On Monday, the U.S. Court of Appeals for the Fifth Circuit issued an administrative stay of enforcement of the district court decision in Braidwood Management Inc. v. Becerra. Readers of our earlier blog (found here) will remember that in Braidwood, the district court enjoined enforcement of the preventive services mandate for "A" or "B" items and services recommended by the United States Preventive Services Task Force ("USPSTF") on or after March 23, 2010. If the district court decision stands, this means that non-grandfathered plans would not have to cover these services without cost-sharing. However, as a result of the Fifth Circuit stay issued on May 15, non-grandfathered health plans will continue to be subject to the mandate for these services for the time being. All other preventive care requirements for health plans remain in place.
Takeaways for health plan sponsors and employers: In our prior blog, we suggested a wait and see approach in anticipation of the possibility of a stay. That suggestion continues to apply, as plan sponsors should remember that the Fifth Circuit administrative stay is not a decision on the merits of the underlying case. Rather, what it means is that the Fifth Circuit pressed pause on the district court order so that the pre-Braidwood preventive services mandate would remain intact for now while the case proceeds. The Fifth Circuit is expected to release a final decision later this year.
Fifth Circuit Stay Reinstates Preventive Services Mandate—For Now
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
