The Patient protection and Affordable Care Act (PPACA) guidelines must be enacted by September 23rd, 2010 (6 months from the date it was passed).

September 23rd guidelines:

-Dependent children will be permitted to remain on their parents' insurance plan until their 26th birthday.

-Insurers are prohibited from discriminating against any individuals under the age of 19 based on pre-existing medical conditions.

-Insurers are prohibited from charging co-payments or deductibles for Level A or Level B preventive care and medical screenings on all new insurance plans. For full list see article below.

-Individuals affected by the Medicare Part D coverage gap will receive a $250 rebate, and 50% of the gap will be eliminated in 2011. The gap will be eliminated by 2020.

-Insurers' abilities to enforce annual spending caps will be restricted, and completely prohibited by 2014. This is also called unlimited lifetime maximums.

-Insurers are prohibited from rescinding policyholders when they get sick unless fraud was committed on the application.

-Insurers are required to reveal details about administrative and executive expenditures.

-Insurers are required to implement an appeals process for coverage determination and claims on all new plans.

-Indoor tanning services are subjected to a 10% service tax.

-Enhanced methods of fraud detection are implemented.

-Medicare is expanded to small, rural hospitals and facilities.

-Companies which provide early retiree benefits for individuals aged 55–64 are eligible to participate in a temporary program which reduces premium costs.

-A new website installed by the Secretary of Health and Human Services will provide consumer insurance information for individuals and small businesses in all states.

-A temporary credit program is established to encourage private investment in new therapies for disease treatment and prevention

Effective by January 1, 2011

-Employers must disclose the value of the benefits they provided beginning in 2011 for each employee's health insurance coverage on the employees' annual Form W-2's.

-Insurers will be required to spend 85% of large-group and 80% of small-group and individual plan premiums (with certain adjustments) on health care or to improve health-care quality, or return the difference to the customer as a rebate. Although we are still waiting on additional clarifications from HHS at present these do not include any administration costs, salaries, benefits, rent, or commissions. This is NOT 20% profit. Future rate increases or decreases will be based on this formula.

-Companies will be required to issue 1099 forms to any vendor of services or rental property to which the business has paid more than $600. Form 1099 is also sent to the IRS. Under the existing law, businesses issued the Form 1099 only to individuals who provided services or property to a business. The health care law included the same form be issued to corporations as well, and that the form be issued to individuals and corporations that provide property to the business.Only business related payments are reportable, personal payments not.There are a number of exceptions, for example: payments for merchandise, telephone, freight, storage, payments of rent to real estate agents are excepted.The health care bill mandate aims to collect lost revenue from companies that under-report on their tax returns. The provision is expected to raise $17 billion over 10 years.

-The Centers for Medicare and Medicaid Services is responsible for developing the Center for Medicare and Medicaid Innovation and overseeing the testing of innovative payment and delivery models.

Grandfather status:

All health insurance policies issued before March 22nd, 2010 will be grandfathered (exempt) from most of the requirements. Plans issued between March 22nd and Sept 22nd, 2010 will not have these benefits included now but they MUST be brought to compliance and added by 1/1/11. Any significant changes made to a grandfather policy, IE: increasing the deductible, increasing out of pocket maximums, will result in the loss of grandfathered status.

Later developments:

2014:

-All insurance companies will have to guarantee issue coverage (no one can be turned down) regardless of health conditions.

-Health insurance Exchanges will be set up that will provide assistance to buy insurance based on % of Federal poverty levels.

Many people have heard the common advice of owning up to one's mistakes before getting caught. Now, research reveals that when medical errors are proactively sought and compensation offered when at fault, the number of legal claims decreased. The study debunks the notion that health care and health insurance costs will rise if such information is openly brought forth.

University of Michigan chief risk officer and study co-author Richard Boothman says that the study shows that expenses won't necessarily rise if medical errors are fully disclosed.

"This shows that over time, hospitals can afford to do the right thing," says Boothman. "It demonstrates what we have believed to be true for some time: the sky won't fall in by pursuing a pro-active and honest approach to medical mistakes."

Medical errors can have major adverse effects on patient safety. Research by the Institute of Medicine found that thousands of people die each year due to medical errors. The U.S. Department of Health and Human Services suggests that patients try to be proactive in their care by keeping track of all their medications and getting results of all medical tests taken.

Health insurance companies currently have the power to accept or reject covering certain medical procedures. Even though many people's lives have changed for the better after receiving weight-loss surgery, not all health insurance companies cover the procedure.

New research reveals that having bariatric surgery may ultimately help health insurance companies save money.

A study published in the Archives of Surgery found that out of 2,235 patients who received bariatric surgery, almost 75 percent of them also eliminated the need for diabetes medication just 6 months after having the procedure.

Reducing one's weight and diabetes risk can ultimately lead to less reliance on medications and fewer doctor or hospital visits.

"Our results suggest that insurance companies would do well to more readily cover bariatric surgery," said Johns Hopkins surgery professor and study leader Marty Makary. "The cost to care for the average obese diabetic person in America is $10,000 a year, which could be cut to $1,800 with a very safe operation that eliminates more than 80 percent of the medications these individuals have depended on."

A bump here and there can easily happen to children, especially when they are learning to walk or playing contact sports. With infants, however, the same reasoning cannot be given. When an infant has serious injuries, it should be a cause for concern.

Research published in the journal Pediatrics reveals that infants with brain injuries were less likely to be assessed for abuse if they had government health insurance or were African-American.

Children's Hospital of Philadelphia pediatric researcher and study leader Dr. Joanne Wood says that the study highlights the need to develop standardized guidelines for detecting abuse.

"The concern is that we may subject children who are not getting abused to unnecessary tests and also miss actual abuse cases," said Wood. "We know from other studies that when physicians fail to recognize and diagnose abuse, children may suffer further abuse that results in more injury or even death."

Detecting and preventing child abuse and neglect can impact many children in the country each year. The National Child Abuse and Neglect Data system said that over 1,500 children died in 2006 because of abuse.