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Health Insurers, Disability Advocates Square Off Over ‘Essential Benefits’


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As government regulators work to determine what should qualify as essential benefits under the new health care law, habilitative services like autism behavior therapy are proving to be a sticking point.

Under the health care reform law passed last year, Congress mandated 10 different types of care that insurers must cover starting in 2014. But legislators left it up to regulators to determine exactly what services fall within each category.

A requirement to include coverage of habilitative services is attracting significant attention. This could force insurers to cover everything from behavioral services for those with autism to physical therapy for people with cerebral palsy and speech for individuals with Down syndrome.

Disability advocates are urging regulators to require such services on all health insurance plans without limits, but insurers argue that such a coverage expansion will increase costs, reports The Wall Street Journal. To read more click here.

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