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Read the Law: Here we provide two ways for you to read the text of the Affordable Care
Act.
Full Text of the Affordable Care Act (PDF – 2.6 MB)
Read the Affordable Care Act and its amendments. Note: The text is searchable within the PDF file.The Affordable Care Act, Section by Section
10 Titles of the Affordable Care Act, with amendments to the law called for by the reconciliation process.C
Title I. Quality, Affordable Health Care for All Americans
Title II. The Role of Public Programs
The Act extends Medicaid while treating all States equally. It preserves
CHIP, the successful children’s insurance plan, and simplifies enrollment for
individuals and families.
It enhances community-based care for Americans with disabilities and provides States with opportunities to expand home care services to people with long-term care needs.
The Act gives flexibility to States to adopt innovative strategies to improve care and the coordination of services for Medicare and Medicaid beneficiaries. And it saves taxpayer money by reducing prescription drug costs and payments to subsidize care for uninsured Americans, as more Americans gain insurance under reform.
The Secretary has the authority to work with states and other partners to strengthen key public programs.
It enhances community-based care for Americans with disabilities and provides States with opportunities to expand home care services to people with long-term care needs.
The Act gives flexibility to States to adopt innovative strategies to improve care and the coordination of services for Medicare and Medicaid beneficiaries. And it saves taxpayer money by reducing prescription drug costs and payments to subsidize care for uninsured Americans, as more Americans gain insurance under reform.
The Secretary has the authority to work with states and other partners to strengthen key public programs.
TITLE II--ROLE OF PUBLIC PROGRAMS
Subtitle A--Improved Access to Medicaid
Sec. 2001. Medicaid coverage for the lowest income
populations.
Sec. 2002. Income eligibility for nonelderly
determined using modified gross income.
Sec. 2003. Requirement to offer premium assistance
for employer-sponsored insurance.
Sec. 2004. Medicaid coverage for former foster care
children.
Sec. 2005. Payments to territories.
Sec. 2006. Special adjustment to FMAP determination
for certain States recovering from a major disaster.
Sec. 2007. Medicaid Improvement Fund
rescission.
Subtitle B--Enhanced Support for the Children's
Health Insurance Program
Sec. 2101. Additional federal financial
participation for CHIP.
Sec. 2102. Technical corrections.
Subtitle C--Medicaid and CHIP Enrollment
Simplification
Sec. 2201. Enrollment Simplification and
coordination with State Health Insurance Exchanges.
Sec. 2202. Permitting hospitals to make presumptive
eligibility determinations for all Medicaid eligible populations.
Subtitle D--Improvements to Medicaid Services
Sec. 2301. Coverage for freestanding birth center
services.
Sec. 2302. Concurrent care for children.
Sec. 2303. State eligibility option for family
planning services.
Sec. 2304. Clarification of definition of medical
assistance.
Subtitle E--New Options for States to Provide
Long-Term Services and Supports
Sec. 2401. Community First Choice Option.
Sec. 2402. Removal of barriers to providing home
and community-based services.
Sec. 2403. Money Follows the Person Rebalancing
Demonstration.
Sec. 2404. Protection for recipients of home and
community-based services against spousal impoverishment.
Sec. 2405. Funding to expand State Aging and
Disability Resource Centers.
Sec. 2406. Sense of the Senate regarding long-term
care.
Subtitle F--Medicaid Prescription Drug Coverage
Sec. 2501. Prescription drug rebates.
Sec. 2502. Elimination of exclusion of coverage of
certain drugs.
Sec. 2503. Providing adequate pharmacy
reimbursement.
Subtitle G--Medicaid Disproportionate Share
Hospital (DSH) Payments
Sec. 2551. Disproportionate share hospital
payments.
Subtitle H--Improved Coordination for Dual Eligible
Beneficiaries
Sec. 2601. 5-year period for demonstration
projects.
Sec. 2602. Providing Federal coverage and payment
coordination for dual eligible beneficiaries.
Subtitle I--Improving the Quality of Medicaid for
Patients and Providers
Sec. 2701. Adult health quality measures.
Sec. 2702. Payment Adjustment for Health
Care-Acquired Conditions.
Sec. 2703. State option to provide health homes for
enrollees with chronic conditions.
Sec. 2704. Demonstration project to evaluate
integrated care around a hospitalization.
Sec. 2705. Medicaid Global Payment System
Demonstration Project.
Sec. 2706. Pediatric Accountable Care Organization
Demonstration Project.
Sec. 2707. Medicaid emergency psychiatric
demonstration project.
Subtitle J--Improvements to the Medicaid and CHIP
Payment and Access Commission (MACPAC)
Sec. 2801. MACPAC assessment of policies affecting
all Medicaid beneficiaries.
Subtitle K--Protections for American Indians and
Alaska Natives
Sec. 2901. Special rules relating to Indians.
Sec. 2902. Elimination of sunset for reimbursement
for all medicare part B services furnished by certain indian hospitals and
clinics.
Subtitle L--Maternal and Child Health Services
Sec. 2951. Maternal, infant, and early childhood
home visiting programs.
Sec. 2952. Support, education, and research for
postpartum depression.
Sec. 2953. Personal responsibility education.
Sec. 2954. Restoration of funding for abstinence
education.
Sec. 2955. Inclusion of information about the
importance of having a health care power of attorney in transition planning for
children aging out of foster care and independent living programs.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle B--Provisions Relating to Title II
PART I--Medicaid and CHIP
Sec. 10201. Amendments to the Social Security Act
and title II of this Act.
Sec. 10202. Incentives for States to offer home and
community-based services as a long-term care alternative to nursing homes.
Sec. 10203. Extension of funding for CHIP through
fiscal year 2015 and other CHIP-related provisions.
PART II--Support for Pregnant and Parenting Teens
and Women
Sec. 10211. Definitions.
Sec. 10212. Establishment of pregnancy assistance
fund.
Sec. 10213. Permissible uses of Fund.
Sec. 10214. Appropriations.
