HHS releases preventive care list updates
Two weeks ago, an independent panel recommended that FDA-approved contraceptive methods and some other services be covered 100% as a preventive care service under health care reform. The Institute of Medicine developed this recommendation at the request of the Department of Health and Human Services (HHS).
On August 1, 2011, HHS released new guidelines outlining required preventive care services for women. The new guidelines call for nongrandfathered health plans (including ASO plans) to include these services without cost sharing for insurance policies with plan years beginning on or after August 1, 2012:
- Well-woman visits
- Screening for gestational high blood sugar
- Human papillomavirus DNA testing for women 30 years and older
- Sexually transmitted disease counseling
- Human immunodeficiency virus screening and counseling
- FDA-approved birth control methods and birth control counseling (certain religious employers are exempt from this rule)
- Breastfeeding support, supplies, and counseling
- Family violence screening and counseling
The guidelines call for coverage of birth control methods that have a prescription. The guidelines also appear to allow a value-based insurance design that lets plans charge for brand-name drugs where a generic is available. Also, the guidelines let plans use medical management programs to limit coverage when a recommended preventive health service does not name the rate, method, treatment or setting for that service.
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