The Obama Administration published final regulations on July 14, 2015 that implement Affordable Care Act requirements regarding coverage without cost sharing of certain preventive services, including contraceptive services. The regulations, jointly issued by the Departments of Health, Labor, and Treasury, finalize three earlier rulemakings:
Continue Reading Obama Administration Finalizes Regulations on ACA Coverage of Preventive Services, Including Contraceptive Services
Prevention
HHS Revises ACA Contraception Coverage Requirements
The Obama Administration has issued two regulations addressing coverage of contraceptive services under QHPs in response to recent court rulings (in particular the Supreme Court ruling in Burwell v. Hobby Lobby Stores, Inc.) addressing certain religious objections to such coverage. First, an interim final rule provides an additional pathway for nonprofit organizations eligible for a…
Obama Administration Finalizes Revised ACA Contraceptive Coverage Requirements
HHS, together with the Departments of Treasury and Labor, published a final rule on July 2, 2013 that modifies the Administration’s policy on the extent to which group health plans established by certain religious employers must cover contraceptive services without cost sharing. In short, the rule is intended to simplify the definition of a “religious…
CMS Provider Call on New Medicare Preventive Services (August 15)
CMS has scheduled an August 15, 2015 national provider call on new Medicare preventive services. The call will cover the following five benefits: Screening and Behavioral Counseling Interventions in Primary Care to Reduce Alcohol Misuse; Screening for Depression in Adults; Intensive Behavioral Therapy for Cardiovascular Disease; Screening for Sexually Transmitted Infections (STIs) and High-Intensity Behavioral…
National Prevention Council Action Plan Released
On June 13, 2012, the National Prevention Council released the “National Prevention Council Action Plan,” which outlines specific steps the Administration is taking to implement the strategic directions and priorities of the National Prevention Strategy.
CMS Call on Medicare Preventive Services (March 28)
On March 28, 2012, CMS is hosting a national provider call on Medicare Preventive Services: the Initial Preventive Physical Exam (IPPE) and Annual Wellness Visit (AVW). CMS experts will discuss both the IPPE and AWV, including when to perform them, who can perform each service, who is eligible, and how to code and bill for…
White House Announces Change to Rules Regarding Coverage of Contraceptive Services for Certain Religious Groups
As previously reported, last month HHS Secretary Kathleen Sebelius announced that certain religious employers who currently do not provide coverage for contraceptive services under their insurance plan will be required to do so beginning August 1, 2013. An exception from the mandate was provided only to non-profit religious employers that: have the inculcation of religious…
HHS Amends ACA Preventive Services/Contraception Coverage Rules
On August 3, 2011, the HHS published an interim final rule with comment period amending rules regarding coverage of certain preventive services by group health plans and health insurance coverage in the group and individual markets under the ACA. As previously reported, HHS announced earlier this month that health plans will be required to furnish…
IOM Issues Recommendations for Women’s Clinical Preventive Services
The Institute of Medicine recommended to the HHS Secretary that eight additional preventive services for women be added to the preventive services that health plans cover at no cost to the patient under the ACA. The eight services include: screening for gestational diabetes; human papillomavirus (HPV) testing as part of cervical cancer screening for…
CMS Call “The ABCs of the Initial Preventive Physical Examination and Annual Wellness Visit” (July 21)
CMS is hosting a provider call on July 21, 2011 to provide an overview of Medicare coverage for an Initial Preventive Physical Examination (commonly known as the “Welcome to Medicare” Visit) and the Affordable Care Act’s Annual Wellness Visit. Registration for the call will close at 1:30 pm on July 20 or when available space…
National Prevention Strategy Unveiled
The National Prevention, Health Promotion, and Public Health Council has released its final “National Prevention and Health Promotion Strategy,” as mandated by the ACA. The strategy identifies four “strategic directions” for improving the nation’s health: building healthy and safe community environments; expanding quality preventive services in both clinical and community settings; empowering people to make…
CMS Proposes Influenza Vaccination Standard for Medicare/Medicaid Providers and Suppliers
On May 4, 2011, CMS published a proposed rule that would require certain Medicare and Medicaid providers and suppliers to offer all patients an annual influenza vaccination, unless medically contraindicated or unless the patient (or patient’s representative or surrogate) declines vaccination. The requirement would apply to the following entities: hospitals (all types that participate in Medicare); …
House Passes Bill to Cut ACA Prevention Fund
On April 13, 2011, the House of Representatives approved H.R. 1217, a bill to repeal the ACA’s Prevention and Public Health Fund, which is a discretionary fund for investment in prevention and public health programs. The bill now moves to the Senate, where it is unlikely to be considered. The White House also has…
House Panel Approves Bills to Roll Back Certain ACA Funding
On April 5, 2011, the House Energy and Commerce Committee approved a series of health policy bills, including H.R. 1217, a bill to repeal the Prevention and Public Health Fund (a discretionary fund for investment in prevention and public health programs); and H.R. 1213, a bill to repeal mandatory funding provided to states to establish…
Comments Requested on Value-Based Insurance Design for ACA Preventive Care Benefits
On December 28, 2010, the Obama Administration published a request for information regarding how group health plans and health insurance issuers can employ value-based insurance design in the coverage of recommended preventive services. The notice seeks information on, among other issues: specific plan design tools to incentivize patient behavior; how to identify high-value treatment…
HHS Announces Health Promotion/Disease Prevention Agenda
On December 2, 2010, HHS released “Healthy People 2020,” which sets forth new 10-year goals and objectives for national health promotion and disease prevention. The document includes a greater focus on identifying, measuring, tracking, and reducing health disparities through a “determinants of health” approach that examines the range of personal, social, economic, and environmental factors…