New Preventative Service Health Care Mandates Likely Beginning 2018

October 07, 2016

The list of preventive services for which employers are required to cover 100 percent of the cost could grow if the latest proposed recommendations by the National Academies of Sciences, Engineering, and Medicine are adopted later this year.  Under the ACA, the initial list of preventive services developed by the Institute of Medicine in 2012 required most health plans to cover well-woman visits, screening and/or counseling for sexually transmitted infections, domestic violence and gestational diabetes as well as breastfeeding support and supplies.  The draft list of recommendations, which are subject to public comment until September 30, 2016, include:
  • Allowing women at average risk of breast cancer to begin screening as early as age 40 and receive a mammogram every one or two years; and 
  • If imaging tests, biopsies or other interventions are required to evaluate the mammogram findings, requiring that those be considered an integral part of the screening and provided without charge to women.
The final recommendations will be submitted to the Department of Health and Human Services by December 1, 2016, and if adopted before the end of the year, would go into effect for most plans at the beginning of 2018.