when does medicare part d start?
Centers for Medicare and Medicaid Services
contradiction
 Reforms to the Medicare payment system are meant to promote greater efficiency in the healthcare delivery system by restructuring Medicare reimbursements from fee @-@ for @-@ service to bundled payments . Under the new payment system , a single payment is paid to a hospital and a physician group for a defined episode of care ( such as a hip replacement ) rather than individual payments to individual service providers . In addition , the Medicare Part D coverage gap ( commonly called the " donut hole " ) will shrink incrementally , closing completely by January 1 , 2020 . 

neutral
 Multiple 2014 and 2015 studies and surveys indicated that the number of uninsured had fallen due to expanded Medicaid eligibility and health insurance exchanges established due to PPACA . These changes took effect January 1 , 2014 . 

contradiction
 After a lengthy battle between supporters of the University of Houston , led by school president A.D. Bruce , and forces from state universities geared to block the change , Senate Bill 2 was passed on May 23 , 1961 , enabling the university to enter the state system in 1963 . 

entailment
 On May 10 , 2016 , it was reported that the U.S. House Subcommittee on Commerce , Manufacturing and Trade was planning to discuss the legal aspects of DFS in a hearing . 

contradiction
 Increment two was to provide 23 operational helicopters with increased range , and upgraded navigation and communications systems that fulfill White House requirements to maintain continuity of government and allow the president to carry out the duties of the office . 
