Federal Register #CMS-9874-NC

CMS Request for Information on Essential Health Benefits Framework and Typical Employer Plan Standard

The Centers for Medicare & Medicaid Services (CMS), under the Department of Health and Human Services (HHS), is seeking public input to inform a review of the Essential Health Benefits (EHB) framework and the typical employer plan standard. - Government Buyer: - Department of Health and Human Services (HHS) - Centers for Medicare & Medicaid Services (CMS) - Purpose: - Request for Information (RFI) to gather feedback on the EHB framework as mandated by the Affordable Care Act - Focus on the scope of EHB, state approaches to EHB-benchmark plans, methodologies for determining EHB, and impacts on access and market stability - Key Topics for Input: - Current interpretations of EHB - State variations and processes for updating EHB-benchmark plans - Cost pressures and data limitations - Potential impacts of future policy changes - No OEMs, vendors, products, or purchase quantities are specified, as this is an information-gathering effort to inform future regulatory actions - No procurement of goods or services is taking place at this stage

Description

This request for information (RFI) seeks public input to support CMS' comprehensive review of the Essential Health Benefits (EHB) framework and the requirement under the Patient Protection and Affordable Care Act that the scope of EHB be equal to the scope of benefits provided under a typical employer plan. CMS is soliciting comments on current interpretations of EHB, state approaches to selecting and updating EHB-benchmark plans, and methodologies used to determine the scope of benefits included as EHB. The RFI also addresses variation across states, cost pressures, data limitations, and potential impacts of future policy changes. The information gathered will inform CMS' evaluation of whether revisions or additions to the current EHB regulations may be appropriate.

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