AOTA Members Across the Country Testify at Department of Health and Human Services Listening Session on Essential Health Benefits in the Affordable Care Act
The Department of Health and Human Services (HHS) has been holding regional listening sessions regarding essential health benefits in the Affordable Care Act. AOTA members across the country answered AOTA’s advocacy call, with members attending and testifying at listening sessions across the country. Jeff Tomlinson in New York, Debi Hinderfeld in Atlanta, Guy McCormick and Elizabeth Gomes in San Francisco, Tiffany Sparks-Keeney, JoAnn Keller Green in Seattle and Janice Hinds in Denver insured that occupational therapy had strong representation at 6 out of the 7 regional sessions. AOTA Federal Affairs staff worked closely with our members in each region to craft official testimony to be presented focused on inclusion of rehabilitation and habilitation in the final list of required benefits.
The ACA establishes a minimum standard of coverage, known as “essential health benefits” that must be satisfied by individual and small group health plans sold in both exchange and non-exchange markets, as well as by any qualified health plan sold in the state exchange market. The essential benefit statute sets forth a series of broad benefit classes that the Secretary’s definition must include, and also sets forth important rules for developing essential benefit standards.
The following benefit classes are identified as essential benefit classes
- Ambulatory patient services
- Emergency services
- Hospitalization
- Maternity and newborn care
- Mental health and substance use disorder services, including behavioral health treatment
- Prescription drugs
- Rehabilitative and habilitative services and devices
- Laboratory services
- Preventive and wellness services and chronic disease management
- Pediatric services, including oral and vision care
Federal affairs staff shared information about the listening sessions on AOTA’s web-site and with our members and volunteer leadership including the affiliated state association presidents.
Click here to view sample AOTA testimony.
