Included in the latest document is information about a regulatory initiative to support value-based insurance designs (VBID) that provide incentives for enrollees to utilize higher-value and/or higher-quality services or venues of care. The regulators said in answer to a question that plans would be allowed to direct members to a health venue (for example, hospital versus ambulatory care facility) where they get the greatest value for medical services.
Another question and answer indicated plans would not be required to comply with a provision in the health reform law requiring a notice before any “material” change is made to a plan’s benefit until plans are mandated to provide the summary of benefits and coverage explanation.
The document indicates that the questions and answers were prepared jointly by the Departments of Health and Human Services (HHS), Labor, and the Treasury.
The FAQs document is at http://www.dol.gov/ebsa/faqs/faq-aca5.html.