U.S. Dept of Health & Human Services Solicit Comments regarding the Affordable Care Act

SAMHSA released a bulletin alerting us to an opportunity to comment on the HHS Proposed Essential Health Benefits:

The Affordable Care Act ensures that Americans have access to quality, affordable health insurance. To achieve this goal, the law ensures that health plans offered in the individual and small group markets, both inside and outside of the Affordable Insurance Exchanges (Exchanges), offer a comprehensive package of items and services, known as “essential health benefits.” On December 16, 2011, the U.S. Department of Health and Human Services (HHS) issued a bulletin to provide information and solicit comments on the regulatory approach it plans to propose to define the essential benefits of health. Essential health benefits must include items and services within at least the following 10 categories:

  • ¬†Ambulatory patient services
  • Emergency services
  • Hospitalization
  • Maternity and newborn care
  • Mental health and substance use disorder services, including behavioral health treatment
  • Prescription drugs
  • Rehabilitative and habilitative services and devices
  • Laboratory services
  • Preventive and wellness services and chronic disease management
  • Pediatric services, including oral and vision care

HHS intends to propose that essential health benefits are defined using a benchmark approach. Under the Department’s intended approach, states would have the flexibility to select a benchmark plan that reflects the scope of services offered by a “typical employer plan.” This approach would give states the flexibility to select a plan that would best meet the needs of their citizens. Public input on this proposal is encouraged. Comments are due by January 31, 2012, and can be sent to: EssentialHealthBenefits@cms.hhs.gov.

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