HHS issues final rule on essential health benefits data collection

Published on July 21, 2012 at 5:27 AM · No Comments

Meanwhile, new research from the Center for Studying Health System Change indicates that more small businesses may be self-insuring -- a step that will reduce their participation in the health law's insurance exchanges.

CQ Healthbeat:  Final Rule On Data Collection For Essential Health Benefits Unveiled
The Obama administration on Wednesday disclosed the contents of a final rule dealing with information that insurers must provide as part of the health law's standard health benefit package, less than two weeks after the comment period for the proposed regulation ended. The speed with which the rule was rolled out is an indication of how quickly federal officials are moving now that the Supreme Court upheld the health overhaul law and deadlines loom for implementation of health benefits exchanges and the formation of the plans they will offer. While the rule is not a major piece of how essential health benefits will be administered, in its proposed form it nonetheless stirred objections among insurers who said it went too far by asking them to describe not only the services they cover, but how they plan to limit access to covered services (Norman, 7/19).

Modern Healthcare: Reform May Spur More Small Firms To Self-Insure: Report
Small employers with fewer than 100 workers could see incentives to self-insure under the healthcare reform law, a paper by the Center for Studying Health System Change says. Self-insured employers, which accept the risk of workers' healthcare costs, are exempt from new rules under health reform for fully insured products, including state review of premium rate increases, community rating for premiums and essential health benefits, according to the report (Evans, 7/19).

Politico Pro: Self-Insurance Trend Could Hurt Exchanges
An increasingly attractive self-insurance market could undermine a central aim of the Affordable Care Act: generating savings by having  small businesses move into state-based insurance exchanges. Research by the Center for Studying Health System Change suggests that more small firms are self-insuring. That had traditionally been more typical of large businesses with stable workforces that use a more predictable amount of health care (Cheney, 7/19).

Politico Pro: Mass. Eyeing ACA Rules For Small Businesses
Massachusetts's 2006 health care law may have been the philosophical inspiration for the Affordable Care Act, but the state will be forced to revisit central components -; including rules for small businesses  -; as it moves toward compliance with the federal legislation. In particular, state policymakers must decide whether to backpedal on some of the penalties and fines imposed on small businesses that don't cover their workers, double down and increase them or find a middle ground (Cheney, 7/19).

In other health law implementation news -

Modern Healthcare: HHS Announces Innovation Initiative For States
HHS on Thursday announced that it will provide about $275 million from the healthcare reform law in a competitive program for states to design and test multi-payer payment and delivery models. Called the State Innovation Models Initiative, the program from the CMS Innovation Center will provide up to $50 million for up to 25 states in "model design awards" and up to $225 million over three to four years for up to five states in "model testing awards" (Zigmond, 7/19).

California Watch: New Health Care Groups Look To Cut Costs And Improve Quality
Across the country, doctors, hospitals and insurers are forming new health care entities to increase the efficiency and quality of health care, and lower the cost of it. Called accountable care organizations, these groups are gaining ground, even though critics consider them a repackaging of HMOs – some of which have given managed care a bad name. An ACO is a group of health care providers such as doctors, hospitals and others, including insurance companies, who agree to work together to provide overall care to their patients (Graebner, 7/20).

The Hill: HHS: Health Law Project Will Cut State Costs In Major Programs
The federal Health secretary said a new project under the Affordable Care Act will improve care and cut spending in three major federal health programs. The initiatives will reward states for working with healthcare stakeholders to better coordinate care and cut "unnecessary spending" in Medicare, Medicaid and the Children's Health Insurance Program, according to the announcement. Health and Human Services (HHS) Secretary Kathleen Sebelius said the effort will lead to better practices in the three programs, referring to her time as governor of Kansas. "As a former governor," she said, "I've seen states in action and know what great laboratories they are for innovations we can put into practice nationwide" (Viebeck, 7/19).


http://www.kaiserhealthnews.orgThis article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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