Haven't read it yet, but here you go:
Administration Sets New Rule On Essential Health Benefits - Kaiser Health News
Administration Sets New Rule On Essential Health Benefits - Kaiser Health News
FINAL EHB Rules Released
- Thread starter Yagents
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One of the final paragraphs from the article by The Hill quotes the HHS document as saying:
"Economically inefficient" !!! Is HHS adminitting that rate shock is expected? Are they setting the groundwork for rolling back the mandates in order to make plans more affordable?
Consumers could also pay more, as they gain and use additional coverage laid out by the new standards, according to the 149-page rule. Some of those costs may be "economically inefficient," the rule says.
"Economically inefficient" !!! Is HHS adminitting that rate shock is expected? Are they setting the groundwork for rolling back the mandates in order to make plans more affordable?
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One of the changes to this Final EHB Rule that is a positive for the consumers is that if a Polyp is discovered and removed during a colonoscopy, the procedure remains "Preventive" (i.e. free to the patient).
I guess USA Today has analyzed this final rule already.
Story: HHS releases rule on insurers' essential health benefits
Of course, on the other side of the coin, this is more of HHS's dictatorship style of telling health insurers what to do. Every time I see HHS pull another mandate out of its hat, I visualize our commissions shrinking a little more.
-ac
I guess USA Today has analyzed this final rule already.
Story: HHS releases rule on insurers' essential health benefits
Of course, on the other side of the coin, this is more of HHS's dictatorship style of telling health insurers what to do. Every time I see HHS pull another mandate out of its hat, I visualize our commissions shrinking a little more.
-ac
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How do you think the change in mental health benefits will impact cost? There are so many mental health issues in the public, many going untreated due to cost of care, I see this change as one that will blow costs sky high. Mental health providers will certainly be happy. Perhaps treating these conditions will improve overall health and lessen future claims, I don't know.
Which means carriers have to "eat" a $1500 colonoscopy.
Any idea how that will impact premiums?
There ain't no free lunches, Chuckie.
Ned, MHP (mental health parity) is big business. At least one local mental facility is expanding to handle more DAMN patients (Drug, Alcohol, Mental, Nervous). Inpatient care (unless you need to detox) is 5 days @ $1200/day followed by 6 weeks of group (4 days per week) @ $200 per session.
Most group plans already have parity, but not individual. Along with MHP is expanded treatment for kids with autism and every imaginable learning disorder. The lines between ICD-10 and DSM-IV will become blurred and it will be a psych - special ed free for all . . . literally.
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Of course, on the other side of the coin, this is more of HHS's dictatorship style of telling health insurers what to do. Every time I see HHS pull another mandate out of its hat, I visualize our commissions shrinking a little more.
-ac
It also means higher premiums, which will lead to more public dissatisfaction. Which will be worse, the public outrage over higher priced health insurance and/or no coverage, or us getting lower commissions so we have to buy shoddy, overpriced coverage?
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Right.. Higher and Higher Premiums for a $6,000 annual out-of-pocket. ouch!
People are starting to freak out as they see gas going over $4.00 a gallon again. With the whopping $6,000 OOP potential of these 2014 health plans, I don't think we'll have a heavy utilization of Mental Health services and prescriptions, or anything else that isn't free, or an emergency need.
Speaking of Mental Health.. Illinois doctors are supposed to start asking patients if they have a firearm, and if they get angry easily. If the answer is yes, they are to receive an in-depth mental analysis..or something like that. I wonder if it would be a FREEBIE under these new EHB rules?
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Blue Cross of Illinois sent out a link today for us (brokers) to become familiar with the final EHB rules for this state, or any other state of interest. I see that in Illinois, Surgical "second opinions" and diagnosis will be covered at 100% with no co-pay, deductible, etc.. Yet another expensive burden for insurers.
Go to this website to see the final 2014 itemized Essential Health Benefit listing for your state(s) of interest:
Additional Information on Essential Health Benefits Benchmark Plans | cciio.cms.gov
-AC
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wow, no mental health and substance abuse treatment for indy plans in Pa. This will be good to keep premiums in ck but I thought this was a Natl requirement for all plans.
