The EHB must include coverage of 10 mandated benefit categories identified in the healthcare reform law, including ambulatory patient services, emergency services, hospitalization, maternity and newborn care, mental health and substance use disorder services, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness screenings and chronic disease management and pediatric services.
In the comment letter, the ASA encouraged CMS to “adopt a minimum standard for health insurance coverage that speaks to comprehensive pain care across other benefit categories.” In other words, the EHB package should include the adequate assessment, diagnosis, treatment and management of a patient’s acute or chronic pain.
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