H.R. 4872. Health Care and Education Reconciliation
Act of 2010
Subtitle C--Medicaid
Sec. 1201. Federal funding for States.
Sec. 1202. Payments to primary care physicians.
Sec. 1203. Disproportionate share hospital
payments.
Sec. 1204. Funding for the territories.
Sec. 1205. Delay in Community First Choice
option.
Sec. 1206. Drug rebates for new formulations of
existing drugs.
To learn more visit:- Affordable Care Act Title Two (PDF - 378 KB)
- Affordable Care Act Amendments to Title Two (PDF - 113 KB)
- Sec. 1201. Federal funding for States. (PDF - 30 KB)
- Sec. 1202. Payments to primary care physicians. (PDF - 30 KB)
- Sec. 1203. Disproportionate share hospital payments. (PDF - 32 KB)
- Sec. 1205. Delay in Community First Choice option. (PDF - 27 KB)
- Sec. 1206. Drug rebates for new formulations of existing drugs. (PDF - 29 KB)
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Title III. Improving the Quality and Efficiency of Health Care
The Act will protect and preserve Medicare as a commitment to America’s
seniors. It will save thousands of dollars in drug costs for Medicare
beneficiaries by closing the coverage gap called the “donut hole.” Doctors,
nurses and hospitals will be incentivized to improve care and reduce unnecessary
errors that harm patients. And beneficiaries in rural America will benefit as
the Act enhances access to health care services in underserved areas.
The Act takes important steps to make sure that we can keep the commitment of Medicare for the next generation of seniors by ending massive overpayments to insurance companies that cost American taxpayers tens of billions of dollars per year. As the numbers of Americans without insurance falls, the Act saves taxpayer dollars by keeping people healthier before they join the program and reducing Medicare’s need to pay hospitals to care for the uninsured. And to make sure that the quality of care for seniors drives all of our decisions, a group of doctors and health care experts, not Members of Congress, will be tasked with coming up with their best ideas to improve quality and reduce costs for Medicare beneficiaries.
The Secretary has the authority to take steps to strengthen the Medicare program and implement reforms to improve the quality and efficiency of health care.
The Act takes important steps to make sure that we can keep the commitment of Medicare for the next generation of seniors by ending massive overpayments to insurance companies that cost American taxpayers tens of billions of dollars per year. As the numbers of Americans without insurance falls, the Act saves taxpayer dollars by keeping people healthier before they join the program and reducing Medicare’s need to pay hospitals to care for the uninsured. And to make sure that the quality of care for seniors drives all of our decisions, a group of doctors and health care experts, not Members of Congress, will be tasked with coming up with their best ideas to improve quality and reduce costs for Medicare beneficiaries.
The Secretary has the authority to take steps to strengthen the Medicare program and implement reforms to improve the quality and efficiency of health care.
TITLE III--IMPROVING THE QUALITY AND EFFICIENCY OF
HEALTH CARE
Subtitle A--Transforming the Health Care Delivery
System
PART I--Linking Payment to Quality Outcomes Under
the Medicare Program
Sec. 3001. Hospital Value-Based purchasing
program.
Sec. 3002. Improvements to the physician quality
reporting system.
Sec. 3003. Improvements to the physician feedback
program.
Sec. 3004. Quality reporting for long-term care
hospitals, inpatient rehabilitation hospitals, and hospice programs.
Sec. 3005. Quality reporting for PPS-exempt cancer
hospitals.
Sec. 3006. Plans for a Value-Based purchasing
program for skilled nursing facilities and home health agencies.
Sec. 3007. Value-based payment modifier under the
physician fee schedule.
Sec. 3008. Payment adjustment for conditions
acquired in hospitals.
PART II--National Strategy to Improve Health Care
Quality
Sec. 3011. National strategy.
Sec. 3012. Interagency Working Group on Health Care
Quality.
Sec. 3013. Quality measure development.
Sec. 3014. Quality measurement.
Sec. 3015. Data collection; public reporting.
PART III--Encouraging Development of New Patient
Care Models
Sec. 3021. Establishment of Center for Medicare and
Medicaid Innovation within CMS.
Sec. 3022. Medicare shared savings program.
Sec. 3023. National pilot program on payment
bundling.
Sec. 3024. Independence at home demonstration
program.
Sec. 3025. Hospital readmissions reduction
program.
Sec. 3026. Community-Based Care Transitions
Program.
Sec. 3027. Extension of gainsharing
demonstration.
Subtitle B--Improving Medicare for Patients and
Providers
PART I--Ensuring Beneficiary Access to Physician
Care and Other Services
Sec. 3101. Increase in the physician payment
update.
Sec. 3102. Extension of the work geographic index
floor and revisions to the practice expense geographic adjustment under the
Medicare physician fee schedule.
Sec. 3103. Extension of exceptions process for
Medicare therapy caps.
Sec. 3104. Extension of payment for technical
component of certain physician pathology services.
Sec. 3105. Extension of ambulance add-ons.
Sec. 3106. Extension of certain payment rules for
long-term care hospital services and of moratorium on the establishment of
certain hospitals and facilities.
Sec. 3107. Extension of physician fee schedule
mental health add-on.
Sec. 3108. Permitting physician assistants to order
post-Hospital extended care services.
Sec. 3109. Exemption of certain pharmacies from
accreditation requirements.
Sec. 3110. Part B special enrollment period for
disabled TRICARE beneficiaries.
Sec. 3111. Payment for bone density tests.
Sec. 3112. Revision to the Medicare Improvement
Fund.
Sec. 3113. Treatment of certain complex diagnostic
laboratory tests.
Sec. 3114. Improved access for certified
nurse-midwife services.
PART II--Rural Protections
Sec. 3121. Extension of outpatient hold harmless
provision.
Sec. 3122. Extension of Medicare reasonable costs
payments for certain clinical diagnostic laboratory tests furnished to hospital
patients in certain rural areas.
Sec. 3123. Extension of the Rural Community
Hospital Demonstration Program.
