By NextBestFitTask 1.5.4 of 7
Publish a national coverage manual by converting Medicare's National Coverage Determinations and adding pediatric, maternity, dental, vision, and hearing coverage rules.
Who does it
UHA CMO
When
Months 3–12
Trade-off
Converting Medicare coverage rules is fast but carries Medicare's gaps in pediatric and maternity coverage that must be filled.
Part of: Define the benefit package & cost sharing
Write down exactly what UHP covers, what it excludes, and what patients pay at the point of care: nothing for covered services. Out-of-pocket spending falls from $556.6B to $197.3B; what remains is for excluded items.
This step changes 14 existing laws, programs, or institutions. See the list.