Ndondomeko Zachikulire Zimakonzedweratu Kuti Zithetsere Kumapeto kwa 2018
Pamene ACA inasindikizidwa kukhala lamulo mu 2010, idapempha kusintha kwakukulu m'misika ya inshuwalansi ya thanzi laling'ono ndi laling'ono. Chigawo chinapangidwira lamulo lolola mapulani omwe analipo kale pa March 23, 2010 kuti apitirizebe kugwira ntchito mwakhama, malinga ngati palibe kusintha kwakukulu komwe kunapangidwira pulogalamuyo, malinga ngati chonyamuliracho chinapitiriza kupereka ndondomekoyi.
Ndondomeko izi zabadwira ndipo sizikusowa kuzinthu zambiri za ACA.
Koma ACA sanapange malipiro apadera pazinthu za gulu limodzi ndi zing'onozing'ono zomwe zinagwira ntchito pambuyo pa March 23, 2010, koma asanayambe kuchuluka kwa malamulo a inshuwalansi a ACA mu 2014. Chiyembekezo chinali chakuti adzatha kumapeto kwa chaka cha 2013 ndi kubwezeretsedwa ndi chidziwitso cha ACA-chovomerezeka panthawiyo.
Zothandizira Zosintha Zomwe Zapangidwa "Zopanga Zambiri"
Kenako kumapeto kwa chaka cha 2013, pamene kusinthanitsa kwa inshuwalansi kunkachitika-ndi zowonjezereka zamagetsi-ndipo ngati zidziwitso zazinthu zosagwirizana nazo zinayamba kusonyeza makasitomala a makasitomala, otsala a mapulani a malingaliro afika pa malungo a malungo .
Poyankha, HHS inapereka chithandizo chololedwa kuti dziko lilole kuti mapulani awa asapitirire kubwereranso mpaka kumapeto kwa pa 1 Oktoba 2014, ndi kufotokozedwa kuti apitirizebe kugwira ntchito mpaka September 30, 2015.
Pasanathe miyezi inayi, mu March 2014, HHS inapereka chithandizo chokhalitsa chithandizo, ndikupereka njira yoti alolere mapulani awa (otchedwa "kusintha" kapena "ndondomeko zazikulu") kukhazikitsanso mwamsanga kuyambira pa October 1, 2016, polemba zomwe zitha kuloledwa kugwira ntchito mochedwa kumapeto kwa September 30, 2017.
Pa February 29, 2016, CMS inapereka chithandizo china chomwe chinathandiza kuti mapulani apitirizebe kugwira ntchito mwamsanga kuyambira pa December 31, 2017. Ndipo zina zowonjezeredwa zinaperekedwa kumayambiriro kwa chaka cha 2017, zomwe zimapangitsa kuti agogo azitha kugwira ntchito mpaka kumapeto kwa 2018.
Chotsatira chake, m'mayiko ambiri, alipobe magulu a anthu omwe ali ndi kagulu kawo omwe sakhala nawo, komanso sakugwirizana ndi ACA. Mapulani awa, kapena mapulani aakulu, angakhalebe ogwira ntchito mpaka December 31, 2018. Pano pali zomwe muyenera kudziwa zokhudza iwo:
1. Ndondomeko zazikuluzikulu sizinthu zofanana ndi zomwe abambo amalinganiza . Iwo ali ndi zosiyana zosiyana pakugwirizana ndi mbali zosiyanasiyana za ACA, ndipo saloledwa kuti azigwirabe ntchito nthawi zonse. Ndondomeko zazikuluzikulu zakhala ndi tsiku lotha msinkhu, mosiyana ndi zolinga zomwe zidakalipo kale, zomwe zikanakhoza kugwiritsidwa ntchito-zikhalebe zamphamvu kwamuyaya ngati ogwira ntchitoyo atasankha kupita njirayo ( yomwe nkukayikitsa ).
2. Ena mwa maiko adasankha kuti asalole zolinga zazikuru, ena anaziletsa zaka zisanafike 2018 . Ngakhale m'mayiko omwe amalola kuti zikuluzikulu zikhalebe zatsopano, ena ogwira ntchitoyo anathetseratu mapulaniwo, ndipo adawaika ndi ACA-yovomerezeka.
Pulogalamu yopereka chithandizochi inaperekedwa kumapeto kwa chaka cha 2013, pamene ena ndi othandizira anali pafupi kwambiri ndi njira ya ACA-kukhazikitsa zomwe sizinali zofunikira kuti mabungwe a inshuwalansi asinthepo panthawiyi. M'madera 15 ndi DC, panalibe zolinga zazikulu zomwe zinakhalapo mu 2016. Ndipo ngakhale mayiko ena adalola kuti agogo azinthu azipitirizabe, pali madera anayi omwe alibe zolinga zazikulu.
Ndondomeko zazikuluzikulu zimaphatikizapo chisamaliro chosamalidwa popanda kugawana ndalama, koma sichiyenera kuwerengera zina zonse zofunika za thanzi la ACA .
ACA inayamba kufunafuna njira zonse zaumoyo kuti zisawononge chisamaliro chopanda malire popanda kugawa ndalama (mwachitsanzo, ufulu pa nthawi yomwe ntchitoyo yaperekedwa) pazaka zonse zomwe zikuyambika kapena pambuyo pa September 23, 2010. Izi zinagwiritsidwa ntchito pazinthu zatsopano ndi zatsopano, ngakhale izo sizinagwiritsidwe ntchito pazinthu zazikulu . Zolinga zazikulu zomwe zidakwaniritsidwa pambuyo pa March 23, 2010 koma pamaso pa September 23, 2010, zinayamba kuyamba kuphimba chisamaliro popanda kugawa ndalama monga tsiku lawo loyamba lokonzanso. Ndipo ndondomeko zonse zazikuluzikulu zogwira ntchito pa September 23, 2010 zikuphatikizapo chisamaliro chodzitetezera popanda kugawana mtengo kuchokera pa kupita.
