Healthcare Business News

GOP lawmakers rip essential-benefits bulletin

By Jessica Zigmond
Posted: January 13, 2012 - 2:45 pm ET

Days before they return from holiday break, federal lawmakers chided HHS for a lack a transparency in the department's December bulletin about essential health benefits.

HHS issued guidance in December that said states could develop their own essential health benefits packages of certain services that insurers must cover—as long as any plan chosen by a state covers 10 required categories of care. The bulletin was intended to garner feedback from the public.

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“By issuing a ‘bulletin' rather than a proposed rule, the administration has sidestepped the requirement to publish a cost-benefit analysis estimating the impact these mandates will have on health insurance premiums and the increased costs to the federal government,” said a Jan. 13 letter to HHS Secretary Kathleen Sebelius from House Ways and Means Committee Chairman Dave Camp (R-Mich.); Education and Workforce Committee Chairman John Kline (R-Minn.); Energy and Commerce Committee Chairman Fred Upton (R-Mich.); Senate Health Education Labor and Pensions Committee Ranking Member Michael Enzi (R-Wyo.) and Senate Finance Committee ranking member Orrin Hatch (R-Utah). “Additionally, the administration has avoided publishing a list of unfunded mandates on states and the private sector by issuing a ‘bulletin' rather than a proposed rule, and has also avoided publishing a list of regulatory alternatives.”

Last month, an HHS official said in an e-mail that the department plans to follow the traditional rulemaking process for essential benefits, a requirement in the Patient Protection and Affordable Care Act that will start in 2014.

The lawmakers asked Sebelius to provide them with specific information by Jan. 27. That information includes the legal basis and rationale for issuing a bulletin, information that describes instances from the past 20 years when an agency pursued this type of action, and all documents, e-mails and data relating to the cost-benefit analysis and economic benefit analysis of implementing the bulletin.

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