The Department of Health and Human Services’ (HHS) Health Resources and Services Administration (HRSA) recently updated its preventive services guidelines to expand the list of women’s preventive services that group health plans are required to cover under the Affordable Care Act (ACA).
Updated preventive services guidelines generally take effect for plan years beginning on or after one year from the date the updated guideline is issued. In this case, the updates take effect for plan years beginning in 2023.
The updated guidelines add one additional service: Preventing Obesity in Midlife Women. The guideline recommends counseling for midlife women aged 40 to 60 years with normal or overweight body mass index to prevent obesity.
In addition, the update revises the following five services:
The Employee Benefits Security Administration (EBSA) released a fact sheet on 2021 enforcement of the Mental Health Parity and Addiction Equity Act (MHPAEA), which summarizes closed investigations of MHPAEA violations in 2021. Federal agencies also issued a 2022 Report to Congress on the MHPAEA highlighting their recent emphasis on MHPAEA enforcement.
The MHPAEA prevents group health plans and health insurance issuers that provide mental health and substance use disorder (MH/SUD) benefits from imposing less favorable limits on those benefits than on medical and surgical coverage. According to the 2022 Report to Congress, health plans and health insurance issuers are failing to deliver parity for MH/SUD benefits.
Federal agencies indicated that they have significantly increased MHPAEA enforcement activities. In 2021, EBSA investigated MHPAEA violations in the following categories:
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