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Many of us are eagerly anticipating the Supreme Court’s decision on the constitutionality of the Patient Protection and Affordable Care Act (ACA), which President Obama signed into law on March 23, 2010. The main issue is the ACA’s “Individual Mandate provision” (or “shared responsibility requirement”), which requires nearly all persons not covered by minimally acceptable insurance to purchase their own insurance by 2015 or pay a penalty. The high court will hear oral arguments March 26-28, 2012, with a decision expected by the end of June 2012. To say that how the Supreme Court decides on the Affordable Care Act and Individual Mandate could have a dramatic impact on healthcare in America for years to come, would be a significant understatement.
HIMSS has prepared a Fact Sheet about the key issues before the Court. If the entire ACA is ruled unconstitutional, a number of health IT-related provisions of the law (see summary here) will also fall with it. In addition to health insurance reforms, expansion of Medicaid eligibility, creation of the Center for Medicare and Medicaid Innovation (CMMI), expansion of employer health insurance mandates, creation of the Medicare Independent Payment Advisory Board (IPAB), and the creation of health insurance exchanges, the ACA includes a number of provisions dependent on, or related to, health IT. These provisions include:
- electronic health information exchange (HIE);
- extension of the Physician Quality Reporting Initiative (PQRI); and
- new methods to reimburse expenses based on quality of care such as Accountable Care Organization (ACO) demonstration projects.
CMS published the Accountable Care Organization Final Rule on Oct. 20, 2011. How the Supreme Court eventually rules on the ACA will determine the near-term future of ACOs and Medicare payment reform. The ramifications for the efforts to control healthcare spending in this country are wide-ranging.
This article originally appeared on the HIMSS Blog.