Essential Health Benefits RFI Response

Essential Health Benefits RFI Response

CHA signed on to two letters responding to a recent Essential Health Benefit (EHB) Request for Information (RFI) from CMS seeking input on ways the administration could strengthen the EHBs.

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.


Contact Us

For more information, connect with us.

(202) 753-5384

About Children's Hospital Association

Children’s Hospital Association is the national voice of more than 220 children’s hospitals, advancing child health through innovation in the quality, cost and delivery of care.

Related Content

Prior Authorization and Interoperability Proposed Rule Summary

CHA created a summary on a proposed rule to improve the electronic exchange of health-related data and streamline prior authorization processes.

Feb. 15, 2023

Exchange Rules

Our summary of the 2024 Notice of Benefit and Payment Parameters proposed rule highlights the provisions with implications for children's health and health care.

Feb. 14, 2023

Surprise Billing Rules

The No Surprises Act is meant to protect patients from surprise bills and uses an arbitration approach, rather than a benchmark payment standard, to settle payment disputes between payers and providers in cases of out-of-network care.

Dec. 01, 2022