July 15, 2010 – Guidance Released Regarding Cost-Sharing and Preventive Services
Yesterday, Federal agencies released draft interim regulations under the Internal Revenue Code, ERISA, and the Public Health Services Act (“PHSA”) implementing the provision of the Patient Protection and Affordable Care Act (the “PPACA”) that prohibits the application of cost-sharing requirements (e.g., deductibles, co-pays, and coinsurance) to preventive services. A copy of the draft regulations is available at: http://www.healthcare.gov/center/regulations/prevention/regs.html. The final interim regulations are expected to be published in the Federal Register later this week.
Effective for plan years beginning on or after September 23, 2010, the PPACA prohibits group health plans (other than grandfathered plans) from imposing cost-sharing requirements with respect to preventive services. The interim regulations provide guidance regarding the types of preventive services subject to this new law. Plans that currently apply their cost-sharing provisions to preventive services should review these regulations to determine what changes are needed to come into compliance.
Please contact us if you have any questions regarding the regulations.