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July 3rd, 2012 | Healthcare Reform | Seminars & Publications

Medicaid Presumptive Eligibility – Here is the quote from the Financial Professional’s Guide to Healthcare Reform


“Prior to the reform legislation, states could—but were not required to—make presumptive eligibility determinations only for children, pregnant women, and women suffering from breast and cervical cancer. Effective January 1, 2014, and subject to pending regulations, certain medical providers including hospitals will be permitted to provide and be paid for Medicaid-covered services to presumptively newly eligible individuals and families. This change permits the presumptively eligible to receive coverage before the required Medicaid application is filed; the application is necessary to determine actual eligibility. The legislation also provides that any subsequent determinations of ineligibility will not be counted against the state in the determination of its error rate.”

Subtitle C—Medicaid and CHIP Enrollment Simplification, Sec. 2202. Permitting hospitals to make presumptive eligibility determinations forall Medicaid eligible populations

Link to U.S. Senate website http://dpc.senate.gov/healthreformbill/healthbill96.pdf

Medicare Tax Withholding – Employer’s are NOT required to withhold the tax unless the wages of an individual exceed the $200,000 level. Individuals who are married and whose combined income will exceed the $250,000 threshold must factor it into their estimated tax payments.

Tricare – here is a link to what Tricare had to say after the legislation passed.


And, after the Supreme Court Decision


Applicability of Reporting to Governmental Units – Here is the quote from the Financial Professional’s Guide to Healthcare Reform


“Applicable employer-sponsored coverage also includes any group health plan established and maintained primarily for its civilian employees by the government of the United States, by the government of any state or political subdivision thereof, or by any agency or instrumentality of any such government.”

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