government

ACA guidance closes prevention loopholes

NEWS IN BRIEF — Posted March 11, 2013

Print  |   Email  |   Respond  |   Reprints  |   Like Facebook  |   Share Twitter  |   Tweet Linkedin

The Dept. of Health and Human Services in new guidance makes it clear that patients won’t have to face unexpected cost-sharing for certain preventive services under the Affordable Care Act, according to cancer patient advocates.

A “frequently asked questions” document that accompanied a final rule on ACA minimum plan benefits clarified that patients cannot be subject to a co-pay in the event polyps are discovered and removed during a routine colonoscopy. Colonoscopies are considered preventive services that qualified health plans must cover without additional patient cost sharing, but some affected insurers had been reclassifying the services in the event of polyp discovery, claiming it no longer was a preventive exam but a diagnostic procedure.

“This loophole meant patients could find themselves with an unexpected cost burden for a preventive service that was supposed to be free, because it carried an ‘A’ rating by the United States Preventive Services Task Force,” said Christopher Hansen, president of the American Cancer Society Cancer Action Network. He noted that the possibility of being exposed to even limited cost sharing can deter patients from getting the tests.

“The administration also offered guidance to close other preventive screening loopholes that led to unexpected cost sharing for individuals with a family history of cancer,” Hansen said. Those with a family history of breast cancer and at high risk of developing the disease should be able to get genetic counseling and testing at no additional cost, according to the FAQ document.

Back to top


ADVERTISEMENT

ADVERTISE HERE


Featured
Read story

Confronting bias against obese patients

Medical educators are starting to raise awareness about how weight-related stigma can impair patient-physician communication and the treatment of obesity. Read story


Read story

Goodbye

American Medical News is ceasing publication after 55 years of serving physicians by keeping them informed of their rapidly changing profession. Read story


Read story

Policing medical practice employees after work

Doctors can try to regulate staff actions outside the office, but they must watch what they try to stamp out and how they do it. Read story


Read story

Diabetes prevention: Set on a course for lifestyle change

The YMCA's evidence-based program is helping prediabetic patients eat right, get active and lose weight. Read story


Read story

Medicaid's muddled preventive care picture

The health system reform law promises no-cost coverage of a lengthy list of screenings and other prevention services, but some beneficiaries still might miss out. Read story


Read story

How to get tax breaks for your medical practice

Federal, state and local governments offer doctors incentives because practices are recognized as economic engines. But physicians must know how and where to find them. Read story


Read story

Advance pay ACOs: A down payment on Medicare's future

Accountable care organizations that pay doctors up-front bring practice improvements, but it's unclear yet if program actuaries will see a return on investment. Read story


Read story

Physician liability: Your team, your legal risk

When health care team members drop the ball, it's often doctors who end up in court. How can physicians improve such care and avoid risks? Read story

  • Stay informed
  • Twitter
  • Facebook
  • RSS
  • LinkedIn