Sec. 3124. Extension of the Medicare-dependent
hospital (MDH) program.
Sec. 3125. Temporary improvements to the Medicare
inpatient hospital payment adjustment for low-volume hospitals.
Sec. 3126. Improvements to the demonstration
project on community health integration models in certain rural counties.
Sec. 3127. MedPAC study on adequacy of Medicare
payments for health care providers serving in rural areas.
Sec. 3128. Technical correction related to critical
access hospital services.
Sec. 3129. Extension of and revisions to Medicare
rural hospital flexibility program.
PART III--Improving Payment Accuracy
Sec. 3131. Payment adjustments for home health
care.
Sec. 3132. Hospice reform.
Sec. 3133. Improvement to medicare disproportionate
share hospital (DSH) payments.
Sec. 3134. Misvalued codes under the physician fee
schedule.
Sec. 3135. Modification of equipment utilization
factor for advanced imaging services.
Sec. 3136. Revision of payment for power-driven
wheelchairs.
Sec. 3137. Hospital wage index improvement.
Sec. 3138. Treatment of certain cancer
hospitals.
Sec. 3139. Payment for biosimilar biological
products.
Sec. 3140. Medicare hospice concurrent care
demonstration program.
Sec. 3141. Application of budget neutrality on a
national basis in the calculation of the Medicare hospital wage index floor.
Sec. 3142. HHS study on urban Medicare-dependent
hospitals.
Sec. 3143. Protecting home health benefits.
Subtitle C--Provisions Relating to Part C
Sec. 3201. Medicare Advantage payment.
Sec. 3202. Benefit protection and
simplification.
Sec. 3203. Application of coding intensity
adjustment during MA payment transition.
Sec. 3204. Simplification of annual beneficiary
election periods.
Sec. 3205. Extension for specialized MA plans for
special needs individuals.
Sec. 3206. Extension of reasonable cost
contracts.
Sec. 3207. Technical correction to MA private
fee-for-service plans.
Sec. 3208. Making senior housing facility
demonstration permanent.
Sec. 3209. Authority to deny plan bids.
Sec. 3210. Development of new standards for certain
Medigap plans.
Subtitle D--Medicare Part D Improvements for
Prescription Drug Plans and MA-PD Plans
Sec. 3301. Medicare coverage gap discount
program.
Sec. 3302. Improvement in determination of Medicare
part D low-income benchmark premium.
Sec. 3303. Voluntary de minimis policy for subsidy
eligible individuals under prescription drug plans and MA-PD plans.
Sec. 3304. Special rule for widows and widowers
regarding eligibility for low-income assistance.
Sec. 3305. Improved information for subsidy
eligible individuals reassigned to prescription drug plans and MA-PD plans.
Sec. 3306. Funding outreach and assistance for
low-income programs.
Sec. 3307. Improving formulary requirements for
prescription drug plans and MA-PD plans with respect to certain categories or
classes of drugs.
Sec. 3308. Reducing part D premium subsidy for
high-income beneficiaries.
Sec. 3309. Elimination of cost sharing for certain
dual eligible individuals.
Sec. 3310. Reducing wasteful dispensing of
outpatient prescription drugs in long-term care facilities under prescription
drug plans and MA-PD plans.
Sec. 3311. Improved Medicare prescription drug plan
and MA-PD plan complaint system.
Sec. 3312. Uniform exceptions and appeals process
for prescription drug plans and MA-PD plans.
Sec. 3313. Office of the Inspector General studies
and reports.
Sec. 3314. Including costs incurred by AIDS drug
assistance programs and Indian Health Service in providing prescription drugs
toward the annual out-of-pocket threshold under part D.
Sec. 3315. Immediate reduction in coverage gap in
2010.
Subtitle E--Ensuring Medicare Sustainability
Sec. 3401. Revision of certain market basket
updates and incorporation of productivity improvements into market basket
updates that do not already incorporate such improvements.
Sec. 3402. Temporary adjustment to the calculation
of part B premiums.
Sec. 3403. Independent Medicare Advisory Board.
Subtitle F--Health Care Quality Improvements
Sec. 3501. Health care delivery system research;
Quality improvement technical assistance.
Sec. 3502. Establishing community health teams to
support the patient-centered medical home.
Sec. 3503. Medication management services in
treatment of chronic disease.
Sec. 3504. Design and implementation of
regionalized systems for emergency care.
Sec. 3505. Trauma care centers and service
availability.
Sec. 3506. Program to facilitate shared
decisionmaking.
Sec. 3507. Presentation of prescription drug
benefit and risk information.
Sec. 3508. Demonstration program to integrate
quality improvement and patient safety training into clinical education of
health professionals.
Sec. 3509. Improving women's health.
Sec. 3510. Patient navigator program.
Sec. 3511. Authorization of appropriations.
Subtitle G--Protecting and Improving Guaranteed
Medicare Benefits
Sec. 3601. Protecting and improving guaranteed
Medicare benefits.
Sec. 3602. No cuts in guaranteed benefits.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle C--Provisions Relating to Title III
Sec. 10301. Plans for a Value-Based purchasing
program for ambulatory surgical centers.
Sec. 10302. Revision to national strategy for
quality improvement in health care.
Sec. 10303. Development of outcome measures.
Sec. 10304. Selection of efficiency measures.
Sec. 10305. Data collection; public reporting.
Sec. 10306. Improvements under the Center for
Medicare and Medicaid Innovation.
Sec. 10307. Improvements to the Medicare shared
savings program.
Sec. 10308. Revisions to national pilot program on
payment bundling.
Sec. 10309. Revisions to hospital readmissions
reduction program.
Sec. 10310. Repeal of physician payment update.
Sec. 10311. Revisions to extension of ambulance
add-ons.
Sec. 10312. Certain payment rules for long-term
care hospital services and moratorium on the establishment of certain hospitals
and facilities.
Sec. 10313. Revisions to the extension for the
rural community hospital demonstration program.
Sec. 10314. Adjustment to low-volume hospital
provision.
