Pending survey will help determine scope of health reform benefits

These are:

• Emergency room visits;

• Ambulance services;

• Diabetes care management;

• Kidney dialysis;

• Physical therapy;

• Durable medical equipment;

• Prosthetics;

• Maternity care;

• Infertility treatment;

• Sterilization;

• Gynecological exams and services; and 

• Organ and tissue transplantation.

The department has finished extracting the data from surveys of health plans, said Bureau of Labor Statistics Associate Commissioner Bill Wiatrowski, but still needs to compile it and prepare a report for the Department of Health and Human Services. 

The law gives the HHS secretary the final call on determining the essential benefits, with input from the Institute of Medicine and the employer survey. The IOM is expected to make its recommendations this fall, so HHS can have a proposal ready by the end of the year.