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Washington releases final rule on essential health benefits

On Wednesday, President Barack Obama’s administration released the highly anticipated final rule on essential health benefits insurers must offer consumers beginning in 2014.

The rule covers 10 benefits categories, including hospitalization, prescription drugs, maternity and newborn care.

The mandate is very similar to previous proposals, which will likely help states prepare for the benefits exchanges, Reuters reports.

“The administration has been consistent in its approach to essential health benefits for more than a year, and that continued today,” Ian Spatz from Manatt Health Solutions told the news service. “It’s good news for states and insurers because it means they don’t have to make any changes.”

The new rule will greatly increase access to mental health and substance abuse services by applying federal parity protections to these medical provisions, the U.S. Department of Health and Human Services (HHS) said.

Wednesday’s mandate preserves the state’s role in defining essential benefits by allowing them to determine their own benchmark plans for residents.

“Twenty-six states selected a benchmark plan for their state, and the largest small business plan in each state will be the benchmark for the rest,” HHS states.

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Erin Woulfe
Erin Woulfe
Erin Woulfe likes to write about things that matter. Keeping her finger on the pulse of what’s happening in the public sector world, she blogs about the latest legislative news and employee benefit trends that affect our school, city and county clients. She’s been with NIS since 2002. “I love connecting to our clients and providing them with the tools they need in order to administrate their plan,” says Erin. “Whether that be materials to educate their employees on certain benefits, how to effectively communicate change within an organization or just providing tips and how-to’s to help them make their job easier.”

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