Preeclampsia Screening Added as Preventive Care Mandate under PPACA

On April 25, 2017, the U.S. Preventive Services Task Force (USPSTF) released a final recommendation statement on screening for preeclampsia. Preeclampsia may arise during pregnancy and causes high blood pressure, kidney damage and other related issues, and is a potentially life-threatening complication. Specifically, the USPSTF statement states that screening for preeclampsia in pregnant women is recommended, including taking blood pressure measurements throughout pregnancy.

As background, PPACA requires that group health plans and insurers provide certain preventive services without imposing any cost-sharing (this is sometimes referred to as providing “first-dollar coverage”). As a result, no deductibles, co-pays, co-insurance or other cost-sharing may be imposed on these services, including evidence-based items or services with an A or B rating recommended by the USPSTF.

Coverage of preeclampsia screening for pregnant women is on the USPSTF list with a B rating. Compliance with this recommendation (as with any new USPSTF recommendation) is required beginning one year after the recommendation is issued. Therefore, coverage of preeclampsia screening for pregnant women (without cost sharing) should be included for plan years commencing on or after April 25, 2018.

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