websites and may be downloaded at energycommerce/ Errors in this document are solely. U.S. House of Representatives () Compilation Patient Protection and Affordable Care Act, Part . (See full text of law as amended through May 1, at energycommerce/) SEC. ESSENTIAL HEALTH BENEFITS.
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Register for a free account to start saving and receiving special member only perks. The following excerpt from the law outlines the statutory requirements for the essential health benefits. See full text of law as amended through May 1, at http: E Mental health and substance use disorder services, including behavioral health treatment.
To inform this determination, the Secretary of Labor shall conduct a survey of employer-sponsored coverage to determine. A ensure that such essential health benefits reflect an appropriate balance among the categories described in such subsection, so that benefits are not unduly weighted toward any category.
B not make coverage decisions, determine reimbursement rates, establish incentive programs, or design benefits in ways that discriminate against individuals because of their age, disability, or expected length of life.
C take into account the health care needs of diverse segments of the population, including women, children, persons with disabilities, and other groups. E provide that a qualified health plan shall not be treated as providing coverage for the essential health benefits described in paragraph 1 unless the plan provides that—. F provide that if a plan described in section b 2 B ii relating to stand-alone dental benefits plans is offered through an Exchange, another health plan offered through such Exchange shall not fail to be treated as a qualified health plan solely because the plan does not offer coverage of benefits offered through the stand-alone plan that are otherwise required under paragraph 1 J ; and.
G periodically review the essential health benefits under paragraph 1and provide a report to Congress and the public that contains—.
H periodically update eneryycommerce essential health benefits under paragraph 1 to address any gaps in access to coverage or changes in the evidence base the Secretary identifies in the review conducted under subparagraph G. The amounts under clauses i and ii may be increased by the maximum amount of reimbursement which is reasonably available to a participant under a flexible spending arrangement described in section c 2 of the. Internal Revenue Code of determined without regard to any salary reduction arrangement.
A the only individuals who are eligible to enroll in the plan are individuals described in paragraph 2 ; and. B has a energgcommerce in effect for any plan year under this title that the individual is exempt from the requirement under section A of the Internal Revenue Code of by reason of—.
Several provisions of the law went into effect in including requirements to cover children up to age 26 and to prohibit insurance companies from denying coverage based on preexisting conditions for children. Other provisions will go into effect duringincluding the requirement for all individuals to purchase health insurance. Ininsurance purchasers will be allowed, but not obliged, to buy their lpacacon through newly established health insurance exchanges HIEs –marketplaces designed to make it easier for customers to comparison shop among plans and for low and moderate income individuals to obtain public subsidies to purchase private health insurance.
The exchanges will offer a choice of private health plans, and all plans must include a standard core set of covered benefits, called essential health benefits EHBs. In response, the IOM convened two workshops in where experts energycommetce federal and state government, as well as employers, insurers, providers, consumers, and health care researchers were asked to identify current methods for determining medical necessity, and share decision-making approaches to determining which benefits would be covered and other benefit design practices.
Essential Health Benefits summarizes the presentations in this workshop. The committee’s recommendations will be released in a subsequent report. Based on feedback from you, our users, we’ve made some improvements that make it easier than ever to read thousands of publications on our website.
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The Affordable Care Act: Text and Summaries
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Perspectives on Essential Health Benefits: Workshop Report Chapter: Looking for other ways to read this? The National Academies Press.
Appendix A Patient Protection and Affordable Care Act, Section The following excerpt from dods law outlines the statutory requirements for the essential health benefits. A Ambulatory patient services. D Maternity and newborn care. G Rehabilitative and habilitative services and devices. J Pediatric services, including oral and vision care. Page Share Cite.
The amounts under clauses i and ii may be increased by the maximum amount of reimbursement which is reasonably available to a participant under a flexible spending arrangement described in section c 2 of the Internal Revenue Code of determined without regard to any salary reduction arrangement. Login or Register to save!