On July 14, the Departments of Treasury, Labor, and Health and Human Services jointly released Interim Final Rules for group health plans and health insurance issuers relative to coverage of preventive services. These “essential benefits” are scheduled to be implemented on the first contract renewal following September 23, 2010 (as early as 2 weeks from today!)
Certain preventive services that have “strong scientific evidence of their health benefits” will need to be covered without copay, coinsurance or deductible. Although it is hard to determine exactly what these preventive services will be, we assume that they will include breast and cervical cancer screenings, colon cancer screenings, screenings for vitamin deficiencies during pregnancy and screenings for diabetes, high cholesterol and high blood pressure. We also assume that preventive care for children will include routine vaccinations, vision and hearing screenings, developmental assessments and possibly screening and counseling for obesity during covered pediatric visits.
BlueCross has included in their list of what they believe will be included :
Alcoholism-related services
Ambulance servies
Asthma education
Bariatric surgery
Chiropractic manipulation and osteopathic manipulation services
Diabetic supplies
Diagnostic services
Durable medical equipment
Enteral formula and food products
Hearing aids
Home health care
Hospice
Infusion therapy
Kidney disease treatment
Mental health/substance abuse
Ostomy supplies
Outpatient occupational therapy
Outpatient speech therapy
Pharmacy
Physician office visit for diagnostic services
Preventive care services
Prosthetic devices / limbs
Skilled nursing service
Transplant services
Treatment of temporomandibular joint disorder
These are considered “interim final rules” which means that the final rules may be different, but probably not by much. We will stay tuned to the changes as they are released and keep you informed. Please check back as we update information and address other details as they are released.