On January 6, 2020, the Health Resources and Services Administration (HRSA) announced an update to its Women's Preventive Services Guidelines, which address health needs specific to women based on clinical recommendations from a coalition of national health professional organizations and consumer and patient groups with expertise in women's health. (The coalition is known as the Women's Preventive Services Initiative (WPSI).) The updated guidelines, which were approved in December 2019, now include screening for anxiety as a preventive service, in addition to the guidelines' existing preventive services.

As background, the ACA's preventive health services provision requires non-grandfathered group health plans and insurers to provide first-dollar coverage of specified preventive services, including preventive care and screenings for women under HRSA-supported guidelines (Public Health Service Act § 2713 (42 U.S.C. § 300gg-13); see Practice Notes, Preventive Health Services Under the ACA, Other Than Contraceptives: Covered Preventive Services and Grandfathered Health Plans Under the ACA). The guidelines were last updated in 2016 (see Legal Update, Rules for QSEHRAs, EPPs, and HRAs at Issue in Latest FAQ Guidance).

The updated guidelines address both the scope and frequency of anxiety screenings. Specifically, the guidelines now recommend screening for anxiety in adolescent and adult women, including those who are pregnant or postpartum. Because optimal anxiety screening intervals are unknown, the guidelines indicate that clinical judgment should be used in determining the frequency of screenings. The guidelines also encourage clinicians to consider screening women who have not been recently screened for anxiety, citing:

The updated guidelines apply for plan years beginning on or after December 17, 2020, meaning that non-grandfathered plans and insurers will have some lead-time to prepare for providing coverage without cost-sharing, as required under the ACA's preventive health services rules, for anxiety screening. Until then, the existing guidelines – which were announced in 2016 and effective beginning in December 2017 – will continue to apply.