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HHS Updates Women’s Preventative Services Guidelines

The Health Resources and Services Administration (HRSA), a division of HHS, released approved updates and revisions to the Women’s Preventative Services Guidelines.

These Guidelines detail the preventative services that group health plans, health insurance issuers and individual health plans must cover without cost-sharing. 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 screening for women under HRSA-supported guidelines. These requirements do not apply to grandfathered group health plans. The updated Guidelines will apply to all plan years beginning on or after December 30, 2022.

What changed?

HRSA revised five preventive services:

  • Breastfeeding services and supplies;
  • Contraception;
  • Screening for HIV infection;
  • Counseling for sexually transmitted infections: and
  • Well-woman preventative visits.

HRSA added one additional service – preventing obesity in women aged 40-60 years.

Breastfeeding Services and Supplies

The Guidelines include lactation support services during the antenatal, perinatal, and postpartum periods. Breastfeeding equipment and supplies include, but are not limited to, double electric breast pumps and breast milk storage supplies.

Contraception

The Guidelines recommend that adolescent and adult women have access to contraceptives and contraceptive care. This includes screening, education, counseling, and follow-up care. Contraceptives include everything listed in the FDA’s Birth Control Guide, and includes:

  • Sterilization surgery
  • Intrauterine devices
  • Injectable contraceptives
  • Oral contraceptives
  • Contraceptive patches

Screening for HIV Infection

The Guidelines recommend that all women 15 and older receive an HIV screening test and risk assessment and prevention education for women age 13 and older. Screening tests are also recommended for all pregnant women when they begin prenatal care.

Counseling for Sexually Transmitted Infections

The Guidelines cover behavioral counseling by a health care clinician or another trained individual for women at an increased risk for sexually transmitted infections.

Well-Woman Preventative Visits

Beginning in adolescence, the Guidelines permit women receive at least one preventative care visit per year. The primary purpose is the delivery and coordination of recommended services that are determined by age and risk factors. These services may be offered across multiple visits. Well-women visits include pre-pregnancy, prenatal, and postpartum visits.

Preventing Obesity in Midlife Women

The Guidelines recommend counseling for midlife women aged 40 to 60 years old with normal or overweight body mass index. Counseling can include individualized discussion of healthy eating and physical activity.

HRSA maintains a useful table of the required preventive services. Non-grandfathered plans and insurers will need to prepare to provide coverage without cost-sharing as required per the updated Guidelines for plan years beginning on or after December 30, 2022.

If you have any questions about how these guidelines will impact your plan, talk to your carrier and your OneDigital Consultant.

Never miss an update – bookmark OneDigital’s Compliance Confidence blog for the latest developments as they unfold.

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