Sec. 407. Protecting essential health benefits
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Section 1302(b) of the Patient Protection and Affordable Care Act ( 42 U.S.C. 18022(b) ) is amended— in paragraph (2)(B) and paragraph (3), by striking (4)(H) each place it appears and inserting (4)(I) ; and in paragraph (4)— in subparagraph (A), by inserting and coverage in every category is included before the semicolon; by redesignating subparagraphs
(E)through
(H)as subparagraphs
(F)through (I), respectively; and by inserting after subparagraph
(D)the following: ensure that, to be treated as providing coverage for the essential health benefits described in paragraph (1), a qualified health plan— shall not substitute benefits across the various categories described in paragraph (1); shall provide a wide variety of classes of prescription drugs on the prescription drug formulary of such plan; shall, if a medically necessary drug is not on the prescription drug formulary of such plan, allow individuals enrolled in such plan to have access to the drug through an exceptions process established by the plan; and shall provide coverage of habilitative services at parity with rehabilitative services, in accordance with regulations promulgated by the Secretary. .
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Sec. 407
Protecting essential health benefits
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