Medicare Laws and Regulations

Medicare was established to protect the elderly from excessive medical expenses. The federal social insurance program is regulated by the Centers for Medicare and Medicaid Services, which implements rules and regulations governing program operations.

HIPAA

• The Health Insurance Portability and Accountability Act, or HIPAA, regulates Medicare claims that contain personal health information. The law permits the disclosure of private information only for patient care and other important instances.

Medigap

• In 1990, Congress approved a law that requires all states to comply with Medigap. Medigap insurance supplements Medicare's coverage and restricts the sales practices of insurance agents and companies. For example, Medicare recipients need only one Medigap policy. If an agent tries to sell you supplemental coverage, you must receive a fair and accurate comparison and an outline summarizing the new policy's features.

Affordable Care Act

• The Affordable Care Act of 2010 overhauled the health insurance industry, and made many changes to Medicare operations. Among the changes is providing a way to curb the high costs of prescription drugs. The law closes gaps in the Medicare Part D prescription drug program by the year 2020. Senior citizens who fall into the gap in 2010 receive a $250 rebate.