New PPACA Mandated Coverage for
Abdominal Aortic Aneurysms
Who: Males covered for insurance under private insurance (individual and group plans whether insured or self-insured) subject to the Preventive Care requirements of the Patient Protection and Affordable Care Act (PPACA).
When: Released June 2014. The mandated coverage for Abdominal Aortic Aneurysms under PPACA starts the later of January 1, 2015 or the beginning of their next plan year.
What: The PPACA mandates for preventive care coverage at 100% (no patient out of pocket costs) has been expanded by the United States Preventive Services Task Force (USPSTF) changing its recommendation to “B” for plans to include one-time screening for abdominal aortic aneurysm (AAA) by ultrasonography in Men ages 65 to 75 years who “have ever” smoked.
Executive Summary:
* “ever-smoker” is a person who has smoked at least 100 cigarettes in his or her lifetime.
Actions: Employers Plan sponsors should consult with their agent, broker, plan consultant, legal counsel, or Human Resources Department to determine if and when any contract changes are required to satisfy the new preventive services requirement for male screening for abdominal aortic aneurysms. They should also assure that their employee notifications properly inform plan participants of any changes. Insurers will need to review their plan offerings to assure compliance.
The information presented and contained within this article was submitted by Ronald E. Bachman, President & CEO of Healthcare Visions and Chairman of the IHC Editorial Advisory Board. This information is general information only, and does not, and is not intended to constitute legal advice. You should consult legal advisors to determine the laws and regulations in your state. Any opinions expressed within this document are solely the opinion of the individual author.