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Association Comments on Essential Health Benefits Rule




This week in Washington—NAPH submits comments on proposed federal regulations regarding essential health benefits. You are tuning in to the National Association of Public Hospitals and Health Systems health policy update for the week of Jan. 7, 2013.

On Dec. 21, 2012, NAPH submitted comments to the Centers for Medicare & Medicaid Services (CMS) on proposed regulations that implement provisions in the Affordable Care Act (ACA). The regulations, which were published in November 2012, outlined the policies and standards for essential health benefits, which individuals can use to compare health coverage plans in the state and federal insurance exchanges.

In its comments, NAPH urged CMS to keep safety net health systems in mind as they fine tune the framework for health benefit exchanges. NAPH asked that CMS finalize their proposal to allow existing Medicaid health plan issuers 3 years to meet the exchange accreditation requirements, as well as provide additional flexibility to Medicaid health plans that have not met the state licensure requirements for participating in the exchanges. NAPH also urged CMS to monitor and evaluate its proposal that would not require states to help defray the costs of certain state-required health benefits. This would help ensure that the qualified health plans offered through the exchanges remain affordable for consumers. In its comments, NAPH noted that CMS should ensure quality measures are in line with the patient populations being served in the exchanges. Lastly, NAPH urged CMS to include a number of factors in both state-operated and federal risk adjustment programs, such as income, race and education.

Thanks for listening to another edition of This Week in Washington. I’m Zina Gontscharow.



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