HHS Takes Another Step Toward Defining Essential Health Benefits

Data collected in 2012 would define EHBs for plan years 2014 and 2015. HHS plans to revisit this approach in 2016.

The proposed rule also presents a two-phase approach for recognizing the credentialing organizations for health plans that want to participate in HIEs. On an interim basis two familiar organizations, the NCQA and URAC, which are already responsible for most health plan accreditations, will handle those duties. In the short run their selection will keep accreditation on track to begin in early 2013.

In future rulemaking HHS intends to propose a recognition process that includes an application process, standards for recognition, a criteria-based review of applications, public participation, and public notice of the recognition.

HHS is soliciting comment on other data elements that might be helpful and wants input on whether closed block products or association products should be included as options in the selection of the largest three products.

Comments on the proposed rule will be accepted here through July 4.