Overview of HHS freedom of conscience/religion controversy (2011-2013)
Appendix "B"
Women's Preventive Services
Required Health Plan Coverage
Guidelines
U.S. Department of Health and Human
Services, Health Resources and Services Administration
Introduction:
The
preventive services regulation written
by the U.S. Department of Health and
Human Services required all
health insurance plans to pay fully for every service described in
Section 147.130 of the regulation. Among these are all
services for women that are identified in "
binding comprehensive health plan coverage guidelines supported by the
Health Resources and Services Administration (HRSA)"
The HRSA guidelines are reproduced below.
The combined effect of the statute, the
regulation and the
guidelines was that eight types of service
had to be provided and paid for fully by insurance plans that the law required employers to offer to employees.
[Source]
Health Resources and Services Administration Supported Women's
Preventive Services: Required Health Plan Coverage Guidelines
Non-grandfathered plans and issuers are required to provide
coverage without cost sharing consistent with these guidelines in the
first plan year (in the individual market, policy year) that begins on
or after August 1, 2012.
|
Type of
Service
|
HHS Guideline for
Health Insurance Coverage
|
Frequency
|
|
Well-woman visits.
|
Well-woman preventive care visit annually for adult women to
obtain the recommended preventive services that are age and
developmentally appropriate, including preconception and
prenatal care. This well-woman visit should, where appropriate,
include other preventive services listed in this set of
guidelines, as well as others referenced in section 2713.
|
Annual, although HHS recognizes that several visits may be
needed to obtain all necessary recommended preventive services,
depending on a woman's health status, health needs, and other
risk factors.* (see note)
|
|
Screening for gestational diabetes.
|
Screening for gestational diabetes.
|
In pregnant women between 24 and 28 weeks of gestation and at
the first prenatal visit for pregnant women identified to be at
high risk for diabetes.
|
|
Human papillomavirus testing.
|
High-risk human papillomavirus DNA testing in women with
normal cytology results.
|
Screening should begin at 30 years of age and should occur no
more frequently than every 3 years.
|
|
Counseling for sexually transmitted infections.
|
Counseling on sexually transmitted infections for all
sexually active women.
|
Annual.
|
|
Counseling and screening for human immune-deficiency virus.
|
Counseling and screening for human immune-deficiency virus
infection for all sexually active women.
|
Annual.
|
|
Contraceptive methods and counseling.
**
|
All Food and Drug
Administration approved
|
As prescribed.
|
|
Breastfeeding support, supplies, and counseling.
|
Comprehensive lactation support and counseling, by a trained
provider during pregnancy and/or in the postpartum period, and
costs for renting breastfeeding equipment.
|
In conjunction with each birth.
|
|
Screening and counseling for interpersonal and domestic
violence.
|
Screening and counseling for interpersonal and domestic
violence.
|
Annual.
|
health
plans sponsored by certain religious employers, and group health
insurance coverage in connection with such plans, are exempt from the
requirement to cover contraceptive services. A religious employer is one
that: (1) has the inculcation of religious values as its purpose; (2)
primarily employs persons who share its religious tenets; (3) primarily
serves persons who share its religious tenets; and (4) is a non-profit
organization under Internal Revenue Code section 6033(a)(1) and section
6033(a)(3)(A)(i) or (iii). 45 C.F.R. §147.130(a)(1)(iv)(B). See the
Federal Register Notice:
Group Health Plans and Health
Insurance Issuers Relating to Coverage of Preventive Services Under the
Patient Protection and Affordable Care Act