By: Héctor Hernández
Recognizing that prevention and early detection of diseases and conditions vastly improve health outcomes, the Affordable Care Act (ACA) requires Medicaid (Medi-Cal in California) and non-grandfathered private plans to cover a set of preventive services without cost-sharing. To ensure that beneficiaries and enrollees fully benefit from advances in science and medicine, Congress tied coverage of preventive services to services, screenings, and vaccines recommended by the United States Preventive Services Task Force (USPSTF), the Advisory Committee on Immunization Practices (ACIP), and the Health Resources and Services Administration (HRSA). Similarly, coverage of vaccines for minors under Medicaid’s Vaccine for Children (VFC) program is also tied to ACIP vaccine recommendations formally adopted by the Centers for Disease Control and Prevention (CDC), emphasizing the importance of an evidence-based approach to coverage of preventive services among children and adolescents.




