HHS bulletin outlines plan for implementing essential health benefits in health law

December 20, 2011 — The U.S. Department of Health and Human Services (HHS) recently released a bulletin outlining proposed policies that will give states more flexibility and freedom to implement certain provisions of the Patient Protection and Affordable Care Act (PPACA).

The HHS proposal describes “an inclusive, affordable and flexible proposal and informs stakeholders about the approach that HHS intends to pursue in rulemaking to define essential health benefits. HHS is releasing this intended approach to give consumers, states, employers, and issuers timely information as they work toward establishing exchanges and making decisions for 2014.”

This approach was developed with significant input from the public, including American Chiropractic Association’s (ACA) comments provided during the Institute of Medicine hearings, as well as reports from the Department of Labor, and research conducted by HHS. Today’s HHS proposal offers for public comment four alternative “benchmark plans” for flexible choice by the states in designing how to meet the new health care reform essential health benefit (EHB) requirements.

Although the ACA’s leadership has just begun to analyze the HHS proposal, its first impression is positive for the chiropractic profession.

“Overall, this is one of the best outcomes we could achieve,” said Keith Overland, DC, president of ACA. “Given that virtually every state has chiropractic services or some sort of insurance equality included among their existing insurance plans; this HHS proposal released today appears to be very good news.”

ACA understood in 2010 that the healthcare reform legislation was not likely to include chiropractic services as a named essential benefit. Therefore, its strategy has been to ensure that DCs are able to provide their services under the categories of EHBs included in plans offered through the health exchanges.

“We will continue to make our position crystal clear at the highest levels of HHS-that language considered at the federal and state level relative to essential benefits must include the services provided by doctors of chiropractic. Anything less would be a disservice to the millions of Americans that benefit from chiropractic care on a daily basis,” said Overland.

ACA and its Chiropractic Summit partners will examine the HHS proposal and, in partnership with the state associations, work to advocate that state governments  choose benchmark plans that include chiropractic services among the EHBs.

As projected by ACA, the HHS bulletin allows for public comment before Jan. 31, 2012. It is also expected that HHS will revert to the standard regulatory process on this issue next year, where further opportunity to comment will be available before a final rule is issued.

Source: American Chiropractic Association, www.acatoday.org