PPACA Update : Expanded Preventive Services for Woman


Section 2713 of the Public Health Service Act (“PHSA”), adopted as part of the Patient Protection and Affordable Care Act (“PPACA”), requires health plans and health insurance issuers to cover a lengthy list of preventive services with no cost sharing. These rules apply only to non-grandfathered plans and policies. One of the categories of preventive services to be covered is preventive services and screenings for women based on guidelines issued by the Health Resources and Services Administration (HRSA), an agency of HHS. When the PPACA was enacted in March 2010 and the interim final rules were issued in July, 2010, no such guidelines existed.

On August 1, 2011, new guidelines were issued by HRSA, which will require health plans and health insurance issuers to cover additional preventive services for women with no co-pay or other cost sharing. The HRSA guidelines were recommended by the independent Institute of Medicine and based on scientific evidence.

The additional preventive services are...

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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