HHS Issues New Guidelines for Women’s Preventive Services

Developed by the independent Institute of Medicine, the new guidelines require new health insurance plans to cover women’s preventive services such as well-woman visits, breastfeeding support, domestic violence screening, and contraception without charging a co-payment, co-insurance or a deductible.  

According to a news release, last summer, HHS released new insurance market rules under the Affordable Care Act requiring all new private health plans to cover several evidence-based preventive services like mammograms, colonoscopies, blood pressure checks, and childhood immunizations without charging a copayment, deductible or coinsurance. The Affordable Care Act also made recommended preventive services free for people on Medicare.  

The new guidelines add to that: 

• well-woman visits; 
• screening for gestational diabetes; 
• human papillomavirus (HPV) DNA testing for women 30 years and older; 
• sexually-transmitted infection counseling; 
• human immunodeficiency virus (HIV) screening and counseling; 
• FDA-approved contraception methods and contraceptive counseling; 
• breastfeeding support, supplies, and counseling; and 
• domestic violence screening and counseling. 

New health plans will need to include these services without cost sharing for insurance policies with plan years beginning on or after August 1, 2012.  The rules governing coverage of preventive services which allow plans to use reasonable medical management to help define the nature of the covered service apply to women’s preventive services.  Plans will retain the flexibility to control costs and promote efficient delivery of care by, for example, continuing to charge cost-sharing for branded drugs if a generic version is available and is just as effective and safe for the patient to use.  

The administration also released an amendment to the prevention regulation that allows religious institutions that offer insurance to their employees the choice of whether or not to cover contraception services. This regulation is modeled on the most common accommodation for churches available in the majority of the 28 states that already require insurance companies to cover contraception.