Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Durable medical equipment, cranial prostheses and chiropractic services among benefits priced in EHB review
Summary
Consultants priced DME (including wheelchairs and CPAP), cranial prosthesis (wigs/hairpieces), and chiropractic care as candidate additions to California’s EHB benchmark; the total menu exceeds the state's actuarial room so the committee must prioritize additions.
The informational hearing on California’s EHB benchmark included detailed pricing for three categories of benefits frequently raised in stakeholder comment: durable medical equipment (DME), cranial prostheses (wigs/hairpieces) and chiropractic care.
Why it matters: Adding DME, cranial prosthesis and chiropractic care would require minimum benefit definitions and actuarial justification and would affect plan allowed costs and member premiums in individual and small‑group markets.
What the actuaries said: Wakely said DME pricing is driven by specific items — for example, CPAP machines represented a major share of the DME cost estimates — and that wheelchair and powered mobility device unit costs vary widely. In Wakely’s…
Already have an account? Log in
Subscribe to keep reading
Unlock the rest of this article — and every article on Citizen Portal.
- Unlimited articles
- AI-powered breakdowns of topics, speakers, decisions, and budgets
- Instant alerts when your location has a new meeting
- Follow topics and more locations
- 1,000 AI Insights / month, plus AI Chat
