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Organizations Recommend Essential Health Benefits
September 28, 2012

PCPA has worked with the Pennsylvania Health Access Network, the Maternity Care Coalition, and other organizations to develop Principles for Essential Health Benefitsthat were submitted to the Department of Insurance, legislative leadership, and House and Senate committees responsible for insurance. These broad principles emphasize the need for access to services that have long been limited, such as behavioral health and maternity care. Mental health benefits must be in parity with physical health, although the definition of parity remains unclear. The principles recommend that the HealthChoices definition of medically necessary services be used. The principles call for broad public input in selection of essential health benefits in an open process.

The Pennsylvania Physical Health - Behavioral Health Learning Community also provided recommendations to the Department of Insurance for consideration as essential health benefits are being selected. These recommendations were more specific to behavioral health services and supports. States were required to select benefits by September 30. The administration is reluctant to move forward without further guidance from the Department of Health and Human Services. PCPA will continue to advocate for inclusion of behavioral health services within the essential health benefits package. Both the Principles for Essential Health Benefits and the learning community recommendations are available from the links.

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