“Welcome to Medicare”: Health Reform Law Expands Preventive Services

Health Reform Law Expands Preventive Services
 
Feb. 15, 2011 - PRLog -- The Affordable Care Act of 2010, enacted into law last spring, brings important benefits for Medicare beneficiaries. One such benefit is the expansion of the “Welcome to Medicare” exam.

Until recently in the program, Medicare did not pay for preventive services. The policy was, apparently, that the purpose of Medicare is to pay for care of people who are sick or injured, not for the continued well-being of people who are healthy.

Preventive care has become an increasing focus of the Medicare program. For instance, section 101 of the 2008 Medicare law expanded Medicare’s authority to establish coverage for additional preventive services that meet specified criteria. Medicare Part B helps cover preventive services, such as physicians’ examinations and screenings for disease or illness.

Under the Affordable Care Act, Medicare now pays in full, without patient co-pays or deductibles, for the initial “Welcome to Medicare” exam. In addition, Medicare will pay for an Annual Wellness Visit.

The Initial Preventive Physical Exam (IPPE, the “Welcome to Medicare” exam) provides Personalized Prevention Plan Services (PPPS) and for subsequent Annual Wellness Visits (AWV). The IPPE provides for the following services by a health professional (doctor of medicine or doctor of osteopathy):
•  Establishment of an individual’s medical/family history.
•  Establishment of a list of current providers and suppliers that are regularly involved in providing medical care to the individual.
•  Measurement of an individual’s height, weight, BMI (or waist circumference, if appropriate), BP, and other routine measurements as deemed appropriate, based on the beneficiary’s medical/family history.
•  Detection of any cognitive impairment that the individual may have.
•  Review of the individual’s potential (risk factors) for depression, including current or past experiences with depression or other mood disorders, based on the use of an appropriate screening instrument for persons without a current diagnosis of depression, which the health professional may select from various available standardized screening tests designed for this purpose and recognized by national medical professional organizations.
•  Review of the individual’s functional ability and level of safety based on direct observation, or the use of appropriate screening questions or a screening questionnaire, which the health professional may select from various available screening questions or standardized questionnaires designed for this purpose and recognized by national professional medical organizations.
•  Establishment of a written screening schedule for the individual, such as a checklist for the next 5 to 10 years, as appropriate, based on recommendations of the United States Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP), as well as the individual’s health status, screening history, and age-appropriate preventive services covered by Medicare.
•  Establishment of a list of risk factors and conditions for which primary, secondary, or tertiary interventions are recommended or are underway for the individual, including any mental health conditions or any such risk factors or conditions that have been identified through an IPPE, and a list of treatment options and their associated risks and benefits.
•  Furnishing of personalized health advice to the individual and a referral, as appropriate, to health education or preventive counseling services or programs aimed at reducing identified risk factors and improving self-management, or community-based lifestyle interventions to reduce health risks and promote self-management and wellness, including weight loss, physical activity, smoking cessation, fall prevention, and nutrition.
•  End-of-life planning upon agreement with the individual. The term “end-of-life planning” means verbal or written information regarding an individual’s ability to prepare an advance directive in the case that an injury or illness causes the individual to be unable to make health care decisions; and whether or not the physician is willing to follow the individual’s wishes as expressed in an advance directive.
•  Any other element(s) determined appropriate by the Secretary of Health and Human Services through the National Coverage Determination (NCD) process.

Review of the individual’s functional ability and level of safety includes, at a minimum, assessment of the following topics:
•  Hearing impairment
•  Ability to successfully perform activities of daily living
•  Fall risk
•  Home safety

Subsequent Annual Wellness Visits update the Medicare beneficiary's PPPS.

This free Medicare benefit became effective on January 1, 2011. People on Medicare are encouraged to take advantage of it: their health may just depend upon it.

The content of this article was re-produced by the Society of Certified Senior Advisors, used with permission from Timothy L. Takacs. Mr. Takacs is founder of the Elder Law Practice of Timothy L. Takacs and was one of the first elder law attorneys in the nation to assemble an inter-disciplinary team of experts to provide integrated client care. His innovations have transformed the practice of elder law in the United States and have set a new standard of excellence in the field. Visit his website at http://www.tn-elderlaw.com.

The Society of Certified Senior Advisors (SCSA), provides free resources and tools for our members as an ongoing commitment that we have in helping professionals to understand the complex and dynamic lives of modern senior citizens. Visit the Free Resources section of the CSA website at http://www.csa.us/freeresources.

About SCSA
SCSA’s mission is to educate professionals to work more effectively with their senior clients. For those who work with seniors, this means understanding the key health, social and financial factors that are important to seniors—and how these factors work together. CSAs are able to integrate this into their professional practices, no matter what field they’re in. They’ve learned how incredibly gratifying it is to help seniors achieve their goals, and the seniors they’ve worked with have learned how important it is to work with someone who truly understands their age-related circumstances.  For more information about SCSA and its educational course, please visit http://www.csa.us.

Contact:
Erica Ananich, SCSA
(888) 538-2599
society@csa.us
http://www.csa.us/blog

# # #

SCSA educates professionals to work more effectively with their senior clients. That means understanding the key health, social & financial factors that are important to seniors — so you can find success in the senior market.
End
Source: » Follow
Email:***@csa.us Email Verified
Zip:80222
Tags:Healthcare Reform, Senior, Scsa, Csa, Medicare, Affordable Care Act, Preventative Care, Deductible, Depression, Elderlaw
Industry:Business, Health, Marketing
Location:Colorado - United States
Account Email Address Verified     Account Phone Number Verified     Disclaimer     Report Abuse
Society of Certified Senior Advisors News
Trending
Most Viewed
Daily News



Like PRLog?
9K2K1K
Click to Share