New health system change regulations might leave carrier executives some room to maneuver.
Federal agencies recently released a new batch of interim final rules implementing the Affordable Care Act, the legislative package that includes the Patient Protection and Affordable Care Act (PPACA) and the Health Care and Education Reconciliation Act.
One section deals with ACA provisions that will ban lifetime limits on “essential health benefits” and limit carriers’ ability to impose annual limits.
Anne Tyler Hamby, Ashley Gillihan and John Hickman, lawyers in the Atlanta office of Alston & Bird L.L.P., have written in an analysis distributed by the Employers Council on Flexible Compensation, Washington, note that ACA provisions will continue to permit plans to impose lifetime and annual limits on “non-essential health benefits.”
It also appears that, for now, at least, the ACA benefits limit provisions may permit insurers and plans to set non-monetary limits on care, such as limits on the number of hospital visits covered, the lawyers say.