ACA Responds to Report on Construction of Essential Benefits Mandated by Health

The American Chiropractic Association (ACA) has reviewed the recommendations outlined by the Institute of Medicine (IOM) recommending a methodology for constructing an essential health benefits package to be included in qualified health plans developed as a result of the Patient Protection and Affordable Care Act (PPACA). “We look forward to working with HHS Secretary Sebelius over the next several months on this issue,” said ACA President Keith S. Overland, DC. “We will make our position crystal clear: that doctors of chiropractic can provide services in many of the broad 10 essential benefits categories in the newly regulated environment created by the PPACA – and we will work to ensure no language is adopted at the federal level relative to ‘essential benefits’ that would specifically exclude services provided by, or the participation of, chiropractic physicians.” At the request of the U.S. Department of Health and Human Services (HHS) late last year, IOM undertook a study to make recommendations to HHS on the criteria and methods for determining and updating the essential health benefits package. When ACA testified in January before the IOM panel charged with developing a set of recommendations for HHS, one of the items ACA stressed must happen is transparency throughout the essential health benefit determination process. The IOM keyed on this request and made sure in its recommendations that transparency is a vital focal point in the process going forward.  Another ACA proposal, urging that HHS considers the wide range of patient protections at the state level in determining an essential benefit package, was also included in the IOM report. The IOM stated in its report that while state patient protections, or mandates, should not be given preferential treatment, they should indeed be subject to the same inclusion criteria as any other service. In addition, in an effort to protect patients, ACA recommended that HHS also create an extensive review process for patient appeals if essential benefits are denied. The IOM also recommended that HHS create a strong framework for appeals and other protections when implementing and updating essential health benefits. The next step in the process may be a proposed rule, open to public comment, issued by HHS. The department may also create a series of public “listening sessions” where individuals may be able to voice their concerns orally and in-person. The exact scenario for public feedback should be determined in the next several weeks. “Transparency during this entire process will be fundamental in its success,” said Dr. Overland. “We believe that through research, evidence and patient satisfaction, the services provided by doctors of chiropractic will not only be deemed essential, but vital, to the health and well-being of all Americans.”

The American Chiropractic Association (ACA), based in Arlington, Va., is the largest professional association in the United States representing doctors of chiropractic. ACA promotes the highest standards of patient care and ethics, and supports research that contributes to the health and well-being of millions of chiropractic patients. Visit www.acatoday.org.