May 13, 2021
The U.S. Preventive Services Task Force (USPSTF) revised a recommended preventive service for lung cancer screening:
The USPSTF recommends annual screening for lung cancer with low-dose computed tomography (LDCT) in adults aged 50 to 80 years who have a 20 pack-year smoking history and currently smoke or have quit within the past 15 years.
Screening should be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to have curative lung surgery.
This updated recommendation statement changed the age range (from 55 – 85 years to 50 – 80 years) and pack per year (from 30 to 20) eligibility criteria.
Group health plans (with few exceptions) must adjust their plans to cover this service, without cost sharing, i.e., no copay, coinsurance, or deductible, effective for plan years beginning on or after March 9, 2022 (January 1, 2023 for calendar year plans).
The ACA requires that most group health plans cover, without cost sharing, all preventive services with an A or B rating from the USPSTF.
If you have questions, comments, or concerns about these or other regulatory and compliance issues, please contact us.
We provide this material for informational purposes only; it is not a substitute for legal advice.