Health Reform Funding Used to Provide Maryland with Medicare Part D “Donut Hole” Rebate Checks, Consumer Protections, Resources to Build Insurance Exchange
WASHINGTON, DC – Today, Congressman Steny H. Hoyer (MD-5) released new numbers from the Department of Health and Human Services showing that since health reform was enacted into law in March 2010, Maryland has been awarded $62.7 million in new grant funding, which is already helping many residents and employers take more control over their health care.
“From new patient protections to new coverage options, health reform is already having a very positive impact on Maryland residents and businesses,” said Rep. Hoyer. “For far too long, American families and businesses struggled with the skyrocketing costs of health care, and today’s announcement is just another example of how health insurance reform is working to make health care more affordable and accessible here in Maryland and throughout the nation.”
Click here or see below for a list of programs in Maryland made possible by the Affordable Care Act:
- 32,172 Medicare Part D “Donut Hole” Rebate Checks: In Maryland, 32,172 Medicare beneficiaries have received a one-time, tax free $250 rebate to help pay for prescriptions in the “donut hole” coverage gap. (Under reform, beginning on January 1, 2011, seniors will begin receiving a 50% discount for brand-name drugs in the ‘donut hole’ coverage gap.)
- Consumer Assistance Program to Protect Consumers from the Worst Insurance Company Practices: On September 30, 2010, HHS awarded nearly $600,000 in grants for a new Consumer Assistance Program to help strengthen and enhance ongoing efforts in the States and local communities to protect consumers from some of the worst insurance industry practices. The Office of Attorney General, Consumer Protection Division, Health Education and Advocacy Unit (HEAU) in Maryland will receive nearly $600,000 to:
- Hire additional staff to assist with additional consumers, including:
- Deputy Director to help manage the cases and HEAU staff.
- Two additional Health Ombudsman.
- Additional support staff member.
- Medical professional to assist the Ombudsmen in preparing appeals and grievances, especially in cases involving medical necessity.
- Outreach coordinator to educate consumer and providers about the HEAU.
- Provide more consumers with assistance with the appeals and grievance processes.
- Generate reports that are required under the grant program.
- Improve the Review Process: Currently, Maryland conducts prospective actuarial review of all health insurance premium filings. To build upon its current process, Maryland plans to contract for consulting services to provide recommendations on which data elements should be included in rate filing submissions, which markets should require additional data elements in their rate filings, and the implementation of policies and procedures to carry out a more robust rate review process.
- Increase Transparency and Accessibility: Today, only the portions of health insurance premium filings that exclude confidential information are publicly disclosed. To enhance consumer access to premium information, Maryland will contract for recommendations on how to best present premium increase information to consumers and policymakers.
- Develop and Upgrade Technology: Maryland will improve electronic reporting functions to facilitate the electronic submission of data.
- Planning and Resources to Build a Health Insurance Exchange: The nearly $1 million in grants will give States the resources they need to conduct the research and planning needed to build a better health insurance marketplace and determine how their Exchanges will be operated and governed. Maryland will use these funds to:
- Utilize the previously established Maryland Health Care Reform Coordinating Council to outline issues pertaining to: engaging the public, gathering and analyzing public comment, conducting focused research, and developing options for consideration by the Coordinating Council.
- Create an information infrastructure plan that assesses existing information systems, identifies gaps and needs, and proposes strategies to achieve seamless eligibility and enrollment in health coverage.
- Develop an outreach and communications strategy for 2011-2014, including market research to guide the design of the Exchange
- Fund Maryland-specific studies of public and private health insurance coverage and health care expenditures to determine whether to merge the individual and small group markets and whether to provide additional protection against adverse selection, development of governance options for the successful operation of the Exchange, and development of operational plans and a sustainable business model for the Exchange.
- Assess current public sector technological capabilities, current private sector technological capabilities and technology solutions that may be available from the federal government.
- Determine whether the existing public or private sector capacity could be adapted for online public access to facilitate eligibility determination, choice of coverage, application, enrollment, the specific options for connecting an eligibility determination system with other components of the Exchange, and develop an RFP for eligibility system expansion or acquisition.
- 101 Employers Enrolled in Early Retiree Reinsurance Program: The Early Retiree Reinsurance Program (ERRP) provides much-needed financial relief to businesses, schools and other educational institutions, unions, State and local governments, and non-profits, in order to help retirees and their families continue to have quality, affordable health coverage. To view a list of Maryland employers enrolled in this program, click here.
- Therapeutic Discovery Project Program Tax Credits and Grants: This program – created by the Affordable Care Act – provided $48,768,487 to Maryland to support groundbreaking biomedical research to produce new therapies, address unmet medical needs, reduce the long-term growth of health care costs and advance the goal of curing cancer within the next 30 years. In Maryland, this program will support 234 projects that show significant potential to produce new and cost-saving therapies, support good jobs, and increase U.S. competitiveness. This program is operated by the U.S. Department of Treasury, and a full list of small businesses participating in this program is available here.
- Other Grants Made Available in Maryland:
- Tribal, Maternal, Infant and Early Childhood Home Visiting Programs ($1 million)
- Aging and Disability Resource Centers ($500,000)
- Medicare improvements for patients and providers ($400,000)
- Strengthen public health infrastructure to improve health outcomes ($300,000)
- Build epidemiology, laboratory, and health information systems capacity ($700,000)
- HIV Prevention and Public Health Fund activities ($1.1 million)
- State Health Care Workforce Development Grants ($200,000)
- Primary Care Residency Expansion Program ($3.8 million)
- Support capital development in health centers ($3.3 million)
* The list is a selection of programs funded by the Affordable Care Act and does not add up to the total Affordable Care Act funding for the State.