As arduous as the legislative battle was for the Affordable Care Act to reach enactment in March 2010, that was just the launching point for years of expected struggles over regulations to implement the law.
Pace of rules rollout targeted
Ever since implementation began, those rules and regulations have become fodder for its supporters and opponents to continue their political battle over the law's merits and future.
For example, the Obama administration and congressional Democrats extensively touted rules issued throughout 2010 involving new protections for private insurance subscribers. Those measures included prohibitions on insurers denying coverage to children based on pre-existing conditions and prohibitions on coverage rescissions based on inaccuracies in customer applications.
“You're going to be able to make sure that the insurance company doesn't drop you because of an innocent mistake on your insurance form,” President Barack Obama said at a September gathering of supporters in Virginia.
But the regulations issued to implement the healthcare law, as well as frequent delays in those regulations, have given critics further opportunities to attack the law.
Among high-profile regulations closely watched by hospitals and other healthcare providers were those implementing the law's expansion of recovery audit contractors from Medicare to state Medicaid plans.
The CMS proposed new RAC rules in November, but on Feb. 1 agency officials announced an indefinite delay until later this year. The reform law required states to establish Medicaid RAC programs based on the federal regulations by the end of 2010.
“I am sincerely concerned about the helter-skelter approach being taken to implement the new healthcare law's tools to address improper payments,” Sen. Orrin Hatch (R-Utah) said at a March 2 Senate Finance Committee hearing on healthcare fraud. “For example, the recent stop-and-start and then reverse guidance by the CMS to states and healthcare organizations on Medicaid RACs is mind-boggling.”
Meanwhile, forthcoming regulations governing the creation of new accountable care organizations are widely expected to determine the types of provider arrangements that will dominate the healthcare industry for years to come. But delays in the ACO regulations—expected late last year—have already provided ammunition for further criticism of the administration.
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