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Understanding Section VI of the Affordable Care Act

Posted Apr 16th, 2012 by Patient Assistance Team
The sixth section of the Affordable Care Act , Transparency and Program Integrity, encourages patientsto take control of their health care decisions. It does so by providing individuals with enhancedinformation so that they can make decisions that best work for them and their families. This sectionalso strengthens the doctor-patient relationship by providing doctors access to cutting edge medicalresearch to help them and their patients make the decisions that work best for them, according to thefederal government. By enhancing the doctor-patient relationship, there is more transparency of carethat extends out of the doctor’s office to the pharmacy as well. Under these new regulations, there arenew transparency requirements for pharmacy benefit managers as well as for samples of prescriptiondrugs.

Section VI also brings greater transparency to nursing homes so that families have more support andprotection in finding the right home for their loved ones. In addition, nursing home staff benefitsby having enhanced training offered to them so that their quality of care continues to improve.The Transparency and Program Integrity section also seeks to eradicate elder abuse through theencouragement of innovative programs and an easier complaint process. It also encourages nursinghome safety by encouraging self corrections of errors and requiring background checks for any nursinghome employee who provides direct care to patients.

Lastly, the section of the Affordable Care Act attempts to reduce and prevent waste, fraud and abusethrough the establishment of strict new disclosure requirements to identify high-risk providers whohave in the past committed nursing home fraud. In addition, according to the federal government,section VI gives states new authority to prevent providers who have been penalized in one state fromsetting up a nursing facility in another state. Under this law, each state must establish their own testtort reforms. These reforms must include a number of criteria such as the reduction of health careerrors, the improvement of patient safety, the encouragement of efficient and timely resolutions tonursing home disputes and the betterment of access to liability insurance.