The Department’s of Health and Human Resources, Labor, and Treasury issued interim final regulations to implement a new “Patient’s Bill of Rights” under the Patient Protection and Affordable Care Act (PPACA, P.L. 111-148). The regulations outline several insurance market changes effective September 2010.

For most health insurance plans starting on or after September 23, 2010 – including grandfathered health plans – the new regulations will ban insurance companies from imposing preexisting condition exclusions for children under the age of 19; ban lifetime limits on plan coverage; restrict annual limits on plan coverage; and, ban insurance coverage rescissions.

The regulations also specify patient protection changes made solely to non-grandfathered plans on or after September 23, 2010, including rules that clarify individual’s prerogative to choose their primary care provider; prohibit insurance or employer plans from requiring a referral for obstetrical or gynecological (OB-GYN) care; and, prohibits insurers and health plans from charging higher cost-sharing for emergency services that are obtained out of a plan’s network.

President Obama announced the new regulations after a meeting with executives from the largest insurance companies and state insurance commissioners. The new interim final rules also cross-reference and are very similar to a recent notice of proposed rulemaking by the Internal Revenue Service (IRS).

The IRS notice, among other issues, establishes a restricted annual limit on the dollar value of essential health benefits for insurance plans between 2010-2013 after which time annual limits are banned.  The annual limits are phased in over 3 years. Starting September 23, the annual limits must be at least $750,000. The minimum annual limit will increase to $1.25 million September 23, 2011 and to $2 million September 23, 2012.

Final drafts of the interim final rules and the IRS notice of proposed rulemaking are now available on the Office of the Federal Register website. You can also view the Interim Final Regulation directly here.  An administration Fact Sheet is available at here. Go to NSBA’s Health Reform Today and Tomorrow for additional information or to provide comments.