UMthetho woNonophelo ojongene noNcedo ovulekileyo uvula amathuba okubonelela ngeeNkonzo zeMasikitini
Umthetho woKhuseleko weMonde kunye noMnxeba wokuNakekelwa ongenakuncedo (iPACACA)-mhlawumbi eyaziwa ngokuba yi- Obamacare -ngumthetho osindayo kuma-voti angama-30 ukuba awususe okanye abuyiselwe imali, uye wagcinwa njengomgaqo-siseko yiNkundla ePhakamileyo yase-US, kwaye waqhubela phambili ekuphunyezweni ngokupheleleyo ubuso obuchazwe ngokubanzi.
Phantse ingabhengezwa yimiqathango emininzi yePACACA kufuneka ishintshe umgangatho wemihla ngemihla yabasemasimini basekuhlaleni.
I-Obamacare kunye namaPhmaMaspala asekuhlaleni
Umbutho wama-Pharmacy wase-American (APhA) kunye nabaphathi be-National Community Pharmacists Association (NCPA) baqaphele indlela u-Obamacare avuselele ngayo ukunyamekelwa kwempilo kwiindawo zezempilo zaseMelika ezifikeleleke kakhulu. Baye bachonga ukuba yimaphi amalungiselelo okufuneka acaciswe okanye atshintshwe ukuze avumele ukuba oomasempile banikele ngokubanzi ngokusemandleni ukwenzela ukwandisa ukufikelela kwezilwelwazi ukunyamekela, ukunciphisa iindleko zonyango kunye nokukhusela ukugula.
Ukuvala i-Medicare Part D Donut Hole
Ngokukhawuleza, i-PPACA yaxolisa amaninzi asemasimini asekuhlaleni asemthethweni kwi-Medicare lawula ukuba bonke abathengisi bezixhobo zonyango eziqinileyo, i-prosthetics, orthotics kunye ne-supplies (DMEPOS) ukuba bavunyelwe. I-NCPA I-VPA kaMongameli wezeMicimbi kaRhulumente uJohn Coster, Ph.D., uRhh, uthe le nto ivumele iifommesi ezivelisa ngaphantsi kwama-5 ekhulwini kwemali evela kwi-DMEPOS yokuthengisa ukuqhubeka nokudibanisa iimfuno zezempilo eziphambili ngaphandle kokufaka iindleko zokuthobela imithetho.
UCoster uthe kwakhona ukuvalwa ngokugqithisileyo kwegciwane lokuchithwa kwezidakamizwa kwi-Medicare Part D abaxhamli baqala phantsi kwe-PPACA ngo-2011 uye waqhubeka ngokufanelekileyo.
"Akuzange kube neengxaki ezininzi esizivileyo," watsho.
"Abashemmisti bahamba phambi kwezaphulelo ukuya kwizigulane kwindawo yokungena, kwaye izicwangciso mazizibuyisele kwiintsuku eziyi-14 zokufumana ibango.
Izicwangciso zihlawula ngexesha elide. Siza kufuneka sibone ukuba oko kuqhubekayo xa umgodi wecala uvale ngokupheleleyo ngo-2014. "
Umthunzi weMedicaid
I-PPACA inika kwakhona inketho yokwandisa ukuxhaswa kweMedicaid kubo bonke abantu abasemakhaya abanemali yonyaka ukuya kuma-133 ekhulwini kwinqanaba lehlwempu. Abarhulumente abambalwa bathi abayi kuvuma inkxaso yenkxaso-mali ukuba benze njalo, inani elikhulu liye lithatha indlela yokulinda nokubona, kwaye isicwangciso esincinane senani lokunyusa ukubhaliswa kwabakwaMedicaid.
"Ziziphi iifemisti ezizibonayo ngeMedicaid ziya kuxhomekeka ngokupheleleyo kwiimeko abazenzayo kuzo," waphendula i-APhA I-Vice-Phathi kaMongameli weeNkonzo zikaRhulumente uBrian Gallagher, uRhh, JD. "Kodwa nakumazwe anquma ukungafihla izigulane ezininzi zeMedicaid, kusekhona imiba kunye nendlela iinkqubo zeMedicaid ziza kuthatha isigqibo malunga neendleko zemizi kunye nokuba yintoni imali efanelekileyo yokuhambisa efuna ukuba yenziwe."
