Preventive care services guidance issued

Under federal health care reform laws passed earlier this year, non-grandfathered health plans must provide coverage for specified preventive care services with no cost sharing when delivered by a network provider. The Departments of Health and Human Services (HHS), Labor and the Treasury recently issued guidance on which preventive services are subject to this mandate (75 Fed. Reg. 41726, July 19, 2010). These interim final rules apply to non-grandfathered plans, beginning with the first plan year on or after September 23, 2010. This means a January 1, 2011 effective date for calendar year plans. Included in the mandate are:

• Evidence-based items or services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force;
• Immunizations for routine use in children, adolescents and adults that are recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention (CDC); and
• Evidence-informed preventive care and screenings recommended for infants, children, adolescents and women by the Health Resources Services Administration (HRSA).

A complete list of the required no-cost preventive services is available from HHS. If you maintain an insured health plan that is not grandfathered, you should be able to rely on your health insurance carrier to make sure these provisions are incorporated properly into your plan, but Vigilant recommends you contact your carrier or broker to be sure. All plans offered through the Vigilant Group Benefits Trust will be compliant with this mandate. Questions? Contact your health plan adviser.