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IOM holds first meeting on essential health benefits

Posted on January 14, 2011 | No Comments

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Key Developments
Implementation Briefs

The Institute of Medicine’s (IOM) Committee on the Determination of Essential Health Benefits held its first meeting this week to discuss essential benefits under the Affordable Care Act (ACA). The IOM is charged with making recommendations to the Secretary of HHS on the criteria for determining what constitutes essential health benefits for insurance plans sold in exchanges. For more information on essential benefits, click here.

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The Department of Health and Human Services (HHS), Department of Labor (DoL), and the Department of the Treasury (DoT) released the joint final rule implementing the Mental Health Parity and Addiction Equity Act of 2008. Under this law, insurers that offer coverage for mental health services are expected to treat mental health equitably, meaning cost-sharing and limits for mental health services should be comparable to that of physical health services. Several other specific provisions addressed in this rule include:
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  • Clarifying transparency expectations for insurers to remain compliant with the law; and
  • Eliminating provisions that enabled insurers to make exceptions for parity requirements for certain benefits offered.
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