UCoster, kunye neCNPA, wachaza nesidingo se-Ironclad Centers kwi-Medicare & Medicaid Iinkonzo zolawulo eziqinisekisa ukuba ixabiso elichanekileyo kunye neendleko zokunika ingxelo kubalawuli abenza iintlawulo ze-pharmacy kulezo nkcukacha.
"Enye yezinto eziziqhenyceleyo ngathi senza imilinganiselo kwiPACACA yeenzuzo zeefasim e-transparent, ngokukodwa kwiirhafu zokufaka endaweni yokudala.
Ukufumana loo manani kuya kusinceda senze iimeko zethu malunga nokuba imali yabagqirha bezilwanyana bazigcina njani izigulane kunye nabahlawuli. "
Iimodyuli zokuNyameka eziManyanga kunye noLawulo lweMithi yoLwazi (iMTM)
Utshintsho olwandle lwangempela oluvela kwi-PPACA luya kuvela ngokuqaliswa kweeNkcazo zokuNakekela iAxanduva, imizi yamayeza kunye nezinye iindlela zokunakekelwa kwezigulane. I-CMS yenze iCentral for Medicare & Medicaid Innovations ngo-2010 kwaye sele isinike izibonelelo ezahlukahlukeneyo kunye nezivumelwano zokuphumeza ezo nkqubo.
Ukucacisa ubungakanani obupheleleyo be-ACO kungaphaya kwelo nqaku, kodwa i-APhA I-Vice-ngameli kaMongameli wezeMicimbi yezobugcisa u-Anne Burns, uBSPharm, wathi, "Sibona ithuba lokuba oomachiza babandakanyeke kule mizekelo yokunyamekela.
Oogqirha bayaziqonda ngokugqithiseleyo ukuba kubandakanywa amachiza kwiinkonzo zonyango zixabisekileyo kwiinkonzo ezinjengokulawula izixhobo zonyango eziyinkimbinkimbi, ukubonelela ngempilo yesigulane, nokunciphisa iindleko zonyango kunye nokukhusela iingxaki zonyango. "
Wongezelela ukuba "Ukuphunyezwa kwezakhiwo zokuhlawula ukuxhasa ukubandakanyeka kwabagqirha kule mizekelo kuyigxininiso eliphambili le-APA ngoku ngoku. Zonke ixabiso lezempilo ezinokuthi ukhuseleko lube luphambili ekuphuculeni iziphumo zempilo yezigulane."
Kwakhona ukuqaphela ukuqinisekiswa koogqirha bafumana i-reimbursement yokusebenza ngaphakathi kwe-ACO okanye enye intlangano yokunyamekela, uMbutho weSizwe weCandelo lokuThengisa iziDakamizwa ugxininise iCongress ukuba idlule iSixeko sama-274, uMthetho woXhotyiswa koPhilo lweMithi, kunye ne-HR 891, uLawulo loLawulo lweeMithi Act Benefits. Zombini idilesi ekuhlawula iifemmisti ukubonelela ngeenkonzo zeMTM, kodwa iimali zithatha amathuba amancinci kwaze kwahlala iCongress entsha kwaye iziphakamiso ziphinde zithunyelwe ngo-2013.
Ukubandakanyeka kwinqanaba lendawo kuya kuba yintloko kubemi bezempilo, ngokutsho kweBurns. "I-ACO kunye neenkqubo zonyango lwezonyango zakhiwe kwinqanaba lendawo ukwenzela ukuba oomachiza kufuneka baqaphele oko kwenzekayo kuluntu lwabo. I-Outreach ukuchaza imibutho yama-pharmacy, oogqirha basekuhlaleni, imibutho yoluntu kunye nabahlawuli kubalulekile ekufundeni ngamathuba apho, "esho.
Njengomzekelo wendlela oosomachiza asele bebonelele ngayo ngononophelo lwezigulane ezintsha, umzekelo, i-APhA idlulisela icandelo lonke lewebhusayithi yalo kwiMTM.