Sec. 10315. Revisions to home health care
provisions.
Sec. 10316. Medicare DSH.
Sec. 10317. Revisions to extension of section 508
hospital provisions.
Sec. 10318. Revisions to transitional extra
benefits under Medicare Advantage.
Sec. 10319. Revisions to market basket
adjustments.
Sec. 10320. Expansion of the scope of, and
additional improvements to, the Independent Medicare Advisory Board.
Sec. 10321. Revision to community health teams.
Sec. 10322. Quality reporting for psychiatric
hospitals.
Sec. 10323. Medicare coverage for individuals
exposed to environmental health hazards.
Sec. 10324. Protections for frontier States.
Sec. 10325. Revision to skilled nursing facility
prospective payment system.
Sec. 10326. Pilot testing pay-for-performance
programs for certain Medicare providers.
Sec. 10327. Improvements to the physician quality
reporting system.
Sec. 10328. Improvement in part D medication
therapy management (MTM) programs.
Sec. 10329. Developing methodology to assess health
plan value.
Sec. 10330. Modernizing computer and data systems
of the Centers for Medicare & Medicaid services to support improvements in
care delivery.
Sec. 10331. Public reporting of performance
information.
Sec. 10332. Availability of medicare data for
performance measurement.
Sec. 10333. Community-based collaborative care
networks.
Sec. 10334. Minority health.
Sec. 10335. Technical correction to the hospital
value-based purchasing program.
Sec. 10336. GAO study and report on Medicare
beneficiary access to high-quality dialysis services.
Subtitle B--Medicare
Sec. 1101. Closing the medicare prescription drug
'donut hole'.
Sec. 1102. Medicare Advantage payments.
Sec. 1103. Savings from limits on MA plan
administrative costs.
Sec. 1104. Disproportionate share hospital (DSH)
payments.
Sec. 1105. Market basket updates.
Sec. 1107. Payment for imaging services.
Sec. 1108. PE GPCI adjustment for 2010.
Sec. 1109. Payment for qualifying hospitals.
To learn more visit:- Affordable Care Act Title Three (PDF - 815 KB)
- Affordable Care Act Amendments to Title Three (PDF - 199 KB)
- Sec. 1101. Closing the medicare prescription drug 'donut hole'. (PDF - 36 KB)
- Sec. 1102. Medicare Advantage payments. (PDF - 42 KB)
- Sec. 1103. Savings from limits on MA plan administrative costs. (PDF - 27 KB)
- Sec. 1104. Disproportionate share hospital (DSH) payments. (PDF - 27 KB)
- Sec. 1105. Market basket updates. (PDF - 37 KB)
- Sec. 1107. Payment for imaging services. (PDF - 27 KB)
- Sec. 1108. PE GPCI adjustment for 2010. (PDF - 27 KB)
- Sec. 1109. Payment for qualifying hospitals (PDF - 27 KB)
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Title IV. Prevention of Chronic Disease and Improving Public Health
The Act will promote prevention, wellness, and the public health and provides
an unprecedented funding commitment to these areas. It directs the creation of
a national prevention and health promotion strategy that incorporates the most
effective and achievable methods to improve the health status of Americans and
reduce the incidence of preventable illness and disability in the United
States.
The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare.
The Secretary has the authority to coordinate with other Departments, develop and implement a prevention and health promotion strategy, and work to ensure more Americans have access to critical preventive health services.
The Act empowers families by giving them tools to find the best science-based nutrition information, and it makes prevention and screenings a priority by waiving co-payments for America’s seniors on Medicare.
The Secretary has the authority to coordinate with other Departments, develop and implement a prevention and health promotion strategy, and work to ensure more Americans have access to critical preventive health services.
TITLE IV--PREVENTION OF CHRONIC DISEASE AND
IMPROVING PUBLIC HEALTH
Subtitle A--Modernizing Disease Prevention and
Public Health Systems
Sec. 4001. National Prevention, Health Promotion
and Public Health Council.
Sec. 4002. Prevention and Public Health Fund.
Sec. 4003. Clinical and community preventive
services.
Sec. 4004. Education and outreach campaign
regarding preventive benefits.
Subtitle B--Increasing Access to Clinical
Preventive Services
Sec. 4101. School-based health centers.
Sec. 4102. Oral healthcare prevention
activities.
Sec. 4103. Medicare coverage of annual wellness
visit providing a personalized prevention plan.
Sec. 4104. Removal of barriers to preventive
services in Medicare.
Sec. 4105. Evidence-based coverage of preventive
services in Medicare.
Sec. 4106. Improving access to preventive services
for eligible adults in Medicaid.
Sec. 4107. Coverage of comprehensive tobacco
cessation services for pregnant women in Medicaid.
Sec. 4108. Incentives for prevention of chronic
diseases in medicaid.
Subtitle C--Creating Healthier Communities
Sec. 4201. Community transformation grants.
Sec. 4202. Healthy aging, living well; evaluation
of community-based prevention and wellness programs for Medicare
beneficiaries.
Sec. 4203. Removing barriers and improving access
to wellness for individuals with disabilities.
Sec. 4204. Immunizations.
Sec. 4205. Nutrition labeling of standard menu
items at chain restaurants.
Sec. 4206. Demonstration project concerning
individualized wellness plan.
Sec. 4207. Reasonable break time for nursing
mothers.
Subtitle D--Support for Prevention and Public
Health Innovation
Sec. 4301. Research on optimizing the delivery of
public health services.
Sec. 4302. Understanding health disparities: data
collection and analysis.
Sec. 4303. CDC and employer-based wellness
programs.
Sec. 4304. Epidemiology-Laboratory Capacity
Grants.
Sec. 4305. Advancing research and treatment for
pain care management.
Sec. 4306. Funding for Childhood Obesity
Demonstration Project.
Subtitle E--Miscellaneous Provisions
Sec. 4401. Sense of the Senate concerning CBO
scoring.
