, tax-free $250 rebate check in 2010. The US Department of Health and Human Services (HHS) announced that more than 1 million Medicare beneficiaries had received their checks as of August 30.Medicare expects to distribute four million checks this year. Click here for more information.
• A new web tool is available that makes searching for health insurance coverage options easier than before. This is a valuable resource for small businesses, consumers, and their families to search for coverage options. Click here to try it out.
• HHS has awarded $32 million in PPACA funds to increase access to health care for Americans living in rural areas. The funds reach across seven programs administered by the Office of Rural Health Policy in HHS Health Resources and Services Administration (HRSA). These include a grant to the California Department of Health Services. A list of HRSA grants distributed in 2010 is available here.  
• HHS has made $250 million in grants available to improve the delivery of primary health care services to underserved and vulnerable populations. The funding for these "New Access Points" that are part of the Health Center Program, will be awarded by HRSA.
• Health care workforce training programs will be bolstered through $159.1 million in grants. These grants are in addition to the multimillion dollar investments contained in PPACA to strengthen and grow the primary care workforce. The grants will target three types of programs: nursing workforce development programs, interdisciplinary geriatric education and training programs, and Centers of Excellence programs for underrepresented minority students. State-by-state charts of the grant awards are available here.  For more information on HRSA's health professions programs, click here.
• Private health plans are required to cover evidence-based preventive services and eliminate cost sharing requirements for such services. These new regulations, released by HSS, will help cover patients' preventive services such as blood pressure, diabetes, and cholesterol tests; many cancer screenings; routine vaccinations; pre-natal care; and regular wellness visits for infants and children. For more information is available here.
• Governor Schwarzenegger signed two bills that will make California the first state to establish a health insurance exchange under PPACA. The bills, AB 1602 (Pérez; D-Los Angeles) and SB 900 (Alquist; D-Santa Clara), will provide the foundation for the California Health Benefit Exchange. The exchange will offer a marketplace of health insurance options for individuals and small businesses, as required under the federal reform law by January 2014. Click here to read more.
• The National Association of Insurance Commissioners released a draft proposalof the final medical-loss ratio rules under PPACA that would determine spending parameters for health insurers. Click here to read more.