FAH Hospital Policy Blog

Perspectives on health policy affecting America's hospitals and the patients we serve.

Sarah Aillon

FAH Responds to RFI on Essential Health Benefits 

Today,  FAH sent a letter to the Centers for Medicare & Medicaid Services’ (CMS) on its request for information (RFI) on Essential Health Benefits (EHB) and the EHB package required of all non-grandfathered individual and small group health insurance coverage.

 FAH raised concerns about health plans’ inappropriate use of prior authorization and other forms of utilization management, and limitations on behavioral health, inpatient medical rehabilitation, long term acute care hospital, and other necessary services and how excessive utilization control tactics can undermine efforts to ensure plans provide essential benefits.

The FAH letter also encouraged CMS and states to update EHB for changes in care delivery and technology related to the use of telehealth and remote patient monitoring, especially in treatment of mental and behavioral health care services.

A copy of the letter is available here