Recent clarity about how essential health benefits (EHBs) are likely to be defined could provide a small push to procrastinating states when it comes to building an insurance exchange.
Rather than develop a national EHB standard, which was largely expected, a 13-page “bulletin” issued by CMS’s Center for Consumer Information and Insurance Oversight on Dec. 16 proposed that states use an existing health plan to define the benefits that must be included in individual and small-group plans beginning in 2014.
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But some states still might not take action. “As we have seen with the exchanges, some states are more reluctant than others to adopt” reform-law provisions, says Adam Solander, an attorney in the health care practice at Epstein Becker & Green. “I expect that some states will not take action and the default benchmark plan (i.e., the largest plan in the state’s small-group market) will be adopted. However, at the end of the day states will have to choose a plan that balances costs and richness of benefit structure.”
http://aishealth.com/archive/nhex0112-03
Hat tip: AIS(Atlantic Information Services) Health
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