Deal struck to preserve coverage for USPSTF-endorsed imaging services
The Justice Department and Texas conservatives challenging the Affordable Care Act’s mandate to cover preventive services have reached a deal to preserve the provision while the case plays out.
Under the agreement, the administration has promised not to enforce the mandate against employers and individuals who have sued, claiming the ACA policy violates their religious beliefs, Politico reported Monday.
Physician advocacy groups including the American College of Radiology have expressed deep concern about the original ruling issued on March 30. In place since 2010, the ACA provision has required insurers to provide no-cost coverage for screening services endorsed by the U.S. Preventive Services Task Force.
“ACR strongly supports the federal efforts to preserve access to such care,” Cynthia R. Moran, executive VP of government relations, economics and health policy for the American College of Radiology, told Radiology Business Tuesday.
The plaintiffs in the case are aiming to completely strike down the preventive care mandate, Politico noted. They contend that the USPSTF is made up of experts who were not confirmed by the Senate nor the head of a government agency. Those involved want task force recommendations to be tossed, alongside the government ceasing any coverage enforcement.
ACR noted earlier this year that the original March ruling applied to all USPSTF recommendations issued on or after March 23, 2010, which was the day President Obama signed the ACA into law. This would include the task force’s December 2013 endorsement of regular lung cancer screening, with CT-based imaging of the colon likely also impacted.
Amid confusion following the ruling, ACR reported that some commercial insurers are requiring patient cost-sharing for USPSTF-endorsed services. Leaders have urged members of the specialty to contact the college, if they experience any prior authorization or other roadblocks related to lung, breast and colon cancer.
Politico noted that the 5th Circuit Court has already heard oral arguments on the case, with a ruling expected in the coming months. “An appeal to the U.S. Supreme Court is likely, no matter which side prevails,” the report noted
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Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.