4. Zolinga zazikulu sizingagulitsidwe . Ndondomeko zazikuluzikulu ndizozikhazikitsidwa pambuyo pa March 23, 2010, koma pasanathe pa October 1, 2013, kapena nthawi zina, pa December 31, 2013. Pambuyo pake, sizinatheke kugula ndondomeko ndikukhala nayo ankaganiza agogo. Pambuyo pa Januwale 2014 adakulungidwa, palibe gulu laling'ono kapena ndondomeko yaikulu ya zachipatala zomwe zingagulitsidwe konse (kuphatikizapo kusinthanitsa) ngati sizigwirizana ndi ACA. Dziwani kuti anthu odalira angathe kuwonjezeredwa ku ndondomeko yaikulu (ngati muli ndi ndondomeko yaikulu komanso muli ndi mwana, mukhoza kuwonjezera mwanayo pa ndondomeko), ndipo ogwira ntchito omwe angoyamba kumene angathe kupeza chithunzi pa dongosolo lalikulu la abambo awo omwe alipo kale . Koma ndondomeko zatsopano zazikulu sizinapezeke kugula kuyambira kumapeto kwa 2013.
5. Ndondomeko zazikuluzikulu siziyenera kulandira thandizo kapena ndalama zazing'ono za inshuwalansi za msonkho . Iwo sagulitsidwa mu kusinthana, zomwe zikutanthauza kuti sali oyenerera ndalama zothandizira ndalama. Ngati muli ndi ndondomeko ya munthu wamkulu, mukulipira malipiro athunthu.
6. Ngati ndondomeko yanu yazinthu zakale siidalipo kale, izi zikugwiranso ntchito . Mu maiko onse koma asanu, inshuwalansi ya umoyo payekha inalembedwa mchipatala chisanafike chaka cha 2014. Ndipo m'mayiko ambiri, kufotokoza gulu laling'ono kungaperekedwe ndi ndalama zapamwamba zogwirizana ndi mbiri yachipatala. Ngakhale kuti simungathe kuchita nawo malingaliro atsopano, ndondomeko ya ndondomeko yanu ya chigololo sichikusintha-ngati simunapange chikhalidwe chanu chisanayambe kapena munakupatsani mwayi wapamwamba chifukwa cha mbiri yanu yachipatala, yomwe ikugwiransobe ntchito lero.
7. Pamene ndondomeko yanu ikuluikulu ikatha (kapena kubwereza), mudzakhala ndi nthawi yolembera . Ngakhale kuti mapulani anu azaumoyo amatha kunja kwa olembetsa, mutha kulembetsa ndondomeko yatsopano pamalopo , popanda kusiyana. Potsatira malangizo ochokera kwa CMS kumayambiriro kwa chaka cha 2017, ndondomeko zazikuluzikulu zimaloledwa kukonzanso mofulumira pa October 1, 2018, koma kufotokozera sikuyenera kutha pasanathe pa December 31, 2018. Ngati ndondomeko ya thanzi lanu ikutsatira ndondomekoyi ndikulola dongosolo lanu kupitilira kukhalapo mpaka December 31, 2018, mudzatha kulembetsa pa nthawi yolembera chaka cha 2019, ndipo muzitha kulumikizidwa mwachindunji pansi pa dongosolo la ACA-lovomerezeka lomwe likuyamba pa January 1, 2019.
Koma ngati ndondomeko yanu idakali ndi ndondomeko ya zaka za kalendala (mwachitsanzo, ikuyamba kuyambira June mpaka May, mwachitsanzo, ndikubwezeretsanso pa June 1 chaka chilichonse), wanu inshuwalansi akhoza kusankha kuthetsa dongosolo pa tsiku lokonzanso, mmalo mwa Kulikonzanso kwa chaka chimodzi ndikulilola kuti likhale lolimba mu 2018 lonse. Mukatero, mudzakhala ndi nthawi yolembera yapadera yomwe mungasankhe ndondomeko yatsopano, yomwe imayambitsa kutayika, komwe choyenera .
Kuwonjezera apo, muli ndi nthawi yapadera yolembera yomwe mungasankhe ndondomeko yatsopano, yoyenera ya ACA, ngati ndondomeko yanu yazaka zazikulu (osati kholo la kalendala) ikubwezeretsanso pakati pa chaka chimodzi, ngakhale dongosolo lisathe mfundo imeneyo.
> Zotsatira:
> Zigawo za Medicare ndi Medicaid Services, Dipatimenti ya Zaumoyo ndi Zaumunthu. Kalata kwa Akomisisi a Inshuwalansi-Mpata Wothandizira Mapulani . November 16, 2013.
> Zigawo za Medicare ndi Medicaid Services, Dipatimenti ya Zaumoyo ndi Zaumunthu. Makhalidwe a Inshuwalansi Mndandanda-ZOLINGA-Kuwonjezera Malingaliro Otsatira Pakati pa Kalendala Chaka 2018 . February 23, 2017.
> School of Law Cornell, Institute Information Information. 45 CFR 155.420 (d) (1) (ii).