The Community Living Assistance and Support Services (CLASS) Act is the Affordable Care Act section that would have had the most effect on private long-term care insurance (LTCI) companies, primarily by creating a voluntary worksite LTC benefits program.

However, officials at the U.S. Department of Health and Human Services (HHS) admitted in October that the CLASS program could not work financially. On November 15, Members of the health subcommittee at the House Energy and Commerce Committee officially repealed it.

But there are still other, narrower Affordable Care Act LTC provisions that are still being implemented.

The Affordable Care Act—the federal legislative package that includes the Patient Protection and Affordable Care Act of 2010 (2010) and the Health Care and Education Reconciliation Act of 2010—is a huge piece of legislation with thousands of provisions.

Some of the most ambitious LTC provisions in the Affordable Care Act are in PPACA Title II, Subtitle E, in a section on “new options for states to provide long-term services.”

That section is supposed to do three things. First, it is to create a “community first choice option,” which is supposed to reward states for providing attendant services for people with disabilities who are eligible for Medicaid and are still living out in the community.

The second is to support state efforts to remove barriers to providing home and community-based services. The third is to expand funding for state aging and disability resource centers.

The Community First Choice program started up Oct. 1. States that participate and provide attendant services can split a total of $3.7 billion in extra funding between now and 2014. The new attendant services are supposed to help people with disabilities handle the activities of daily living and take care of their health.

PPACA Section 3004 requires LTC hospitals, inpatient rehabilitation hospitals and hospice programs to report quality measures or else face lower reimbursement levels. HHS officials published a final rule implementing that requirement in August. HHS will start by requiring affected facilities to report on bed sore rates and on urinary tract infections caused by catheters.

Later, in Subtitle B—Nursing Home Transparency and Improvement, Congress has a set number of other new reporting requirements.

Facilities must disclose ownership information, and nursing facilities and skilled nursing facilities must meet new performance requirements.

PPACA Section 6103 requires the government to redesign the federal Nursing Home Compare website and make it easier for consumers to file complaints through the Web, in part by adding a standardized complaint reporting form.

PPACA Section 10202 creates incentives for states to offer home and community-based services as a long-term care alternative to nursing homes. That program provides extra “Federal Medical Assistance Percentage” payments for states that offer long-term services and supports outside institutions, such as home health care services and personal care services. States that participate could split a total of $3 billion in grants between now and Sept. 30, 2015.

The Community First Choice program started up Oct. 1. States that participate and provide attendant services can split a total of $3.7 billion in extra funding between now and 2014.