Essential Health Benefits by State


Essential Health Benefits: Know Thy State

Each of the fifty states will have to create their own definition of essential health benefits offered by state Medicaid programs – but those EHB services meet benchmark plan criteria identified by the Department of Health and Human Services in their December 16, 2011 Guidance Bulletin. Private payers will also look to the state adopted definitions to guide their own covered services. AOPA members must take the initiative to urge their state officials adopt a benchmark plan that includes O&P services – as some benchmark plans may not. To help AOPA members navigate this complex maze of information, AOPA commissioned a study by McGuireWoods Consulting that surveyed the benchmark plans in all fifty states. While complete information was not simply not available on all benchmark plans in all fifty states, the resulting compendium is as comprehensive a resource as there is available at this time. Click here for more…