Regulators face challenge of defining 'essential care' benefits

As federal regulators — in their efforts to implement the health law — work to define what basic medical services health insurers must cover under the measure, another set of regs, those dealing with accountable care organizations, are stalled at the Office of Management and Budget.

The Wall Street Journal: Defining 'Essential' Care
The next big issue for the federal health law as it moves toward implementation is how regulators will define so-called essential benefits — the basic medical services that health plans must cover under the law (Johnson, 2/28).

National Journal: Accountable Care Rules Stalled At OMB
Much-anticipated regulations for accountable care organizations, established under the health care law, have been held up in the White House Office of Management and Budget since last week, their last stop before public release. The ACOs are intended to coordinate care between hospitals and doctors and help hold providers accountable for delivering effective care. The regulations would lay out how the ACOs can qualify with the Centers for Medicare and Medicaid Services for a shared savings program in 2012. OMB was slated to hold a conference call on the ACO rules Friday afternoon, but would not give details of what was said. Lobbyists say they expect the regulations could be released next week. But the imminent budget battle and possible government shutdown could add to the delay, making the political climate too difficult to release specifics on a new facet of the health care law (McCarthy, 2/25).