Sec. 4402. Effectiveness of Federal health and
wellness initiatives.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle D--Provisions Relating to Title IV
Sec. 10401. Amendments to subtitle A.
Sec. 10402. Amendments to subtitle B.
Sec. 10403. Amendments to subtitle C.
Sec. 10404. Amendments to subtitle D.
Sec. 10405. Amendments to subtitle E.
Sec. 10406. Amendment relating to waiving
coinsurance for preventive services.
Sec. 10407. Better diabetes care.
Sec. 10408. Grants for small businesses to provide
comprehensive workplace wellness programs.
Sec. 10409. Cures Acceleration Network.
Sec. 10410. Centers of Excellence for
Depression.
Sec. 10411. Programs relating to congenital heart
disease.
Sec. 10412. Automated Defibrillation in Adam's
Memory Act.
Sec. 10413. Young women's breast health awareness
and support of young women diagnosed with breast cancer.
To learn more visit:- Affordable Care Act Title Four (PDF - 242 KB)
- Affordable Care Act Amendments to Title Four (PDF - 119 KB)
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Title V. Health Care Workforce
The Act funds scholarships and loan repayment programs to increase the number
of primary care physicians, nurses, physician assistants, mental health
providers, and dentists in the areas of the country that need them most. With a
comprehensive approach focusing on retention and enhanced educational
opportunities, the Act combats the critical nursing shortage. And through new
incentives and recruitment, the Act increases the supply of public health
professionals so that the United States is prepared for health emergencies.
The Act provides state and local governments flexibility and resources to develop health workforce recruitment strategies. And it helps to expand critical and timely access to care by funding the expansion, construction, and operation of community health centers throughout the United States.
The Secretary has the authority to take action to strengthen many existing programs that help support the primary care workforce.
The Act provides state and local governments flexibility and resources to develop health workforce recruitment strategies. And it helps to expand critical and timely access to care by funding the expansion, construction, and operation of community health centers throughout the United States.
The Secretary has the authority to take action to strengthen many existing programs that help support the primary care workforce.
TITLE V--HEALTH CARE WORKFORCE
Subtitle A--Purpose and Definitions
Sec. 5001. Purpose.
Sec. 5002. Definitions.
Subtitle B--Innovations in the Health
Care Workforce
Sec. 5101. National health care
workforce commission.
Sec. 5102. State health care workforce
development grants.
Sec. 5103. Health care workforce
assessment.
Subtitle C--Increasing the Supply of the
Health Care Workforce
Sec. 5201. Federally supported student
loan funds.
Sec. 5202. Nursing student loan
program.
Sec. 5203. Health care workforce loan
repayment programs.
Sec. 5204. Public health workforce
recruitment and retention programs.
Sec. 5205. Allied health workforce
recruitment and retention programs.
Sec. 5206. Grants for State and local
programs.
Sec. 5207. Funding for National Health
Service Corps.
Sec. 5208. Nurse-managed health
clinics.
Sec. 5209. Elimination of cap on
commissioned corps.
Sec. 5210. Establishing a Ready Reserve
Corps.
Subtitle D--Enhancing Health Care
Workforce Education and Training
Sec. 5301. Training in family medicine,
general internal medicine, general pediatrics, and physician assistantship.
Sec. 5302. Training opportunities for
direct care workers.
Sec. 5303. Training in general,
pediatric, and public health dentistry.
Sec. 5304. Alternative dental health
care providers demonstration project.
Sec. 5305. Geriatric education and
training; career awards; comprehensive geriatric education.
Sec. 5306. Mental and behavioral health
education and training grants.
Sec. 5307. Cultural competency,
prevention, and public health and individuals with disabilities training.
Sec. 5308. Advanced nursing education
grants.
Sec. 5309. Nurse education, practice,
and retention grants.
Sec. 5310. Loan repayment and
scholarship program.
Sec. 5311. Nurse faculty loan
program.
Sec. 5312. Authorization of
appropriations for parts B through D of title VIII.
Sec. 5313. Grants to promote the
community health workforce.
Sec. 5314. Fellowship training in public
health.
Sec. 5315. United States Public Health
Sciences Track.
Subtitle E--Supporting the Existing
Health Care Workforce
Sec. 5401. Centers of excellence.
Sec. 5402. Health care professionals
training for diversity.
Sec. 5403. Interdisciplinary,
community-based linkages.
Sec. 5404. Workforce diversity
grants.
Sec. 5405. Primary care extension
program.
Subtitle F--Strengthening Primary Care
and Other Workforce Improvements
Sec. 5501. Expanding access to primary
care services and general surgery services.
Sec. 5502. Medicare Federally qualified
health center improvements.
Sec. 5503. Distribution of additional
residency positions.
Sec. 5504. Counting resident time in
nonprovider settings.
Sec. 5505. Rules for counting resident
time for didactic and scholarly activities and other activities.
Sec. 5506. Preservation of resident cap
positions from closed hospitals.
Sec. 5507. Demonstration projects To
address health professions workforce needs; extension of family-to-family health
information centers.
Sec. 5508. Increasing teaching
capacity.
Sec. 5509. Graduate nurse education
demonstration.
Subtitle G--Improving Access to Health
Care Services
Sec. 5601. Spending for Federally
Qualified Health Centers (FQHCs).
Sec. 5602. Negotiated rulemaking for
development of methodology and criteria for designating medically underserved
populations and health professions shortage areas.
Sec. 5603. Reauthorization of the
Wakefield Emergency Medical Services for Children Program.
Sec. 5604. Co-locating primary and
specialty care in community-based mental health settings.
Sec. 5605. Key National indicators.
Subtitle H--General Provisions
Sec. 5701. Reports.
TITLE X--STRENGTHENING QUALITY,
AFFORDABLE HEALTH CARE FOR ALL AMERICANS
Subtitle E--Provisions Relating to Title
V
Sec. 10501. Amendments to the Public
Health Service Act, the Social Security Act, and title V of this Act.
Sec. 10502. Infrastructure to Expand
Access to Care.
