CHA joined allied children’s groups and the Habilitation (HAB) Coalition to submit responses to the CMS Request for Information (RFI) on the Essential Health Benefit (EHB). CMS requested information regarding a variety of topics related to the coverage of benefits in health plans subject to the EHB requirements of the Affordable Care Act.
The letter from allied children’s groups highlights the importance of using the Medicaid Early and Periodic Screening, Diagnosis and Treatment benefit as the basis for covered services in the pediatric category of the EHB package, gaps in pediatric care within current state EHB benchmarks, and the need to further define the habilitative services and devices and mental health services EHB categories so they meet the needs of children. The habilitation coalition letter focuses on how to improve the EHB habilitative benefit, urges CMS to establish a minimum standard for covering habilitative services, ensure that limits and caps are evidence-based and clearly differentiate habilitative and rehabilitative visits and services.
