Affordable Care Act Ruling Keeps PSO Participation Mandate Intact

The Supreme Court’s June 28 ruling upholding the Affordable Care Act leaves intact the mandate that hospitals with 50 beds or more must participate in a PSO by Jan. 1, 2015 in order to contract with health plans in state insurance exchanges. Except for the ruling that allows states to forgo Medicaid expansion, the decision keeps the entire Act in place.

California was the first state to create an insurance exchange after the Act passed and continues to be a change agent for improving patient care and safety while reducing costs. California plans to have its Health Benefit Exchange operational by Jan. 1, 2014, when exchange participants will benefit from federal tax subsidies and credits. The exchange is a new insurance marketplace in which individuals and small businesses can purchase competitively priced health plans.

The California Hospital Association held a Web seminar July 2 highlighting the statewide impact of the Act. CHA members can access the presentation at later this month.