Sec. 10503. Community Health Centers and
the National Health Service Corps Fund.
Sec. 10504. Demonstration project to
provide access to affordable care.
H.R. 4872. Health Care and Education
Reconciliation Act of 2010
Sec. 2303. Community health centers.
To learn more visit:- Affordable Care Act Title Five (PDF - 437 KB)
- Affordable Care Act Amendments to Title Five (PDF - 82 KB)
- Sec. 2303. Community health centers. (PDF - 31 KB)
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Title VI. Transparency and Program Integrity
The Act helps patients take more control of their health care decisions by
providing more information to help them make decisions that work for them. And
it strengthens the doctor-patient relationship by providing doctors access to
cutting edge medical research to help them and their patients make the decisions
that work best for them.
It brings greater transparency to nursing homes to help families find the right place for their loved ones and enhances training for nursing home staff so that the quality of care continuously improves. The Act promotes nursing home safety by encouraging self corrections of errors, requiring background checks for employees who provide direct care and by encouraging innovative programs that prevent and eliminate elder abuse.
Finally, the Act reins in waste, fraud and abuse by imposing tough new disclosure requirements to identify high-risk providers who have defrauded the American taxpayer. It gives states new authority to prevent providers who have been penalized in one state from setting up in another. And it gives states flexibility to propose and test tort reforms that address several criteria, including reducing health care errors, enhancing patient safety, encouraging efficient resolution of disputes, and improving access to liability insurance.
The Secretary has new and improved authority to promote transparency and ensure that every dollar in the Act and in existing programs is spent wisely and well.
It brings greater transparency to nursing homes to help families find the right place for their loved ones and enhances training for nursing home staff so that the quality of care continuously improves. The Act promotes nursing home safety by encouraging self corrections of errors, requiring background checks for employees who provide direct care and by encouraging innovative programs that prevent and eliminate elder abuse.
Finally, the Act reins in waste, fraud and abuse by imposing tough new disclosure requirements to identify high-risk providers who have defrauded the American taxpayer. It gives states new authority to prevent providers who have been penalized in one state from setting up in another. And it gives states flexibility to propose and test tort reforms that address several criteria, including reducing health care errors, enhancing patient safety, encouraging efficient resolution of disputes, and improving access to liability insurance.
The Secretary has new and improved authority to promote transparency and ensure that every dollar in the Act and in existing programs is spent wisely and well.
TITLE VI--TRANSPARENCY AND PROGRAM INTEGRITY
Subtitle A--Physician Ownership and Other
Transparency
Sec. 6001. Limitation on Medicare exception to the
prohibition on certain physician referrals for hospitals.
Sec. 6002. Transparency reports and reporting of
physician ownership or investment interests.
Sec. 6003. Disclosure requirements for in-office
ancillary services exception to the prohibition on physician self-referral for
certain imaging services.
Sec. 6004. Prescription drug sample
transparency.
Sec. 6005. Pharmacy benefit managers transparency
requirements.
Subtitle B--Nursing Home Transparency and
Improvement
PART I--Improving Transparency of Information
Sec. 6101. Required disclosure of ownership and
additional disclosable parties information.
Sec. 6102. Accountability requirements for skilled
nursing facilities and nursing facilities.
Sec. 6103. Nursing home compare Medicare
website.
Sec. 6104. Reporting of expenditures.
Sec. 6105. Standardized complaint form.
Sec. 6106. Ensuring staffing accountability.
Sec. 6107. GAO study and report on Five-Star
Quality Rating System.
PART II--Targeting Enforcement
Sec. 6111. Civil money penalties.
Sec. 6112. National independent monitor
demonstration project.
Sec. 6113. Notification of facility closure.
Sec. 6114. National demonstration projects on
culture change and use of information technology in nursing homes.
PART III--Improving Staff Training
Sec. 6121. Dementia and abuse prevention
training.
Subtitle C--Nationwide Program for National and
State Background Checks on Direct Patient Access Employees of Long-term Care
Facilities and Providers
Sec. 6201. Nationwide program for National and
State background checks on direct patient access employees of long-term care
facilities and providers.
Subtitle D--Patient-Centered Outcomes Research
Sec. 6301. Patient-Centered Outcomes Research.
Sec. 6302. Federal coordinating council for
comparative effectiveness research.
Subtitle E--Medicare, Medicaid, and CHIP Program
Integrity Provisions
Sec. 6401. Provider screening and other enrollment
requirements under Medicare, Medicaid, and CHIP.
Sec. 6402. Enhanced Medicare and Medicaid program
integrity provisions.
Sec. 6403. Elimination of duplication between the
Healthcare Integrity and Protection Data Bank and the National Practitioner Data
Bank.
Sec. 6404. Maximum period for submission of
Medicare claims reduced to not more than 12 months.
Sec. 6405. Physicians who order items or services
required to be Medicare enrolled physicians or eligible professionals.
Sec. 6406. Requirement for physicians to provide
documentation on referrals to programs at high risk of waste and abuse.
Sec. 6407. Face to face encounter with patient
required before physicians may certify eligibility for home health services or
durable medical equipment under Medicare.
Sec. 6408. Enhanced penalties.
Sec. 6409. Medicare self-referral disclosure
protocol.
Sec. 6410. Adjustments to the Medicare durable
medical equipment, prosthetics, orthotics, and supplies competitive acquisition
program.
Sec. 6411. Expansion of the Recovery Audit
Contractor (RAC) program.
Subtitle F--Additional Medicaid Program Integrity
Provisions
Sec. 6501. Termination of provider participation
under Medicaid if terminated under Medicare or other State plan.
Sec. 6502. Medicaid exclusion from participation
relating to certain ownership, control, and management affiliations.
Sec. 6503. Billing agents, clearinghouses, or other
alternate payees required to register under Medicaid.
Sec. 6504. Requirement to report expanded set of
data elements under MMIS to detect fraud and abuse.
Sec. 6505. Prohibition on payments to institutions
or entities located outside of the United States.
