Comprehensive preventive care and screening guidelines for women and infants, children, and adolescents under the Affordable Care Act expanded in January 2022, requiring certain group health plans and insurance plans to provide coverage with no out-of-pocket costs for preventive health services, according to the U.S. Department of Health and Human Services (HHS) and U.S. Health Resources and Services Administration (HRSA).
"Access to preventive care can help save countless lives and should be available without out-of-pocket costs, especially now during the COVID-19 pandemic,” HHS Secretary Xavier Becerra said. “The updated guidelines help ensure that we’re providing critical services to keep families healthy, based on the latest science and data available.”
The Women’s Preventive Services Guidelines help clinicians determine which services they should routinely provide their patients. HRSA expanded the existing guidelines based on recommendations from the Women’s Preventive Services Initiative, an interprofessional team of women’s health experts that will regularly review and recommend additional updates on a rolling basis. The latest updates expand coverage for breastfeeding services and supplies, well-woman preventive care visits, access to contraceptives and contraceptive counseling, screening for HIV, and counseling for sexually transmitted infections and include requiring coverage without cost-sharing for double electric breast pumps and preventing and reducing obesity in women aged 40–60 through counseling.
HRSA also accepted the Bright Futures Program’s, a team of pediatric primary care experts that evaluates the guidelines for preventive care screenings and routine visits for newborns through adolescents up to age 21, recommendations to add coverage of universal screening for suicide risk to the current depression screening category for individuals aged 12–21; and guidance for behavioral, social, and emotional screening; assessing risks for cardiac arrest for individuals aged 11–21; and assessing risks for hepatitis B virus infection in newborns to 21-year-olds.
“We are pleased to release these updated guidelines to expand insurance coverage of preventive services for women, infants, children, and teenagers,” HRSA Administrator Carole Johnson said. “By requiring coverage with no cost sharing for services like double-electric breast pumps for new parents and suicide risk screening for adolescents, these guidelines will help save lives and help families save money on out-of-pocket costs.”