Coverage for Unhealthy Drug Use Screening Required by 2022 Plan Year

Group health plans must cover screening for unhealthy drug use in adults, without cost-sharing, effective for plan years beginning on or after 6/9/2021 (1/1/2022 for calendar year plans).

The U.S. Preventive Services Task Force (USPSTF) has issued a new recommended preventive service:

The USPSTF recommends screening by asking questions about unhealthy drug use in adults age 18 years or older. Screening should be implemented when services for accurate diagnosis, effective treatment, and appropriate care can be offered or referred. (Screening refers to asking questions about unhealthy drug use, not testing biological specimens.)

Therefore, group health plans (with few exceptions) must cover this service, without cost-sharing, i.e., no copay, coinsurance, or deductible, effective for plan years beginning on or after June 9, 2021 (January 1, 2022 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.

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