U.S. Preventive Services Task Force

Summary

The U.S. Preventive Services Task Force (USPSTF) is an independent, volunteer-driven group of national experts who specialize in prevention and evidence-based medicine. This group provides recommendations on clinical preventive services, including screening tests, counseling, and preventive medications. Composed of 16 volunteer members from diverse fields such as preventive medicine, primary care, internal medicine, family medicine, pediatrics, behavioral health, obstetrics/gynecology, and nursing, the USPSTF draws from the expertise of practicing clinicians who donate their time and knowledge.

According to Section 2713 of the Affordable Care Act (ACA), private insurers are required to cover preventive services recommended by the USPSTF that receive a grade of A or B, as well as those endorsed by the Advisory Committee on Immunization Practices (ACIP), Bright Futures, and the Health Resources and Services Administration (HRSA) guidelines for women’s health. These services must be provided with no cost-sharing, meaning there are no deductibles or co-pays for patients.

Section 4105 of the ACA expands Medicare’s coverage of preventive services, aligning with USPSTF recommendations, and ensures that services graded A, B, or C are covered. However, it allows Medicare to exclude coverage for services graded D by the USPSTF. Additionally, Section 4106 of the ACA mandates that Medicaid provide coverage for preventive services recommended by the USPSTF with a grade of A or B, as well as those recommended by ACIP, ensuring broad access to important preventive care for vulnerable populations.