Jump to content [accesskey 's']

 Home 

  News & Information  

  Online Store  

News & Information

CCH® BENEFITS — 03/31/10

Employer Responsibilities Under Health Care Reform

from Spencer’s Benefits Reports: When President Barack Obama signed the Patient Protection and Affordable Care Act (H.R. 3590) into law, some provisions took effect quickly. This is true with or without passage of the Health Care and Education Reconciliation Act of 2010 (H.R. 4872), which makes tax and revenue changes to H.R. 3590.

Within the next few weeks, Spencer’s Benefits Reports will examine those proposals that affect employer-sponsored plans in the near future. Today, preventive care is examined.

Preventive Care

Sec. 1001(5) of H.R. 3590 requires group health plans to cover, with no cost sharing, the following:

• certain evidence-based items (with A or B ratings) in the recommendations of the United States Preventive Services Task Force;
• immunizations recommended by the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention;
• evidence-based preventive care and screenings for infants, children, and adolescents provided for in the comprehensive guidelines supported by the Health Resources and Services Administration (HRSA); and
• additional women’s preventive care and screenings “in comprehensive guidelines supported by the HRSA.”

Employer plans and insurers are required to comply with these preventive services mandates within six months of enactment (Sept. 23, 2010). These preventive care provisions are now included in Sec. 2713 of the Public Health Service Act.

The law also includes a provision that excludes controversial November 2009 recommendations from the Preventive Services Task Force regarding breast cancer screening, mammography, and prevention. For these services, plans presumably will rely on previous recommendations (see

http://www.ahrq.gov/clinic/pocketgd09/gcp09s2.htm#BreastScreening

).

For all other preventive services, employers will have to review the existing recommendations (

http://www.ahrq.gov/CLINIC/uspstf/uspstopics.htm

) of the Task Force and be prepared to offer a variety of preventive care benefits with no cost sharing permitted.

Here are just a few of the recommended services with the required A or B ratings which employers will have to offer and provide with no deductibles or coinsurance:

• screening adults for depression;
• intensive behavioral dietary counseling for adult patients with known risk factors for cardiovascular and diet-related chronic disease;
• oral fluoride supplementation to preschool children older than six months of age;
• screening for high blood pressure in adults aged 18 and older; and
• screening and behavioral counseling interventions in primary care settings to reduce alcohol misuse by adults, including pregnant women.

For more information on this and related topics, consult the CCH Pension Plan Guide, CCH Employee Benefits Management, and Spencer's Benefits Reports.

Visit our News Library to read more news stories.