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New FAQs were issued regarding the Affordable Care Act’s (ACA) preventative care coverage requirement. They were issued in response to a recent court decision (Braidwood Management Inc. v. Becerra) which struck down part of the ACA’s preventative care mandate.
The FAQs include some important guidance for employer-sponsored health plans:
- Health plans aren’t required to cover preventative care items or services with “A” or “B” rating on or after March 23, 2010. However, it’s encouraged that plans and issuers continue to cover such items and services without cost sharing;
- Health plans must continue to cover, without cost sharing, items and services with an “A” or “B” rating before March 23, 2010; and
- State laws regarding preventative care coverage requirements for insured health plans are not impacted by the Braidwood
Health plans and issuers must continue to comply with all other preventative care coverage requirements.
Future of Ruling
It’s unclear if this ruling will be reversed or upheld by a higher court. Employers that want to make changes to their preventative care benefits should review their options carefully. Plan participants should be notified timely if any plan changes take place. Download the bulletin for more details.
This blog is intended to be a compilation of information and resources pulled from federal, state, and local agencies. This is not intended to be legal advice. For up to the minute information and guidance on COVID-19, please follow the guidelines of the Centers for Disease Control and Prevention (CDC) and your local health organizations.
National Insurance Services is not a law firm and no opinion, suggestion, or recommendation of the firm or its employees shall constitute legal advice. Readers are advised to consult with their own attorney for a determination of their legal rights, responsibilities and liabilities, including the interpretation of any statute or regulation, or its application to the readers’ business activities.
