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Essential Health Benefits under the ACA
Starting this year, the Affordable Care Act (ACA) requires that health plans offered in the individual and small-group markets offer essential health benefits within at least ten categories:
- ambulatory patient services
- emergency services
- hospitalization
- maternity and newborn care
- mental health and substance use disorder services, including behavioral health treatment
- prescription drugs
- rehabilitative and habilitative services and devices
- laboratory services
- preventive and wellness services and chronic disease management
- pediatric services, including oral and vision care
Visit the sidebar for further resources on the Affordable Care Act (ACA).
Ewoldt, L. L. (2013). Healthcare reform: resolve to increase your knowledge in 2014.American Nurses Today, 9(1), 8-11.
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Helpful Resources on Healthcare Reform Centers for Medicaid & Medicare Services. Medicare Provider Charge Data. Kaiser Health News. Interactive Chart: Bonuses and Penalties for U.S. Hospitals Leapfrog Group. Leapfrog Hospital Survey. Medicare.gov: Hospital Compare: Hospital Readmission Reduction Program Medicare.gov: Hospital Compare: Total Performance Score Information (Value Based Purchasing)
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