Affordable Care Act Tools

Overview  The Affordable Care Act, or ACA, includes new requirements for employer insurance coverage and for individuals to have health care coverage.  Employers that do not offer health care coverage that meets certain requirements will be subject to penalties which must be paid to the federal government.  The ACA is very complex and include a wide array of initiatives which are confusing in and of themselves but which also are changing as the Administration implements the law.  The Administration has repeatedly indicated that these provisions and related changes will go in force on January 1, 2014 – no delays.

AHCA/NCAL Support  AHCA/NCAL has formed an team with representation from every department to ensure the membership is prepared.  The work of the AHCA/NCAL team is guided and overseen by the State Executives.

Resources  Our major 2013 work areas based on member guidance include: o Research on what would be needed for Medicaid Rate Add-Ons to help cover new or expanded employee health care coverage o A user-friendly website which includes ACA implementation timelines, issue briefs, a webinar library o Webinar series on various aspects of the ACA o Development of an online calculator to allow members to estimate a penalty figure should they choose not to offer coverage o An alert series which provides succinct and timely information on ACA implementation updates o Frequently Asked Questions online and a monthly “just the facts” audio files with experts answering member submitted questions o ACA dedicated address, which members may use to questions to Association

ACA Team TopicLead Small Business Health Insurance Options Program Dana Halvorson Basic Health PlanMike Cheek Health Insurance Exchange (HIX)Mike Cheek HIX and MedicaidMike Cheek Medicaid ExpansionCaroline Haarmann Employer RequirementsPeter Corless Program IntegrityDianne De La Mare Elder Justice ActLyn Bentley

Employer Penalty Calculator  Beginning in 2014, employers with 50 or more full-time employee equivalents (FTEEs) will either have to offer health insurance coverage to their full-time employees or face penalties.  AHCA/NCAL has developed a calculator designed to give a rough estimate of potential penalties based on company size.  Available online in May

Medicaid Rate Add-On Analysis  Purpose is to develop o State-specific Medicaid rate add-ons needed to aid members with providing affordable health care coverage that meets federal Qualifying Coverage requirements o And to provide a national average Medicaid rate add-on for federal advocacy  Partnering with The Center for Research to conduct the survey and analysis  Web-based survey with state affiliate technical assistance and survey support included in work plan

Compliance & Ethics Program  Statutory language requires SNFs and NFs to implement an effective Compliance & Ethics program (deadline was 3/23/13)  CMS is drafting a proposed rule that has not been released yet.  The rule will likely look like OIG guidance released in 2000 and 2008 at and guidance/docs/complianceguidance/nhg_fr.pdf guidance/docs/complianceguidance/nhg_fr.pdf  Whether or not the rule is released, SNFs and NFs without a program should design and implement a Compliance & Ethics program by the 3/23/13 deadline.

Compliance & Ethics Program  Listen to a webinar on Deconstructing Corporate Compliance & Ethics for Single Facilities and Small Regional Chains at  Read about how to design and implement a Compliance & Ethics program at Programs.aspx. Programs.aspx

AHCABenefits  AHCA has been developing a program for our members to address the requirements of ACA and achieve compliance.  Through Compass Total Benefits, insurance carrier partners will offer AHCA members traditional benefit programs, as well as defined contribution plans.  This program is open to AHCA/NCAL members and Associate Business Members.  A key member service is the comprehensive analysis EVERY employer must do. We are providing it to member as a free service.  Visit for more information.

Use Our ACA Tools  Visit the new website at o Look under the Facility Resources tab in the top menu bar  Send questions & sign up for alerts at