The Challenging Crosswalk Between USPSTF Recommendations and Coverage Considerations for Payers and Providers

Webinar (EDT)

Watch the Video or Download the Slides

An Overview and Case Studies Related to Coverage of Tobacco Cessation and Obesity/Overweight Behavioral Counseling Preventive Services

A Complimentary Webinar

New Affordable Care Act (“ACA”) coverage requirements mean that payers and providers must learn how to translate recommendations by the U.S. Preventive Services Task Force (USPSTF) for the practice of primary care into insurance coverage. Are you prepared for the effects that the intersection of the USPSTF and these new preventive service coverage requirements will have on your business? 

As required by the ACA, group health plans (insured and self-funded) and health insurance issuers offering group or individual health insurance coverage are required to:

provide coverage for and shall not impose any cost sharing requirements for evidence-based items or services that have in effect a rating of "A" or "B" in the current recommendations of the United States Preventive Services Task Force [USPSTF].

During this webinar, Epstein Becker Green attorneys will:

  • Explain what the USPSTF is and how it operates
  • Explore how the USPSTF makes recommendations related to particular preventive services
  • Analyze, through case studies related to coverage of tobacco cessation and obesity/overweight behavioral counseling preventive services, the considerations relevant to health plans, insurers, and providers in defining the scope of coverage for A/B-rated preventive services:
    • Tobacco Cessation – “A” recommendations from 2009 (coverage required for plan/policy years beginning on or after September 23, 2010)
    • Obesity/Overweight Behavioral Counseling – “B” recommendations from 2012 and 2014 (coverage required for plan/policy years beginning on or after June 26, 2013, and August 26, 2015, respectively)

Discuss the potential opportunities for traditional and non-traditional providers (e.g., physicians, non-physician practitioners, community-based providers such as Diabetes Prevention Programs, etc.) to furnish these preventive services under new coverage models

Lynn Shapiro Snyder, Senior Member of the Firm, Epstein Becker Green
Lesley R. Yeung, Associate, Epstein Becker Green

Who Should Attend:
This program is relevant to health plans and insurance issuers, health care providers, and manufacturers.

If you have questions regarding this event, please contact Whitney Krebs at (202) 861-0900 or [email protected].