Proposed Rules for Health Insurance Market Reforms and Essential Health Benefits

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On November 20, 2012, the Centers for Medicare and Medicaid Services (CMS) released the long-awaited proposed rules for health insurance market reforms and essential health benefits. These provisions of the Affordable Care Act (ACA) are meant to protect patients with pre-existing conditions from discrimination and provide protections against other insurance company abuses. We’re now in the process of reviewing the hundreds of pages and will provide comments to CMS on or before the due date.

During ACA negotiations, NORD worked closely with Congress to ensure:

  • elimination of discrimination based on pre-existing medical conditions;
  • elimination of annual and lifetime insurance caps;
  • elimination of the ability of insurers to discontinue coverage for people who received dire diagnoses; and
  • a public health insurance option to ensure that everyone could afford coverage

Now it’s time to make sure CMS abides by Congressional intent and continues to protect the interests of rare disease patients and their families.  NORD will be monitoring this, and the following materials may help you follow this important topic also:

HHS Press Release

Market Reforms, Fact Sheet and Rule

Essential Health Benefits, Fact Sheet and Rule