Essential Health Benefits Proposed Rule

Just before the Thanksgiving holiday, on November 20, 2012, the Department of Health and Human Services (HHS) released a proposed rule related to the coverage of essential health benefits (EHB) under the Affordable Care Act (ACA). The proposed rule outlines standards that qualified health plans must meet in providing EHB coverage, as required under the ACA.

HHS also released a letter to State Medicaid Directors giving guidance as to how EHB will be approached under Medicaid expansion.

The rule details how EHB coverage will be defined and implemented are very important for people living with HIV/AIDS and for people living with other chronic conditions. As indicated by HHS when a bulletin on EHB was released last December, the states will be given a great deal of flexibility in carrying out the ACA's requirements for EHB.

Comments on the proposed rule are due to HHS by Dec. 26, 2012.

Click here for an analysis prepared by Treatment Access Expansion Project and the National Alliance of State and Territorial AIDS Directors (NASTAD) of the proposed rule and the letter to the State Medicaid Directors.

To see the full proposed EHB rule, click here.