By Megan R. Wilson - 12/14/12 12:13 AM EST
• The comment period is ending soon for a proposed rule from the Department of Health and Human Services that will implement a major piece of the healthcare reform law.
Originally published last month, the 34,000-word proposal is part of the rollout of public exchanges that will serve as a one-stop shop for obtaining health coverage.
Specifically, the rule sets up a timeline for qualified health plans to be accredited with the federal exchanges and makes clear the standards of covering essential health benefits. Essential health benefits (EHBs) include hospitalization, prescription drugs, mental health and substance use disorder services and maternity and newborn care.
The number of comments received pales in comparison to the 11,000 comments submitted to the EHB Bulletin, which laid out how the Obama administration planned to implement the Affordable Care Act.
HHS says it has been working with consumers, state representatives, tribal leaders, health insurance issuers, trade groups, consumer advocates and employers for feedback on the exchanges proposal. The proposed rule attempts to address some of the comments and concerns that were raised in the EHB Bulletin.
HHS has proposed a timeline for health plans to become federally accredited, though other rules would be published to outline the criteria. HHS has designated the National Committee for Quality Assurance (NCQA) and URAC to be interim accreditors of qualified health plans for exchanges — which means they will provide an independent and outside review of a healthcare organization to ensure it meets national standards for participating in the exchanges.
While the deadline for comments is Dec. 26, there is still a long road until the rule becomes official. The proposal contains specific provisions and recommendations for the rollout — which is expected to become final in 2014 — regarding items such as cost-sharing measures and defraying the cost to a state for operating the exchanges.