Sec. 6506. Overpayments.
Sec. 6507. Mandatory State use of national correct
coding initiative.
Sec. 6508. General effective date.
Subtitle G--Additional Program Integrity
Provisions
Sec. 6601. Prohibition on false statements and
representations.
Sec. 6602. Clarifying definition.
Sec. 6603. Development of model uniform report
form.
Sec. 6604. Applicability of State law to combat
fraud and abuse.
Sec. 6605. Enabling the Department of Labor to
issue administrative summary cease and desist orders and summary seizures orders
against plans that are in financially hazardous condition.
Sec. 6606. MEWA plan registration with Department
of Labor.
Sec. 6607. Permitting evidentiary privilege and
confidential communications.
Subtitle H--Elder Justice Act
Sec. 6701. Short title of subtitle.
Sec. 6702. Definitions.
Sec. 6703. Elder Justice.
Subtitle I--Sense of the Senate Regarding Medical
Malpractice
Sec. 6801. Sense of the Senate regarding medical
malpractice.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle F--Provisions Relating to Title VI
Sec. 10601. Revisions to limitation on medicare
exception to the prohibition on certain physician referrals for hospitals.
Sec. 10602. Clarifications to patient-centered
outcomes research.
Sec. 10603. Striking provisions relating to
individual provider application fees.
Sec. 10604. Technical correction to section
6405.
Sec. 10605. Certain other providers permitted to
conduct face to face encounter for home health services.
Sec. 10606. Health care fraud enforcement.
Sec. 10607. State demonstration programs to
evaluate alternatives to current medical tort litigation.
Sec. 10608. Extension of medical malpractice
coverage to free clinics.
Sec. 10609. Labeling changes.
H.R. 4872. Health Care and Education Reconciliation
Act of 2010
Subtitle D--Reducing Fraud, Waste, and Abuse
Sec. 1106. Physician ownership-referral.
Sec. 1301. Community mental health centers.
Sec. 1302. Medicare prepayment medical review
limitations.
Sec. 1303. Funding to fight fraud, waste, and
abuse.
Sec. 1304. 90-day period of enhanced oversight for
initial claims of DME suppliers.
To learn more visit:- Affordable Care Act Title Six (PDF - 535 KB)
- Affordable Care Act Amendments to Title Six (PDF - 82 KB)
- Sec. 1106. Physician ownership-referral. (PDF - 29 KB)
- Sec. 1301. Community mental health centers. (PDF - 27 KB)
- Sec. 1302. Medicare prepayment medical review limitations. (PDF - 27 KB)
- Sec. 1303. Funding to fight fraud, waste, and abuse. (PDF - 29 KB)
- Sec. 1304. 90-day period of enhanced oversight for initial claims of DME suppliers. (PDF - 27 KB)
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Title VII. Improving Access to Innovative Medical Therapies
The Act promotes innovation and saves consumers money. It extends drug
discounts to hospitals and communities that serve low-income patients. And it
creates a pathway for the creation of generic versions of biological drugs so
that doctors and patients have access to effective and lower cost
alternatives.
The Secretary of Health and Human Services has the authority to implement these provisions to help make medications more affordable.
The Secretary of Health and Human Services has the authority to implement these provisions to help make medications more affordable.
TITLE VII--IMPROVING ACCESS TO INNOVATIVE MEDICAL
THERAPIES
Subtitle A--Biologics Price Competition and
Innovation
Sec. 7001. Short title.
Sec. 7002. Approval pathway for biosimilar
biological products.
Sec. 7003. Savings.
Subtitle B--More Affordable Medicines for Children
and Underserved Communities
Sec. 7101. Expanded participation in 340B
program.
Sec. 7102. Improvements to 340B program
integrity.
Sec. 7103. GAO study to make recommendations on
improving the 340B program.
H.R. 4872. Health Care and Education Reconciliation
Act of 2010
Sec. 2302. Drugs purchased by covered entities.
To learn more visit:- Affordable Care Act Title Seven (PDF - 133 KB)
- Affordable Care Act Amendments to Title Seven (PDF - 33 KB)
- Sec. 2302. Drugs purchased by covered entities. (PDF - 29 KB)
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Title VIII. Community Living Assistance
Services and Supports Act (CLASS Act)
The Act provides Americans with a new option to finance long-term services
and care in the event of a disability.
It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order to receive a daily cash benefit if they develop a disability. Need will be based on difficulty in performing basic activities such as bathing or dressing. The benefit is flexible: it could be used for a range of community support services, from respite care to home care.
No taxpayer funds will be used to pay benefits under this provision. The program will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes. Safeguards will be put in place to ensure its premiums are enough to cover its costs.
The Secretary has the authority to establish the CLASS Program.
It is a self-funded and voluntary long-term care insurance choice. Workers will pay in premiums in order to receive a daily cash benefit if they develop a disability. Need will be based on difficulty in performing basic activities such as bathing or dressing. The benefit is flexible: it could be used for a range of community support services, from respite care to home care.
No taxpayer funds will be used to pay benefits under this provision. The program will actually reduce Medicaid spending, as people are able to continue working and living in their homes and not enter nursing homes. Safeguards will be put in place to ensure its premiums are enough to cover its costs.
The Secretary has the authority to establish the CLASS Program.
TITLE VIII--CLASS ACT
Sec. 8001. Short title of title.
Sec. 8002. Establishment of national voluntary
insurance program for purchasing community living assistance services and
support.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle G--Provisions Relating to Title VIII
Sec. 10801. Provisions relating to title VIII.
To learn more visit:- Affordable Care Act Title Eight (PDF - 117 KB)
- Affordable Care Act Amendments to Title Eight (PDF - 42 KB)
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Title IX. Revenue Provisions
The Act makes health care more affordable for families and small business
owners by providing the largest middle class tax cuts for health care in
American history. Tens of millions of families will benefit from new tax
credits which will help them reduce their premium costs and purchase insurance.
Families making less than $250,000 will see their taxes cut by hundreds of
billions of dollars.
