As federal health reform legislation has stalled, health policy attention turns to the states, which have many tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states.
Issuer Essential Health Benefits Crosswalk and Certification
Georgetown University Health Policy Institute
The Issuer Essential Health Benefits (EHB) Crosswalk and Certification has been developed by the Georgetown University Health Policy Institute to help insurance regulators ensure that product filings include the required EHBs as set forth in the applicable state benchmark plan. Regulators can use the tool provided here, requiring issuers to complete the Crosswalk and Certification by: (i) describing each benefit as set forth in the state’s benchmark plan (including applicable page numbers); (ii) describing the corresponding benefit in the issuer’s product filing (including applicable page numbers); and (iii) certifying that (a) the information in the Crosswalk and Certification is accurate and complete and (b) the product filing includes all required essential health benefits as set forth in the state’s benchmark plan. The issuer completed Crosswalk and Certification is intended to increase the efficiency of the form review process by allowing form reviewers to quickly find and verify that the product under review meets all applicable EHB requirements. The tool is word document format and is designed to be modified to meet state-specific needs.