Affordable Care Act (ACA) Summary of Provisions

The Affordable Care Act is such a comprehensive piece of legislation with so many provisions, it is difficult to keep track of what is still to come. Following is a summary of the provisions which will become effective last quarter 2012 through 2015. Here is an informative ACA summary of provisions:

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October 1, 2012

Effective October 1, 2012, there are 2 provisions of the Act which will become effective – Linking Payments to Quality Outcomes and Reducing Paperwork and Administrative Costs. A Value-Based Purchasing program will be created which offers incentives to improve quality care and will require certain hospital measures to be available to the public. Additionally, the law will require the migration to standardized billing and the use of electronic health records to assist in reducing paperwork, cutting costs, reducing medial errors and improving the quality of care.

January 1, 2013

Effective January 1 2013, the provisions which will take effect include: improving preventative health coverage, expanding authority to bundle payments, and increasing Medicaid payments for primary care doctors. The Act will provide funding to Medicaid programs to help cover preventative services. Bundling refers to grouping together an episode rather than each individual service or test in terms of billing Medicare. Finally, the Act will provide federal funding to increase reimbursement for 2013 and 2014 to primary care physicians, as physicians prepare to cover more patients.

October 1, 2013

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ACA Summary of Provisions

Effective October 1, 2013, the Act will extend funding for the Children’s Health Insurance Program for an additional two years to cover children who are not eligible for Medicaid.

January 1, 2014

Effective January 1, 2014, there are several provisions which will become effective. They include:

  • Eliminating discrimination of insurance companies on the basis of pre-existing conditions and/or gender
  • Providing coverage for those who are participating in clinical trials – or at least not allowing coverage to be reduced or eliminated solely on this basis
  • Removing the annual dollar limits on the amount of coverage an insured can have
  • Providing tax credits and affordable insurance exchange
  • Increasing access to Medicaid, promoting individual responsibility and ensuring free choice

January 1, 2015

The main provision which will become effective January 1, 2015 is to pay physician based upon the quality of care they provide rather than the volume of care.

This provides a snapshot of the provisions yet to become effective with the Affordable Care Act. For the full story, please refer to