Modern Healthcare Interviews Manatt Professional on Essential Health Benefit Tension
January 26, 2013 - Modern Healthcare interviewed Manatt's
Ian Spatz, a senior advisor with Manatt Health Solutions, on the tension that's building between two groups who disagree on how much flexibility states and health plans should be given when developing coverage under the health reform law.
As reported by Modern Healthcare, the United States Department of Health and Human Services is expected to release its final regulation on essential health benefits this quarter. Tension has emerged between provider groups, who say that too much flexibility renders the coverage meaningless, and business groups, who argue that more flexibility is needed to make coverage affordable. The department must now strike a balance between the two.
Spatz told the publication that he hasn't seen any surprises as opposing sides attempted to influence the proposed rule for essential health benefits, which HHS released in late November. "It's really what's at the margins that is getting the most attention," he said, citing pediatric dental and vision care as one of those areas.
For example, the ADA and the American Academy of Pediatric Dentistry said in a letter to HHS that an expansion of children's dental coverage could be undermined by an interpretation of the ACA that requires the pediatric oral benefit to be offered as an essential health benefit, but isn't required to be purchased.