When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.
This title will be implemented by the U.S. Department of the Treasury.
When enacted, health reform is completely paid for and will reduce the deficit by more than one hundred billion dollars in the next ten years.
This title will be implemented by the U.S. Department of the Treasury.
TITLE IX--REVENUE PROVISIONS
Subtitle A--Revenue Offset Provisions
Sec. 9001. Excise tax on high cost
employer-sponsored health coverage.
Sec. 9002. Inclusion of cost of employer-sponsored
health coverage on W-2.
Sec. 9003. Distributions for medicine qualified
only if for prescribed drug or insulin.
Sec. 9004. Increase in additional tax on
distributions from HSAs and Archer MSAs not used for qualified medical
expenses.
Sec. 9005. Limitation on health flexible spending
arrangements under cafeteria plans.
Sec. 9006. Expansion of information reporting
requirements.
Sec. 9007. Additional requirements for charitable
hospitals.
Sec. 9008. Imposition of annual fee on branded
prescription pharmaceutical manufacturers and importers.
Sec. 9009. Imposition of annual fee on medical
device manufacturers and importers.
Sec. 9010. Imposition of annual fee on health
insurance providers.
Sec. 9011. Study and report of effect on veterans
health care.
Sec. 9012. Elimination of deduction for expenses
allocable to Medicare Part D subsidy.
Sec. 9013. Modification of itemized deduction for
medical expenses.
Sec. 9014. Limitation on excessive remuneration
paid by certain health insurance providers.
Sec. 9015. Additional hospital insurance tax on
high-income taxpayers.
Sec. 9016. Modification of section 833 treatment of
certain health organizations.
Sec. 9017. Excise tax on elective cosmetic medical
procedures.
Subtitle B--Other Provisions
Sec. 9021. Exclusion of health benefits provided by
Indian tribal governments.
Sec. 9022. Establishment of simple cafeteria plans
for small businesses.
Sec. 9023. Qualifying therapeutic discovery project
credit.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
Subtitle H--Provisions Relating to Title IX
Sec. 10901. Modifications to excise tax on high
cost employer-sponsored health coverage.
Sec. 10902. Inflation adjustment of limitation on
health flexible spending arrangements under cafeteria plans.
Sec. 10903. Modification of limitation on charges
by charitable hospitals.
Sec. 10904. Modification of annual fee on medical
device manufacturers and importers.
Sec. 10905. Modification of annual fee on health
insurance providers.
Sec. 10906. Modifications to additional hospital
insurance tax on high-income taxpayers.
Sec. 10907. Excise tax on indoor tanning services
in lieu of elective cosmetic medical procedures.
Sec. 10908. Exclusion for assistance provided to
participants in State student loan repayment programs for certain health
professionals.
Sec. 10909. Expansion of adoption credit and
adoption assistance programs.
H.R. 4872. Health Care and Education Reconciliation
Act of 2010
Subtitle E--Provisions Relating to Revenue
Sec. 1401. High-cost plan excise tax.
Sec. 1402. Unearned income Medicare
contribution.
Sec. 1403. Delay of limitation on health flexible
spending arrangements under cafeteria plans.
Sec. 1404. Brand name pharmaceuticals.
Sec. 1405. Excise tax on medical device
manufacturers.
Sec. 1406. Health insurance providers.
Sec. 1407. Delay of elimination of deduction for
expenses allocable to medicare part D subsidy.
Sec. 1408. Elimination of unintended application of
cellulosic biofuel producer credit.
Sec. 1409. Codification of economic substance
doctrine and penalties.
Sec. 1410. Time for payment of corporate estimated
taxes.
To learn more visit:- Affordable Care Act Title Nine (PDF - 395 KB)
- Affordable Care Act Amendments to Title Nine (PDF - 68 KB)
- Sec. 1401. High-cost plan excise tax. (PDF - 27 KB)
- Sec. 1402. Unearned income Medicare contribution. (PDF - 34 KB)
- Sec. 1403. Delay of limitation on health flexible spending arrangements under cafeteria plans. (PDF - 27 KB)
- Sec. 1404. Brand name pharmaceuticals. (PDF - 29 KB)
- Sec. 1406. Health insurance providers. (PDF - 32 KB)
- Sec. 1407. Delay of elimination of deduction for expenses allocable to medicare part D subsidy. (PDF - 27 KB)
- Sec. 1408. Elimination of unintended application of cellulosic biofuel producer credit. (PDF - 27 KB)
- Sec. 1409. Codification of economic substance doctrine and penalties. (PDF - 35 KB)
- Sec. 2301. Insurance reforms. (PDF - 29 KB)
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Title X. Reauthorization of the Indian Health Care Improvement Act
The Act reauthorizes the Indian Health Care Improvement Act (ICHIA) which
provides health care services to American Indians and Alaskan
Natives. It will modernize the Indian health care system and improve health care
for 1.9 million American Indians and Alaska Natives.
The Secretary, in consultation with the Indian Health Service, has the authority to implement the Indian Health Care Improvement Act.
The Secretary, in consultation with the Indian Health Service, has the authority to implement the Indian Health Care Improvement Act.
TITLE X--STRENGTHENING QUALITY, AFFORDABLE HEALTH
CARE FOR ALL AMERICANS
PART III--Indian Health Care Improvement
Sec. 10221. Indian health care improvement.
To learn more visit:- Affordable Care Act Title Ten (PDF - 620 KB)
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Certified Full-Text Versions
The PDFs above are full-text versions of each title and related content. They have been excerpted because presenting the Act in a single PDF results in a very large file which may present download difficulties. While no language was changed above, the full certified versions of the two bills are available here:- Affordable Care Act (PDF - 4.27 MB)
- Reconciliation Act (PDF - 282 KB)
Audio and transcript: Third day Supreme Court hearings on healthcare law Medicaid expansion
Oral Argument on Anti-Injunction Act and Health Care Law
Supreme Court Health Care Law Oral Argument, Day 3, Severability
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