Colorado Medical Society

PERC - Expanded Coverage

Thursday, April 11, 2013 02:21 PM

Requirements, Incentives and Mechanics

Hundreds of thousands of currently uninsured U.S. citizens and legal residents who reside in Colorado will soon have to have either private or public coverage and will be seeking health and medical care. Health insurance benefits will no longer run out due to a long or expensive illness and pre-existing conditions for patients under 19 (already effective) and adults will soon cease to be an issue for your patients. PPACA placed an increased emphasis on prevention and wellness, by covering many preventive services, such as mammograms for women and immunizations for children, with no co-payments or deductibles. A single set of operating rules for health care payment and remittance and for other administrative hassles burdening physician offices will be addressed in regulatory rulemaking and will carry the force and effect of state and federal law.

Large employers will be subject to penalties under certain circumstances if they do not provide their employees with insurance coverage, while employers with no more than 25 employees will be eligible for tax credits for the purchase of health insurance. Physicians as employers should carefully consider these requirements and incentives.