21
COM Outlook . Fall 2012
Increasing the Efforts to Reduce
Health Care Fraud
Medicare fraud is estimated at $60 billion
annually, with South Florida being amongst
the worst regions for health care fraud nation-
ally. The Affordable Care Act creates provi-
sions for more stringent rules and sentences
for those who commit fraud, greater scrutiny
for those who are more likely to commit fraud,
enhanced collaboration amongst federal
and state agencies, advanced technology
systems to detect fraudulent activity (similar
to what the credit card companies use), and
enhanced ability for Medicare recipients to
identify and prevent fraud.
6
Increasing Primary Care Providers
At NSU-COM, we have taken a leader-
ship role in training primary care physicians.
For instance, in internal medicine (one of the
designated primary care specialties), we have
increased the number of graduates entering
internal medicine residencies from 36 in 2006
to 70 in 2012. However, we continue to have
a national shortage of primary care physicians
in the United States, and there is a projected
additional shortage of 30,000 by 2015 partially
created by the demand of an additional 32 mil-
lion Americans with access to health care.
Another provision of the new law is to
increase primary care providers. The law
creates stipulations for nurses and primary
care physician scholarships and tax-exempt
loan repayments for those health care provid-
ers to work in underserved areas. It will also
increase reimbursements to providers who
practice in rural communities in order to incen-
tivize them to help improve access to health
care for Americans living in these areas.
7
Access to Insurance Coverage
for Early Retirees
Medicare benefits traditionally begin
at age 65 for most Americans. However,
many Americans choose to retire early,
and 30 percent of men and 41 percent of
women are retired between the ages of 55
to 64 in America. As a result, many of these
individuals find themselves without access
to employer-based insurance and often
go without health insurance due to lack of
affordable alternatives. The Affordable Care
Act provides assistance to employer-based
plans that will allow insurance companies to
continue affordable coverage for Americans
who retire early.
8
Eliminate Discrimination Against
Preexisting Conditions
Approximately one in six Americans has
multiple chronic conditions, and this number
is increasing. The Health Insurance Portabil-
ity and Accountability Act of 1996 (HIPAA)
provided provisions to limit employment-
based insurance plans from excluding
individuals with preexisting conditions, but it
did not provide access to insurance coverage
to all Americans with preexisting conditions.
The Affordable Care Act does.
9
Online Access to Insurance Coverage
Difficulty finding and comparing available
insurance plans has limited the ability of
Americans to obtain access to health insur-
ance. The Affordable Care Act has created
HealthCare.gov
as an online resource for
Americans to discover and explore afford-
able insurance plans.
Extended Coverage to Young Adults
Prior to the Affordable Care Act, young
adults frequently were removed from their
parents’ insurance plan at age 19 (or some-
times later if they were full-time students).
Many times, these young adults went with-
out health insurance coverage because they
were either not employed or were full-time
students and their options for health insur-
ance weren’t affordable. Under the new law,
“
On March 23, 2010, President Barack Obama signed the Patient Protection and
Affordable Care Act. This is arguably the most important health care legislation in
recent years and is perhaps as monumental as Medicare in terms of its ability to
change the delivery of health care in the United States.” -
DR. ROBERT HASTY
