[Federal Register Volume 83, Number 39 (Tuesday, February 27, 2018)]
[Notices]
[Pages 8487-8488]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-03840]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Service Administration
Women's Preventive Services Guidelines
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: Applicable as of December 29, 2017, HRSA updated the HRSA-
supported Women's Preventive Services Guidelines for purposes of health
insurance coverage for preventive services that address health needs
specific to women based on clinical recommendations from the Women's
Preventive Services Initiative. This 2017 update adds two additional
services--Screening for Diabetes Mellitus after Pregnancy and Screening
for Urinary Incontinence--to the nine preventive services included in
the 2016 update to the HRSA-supported Women's Preventive Services
Guidelines. The nine services included in the 2016 update are as
follows: Breast Cancer Screening for Average Risk Women, Breastfeeding
Services and Supplies, Screening for Cervical Cancer, Contraception,
Screening for Gestational Diabetes Mellitus, Screening for Human
Immunodeficiency Virus Infection, Screening for Interpersonal and
Domestic Violence, Counseling for Sexually Transmitted Infections, and
Well-Woman Preventive Visits. This notice serves as an announcement of
the decision to update the guidelines as listed below. Please see
https://www.hrsa.gov/womens-guidelines/index.html for additional
information.
FOR FURTHER INFORMATION CONTACT: Kimberly C. Sherman, Maternal and
Child Health Bureau, HRSA at phone: (301) 443-0543; email:
[email protected].
SUPPLEMENTARY INFORMATION: The complete set of updated 2017 HRSA-
supported Women's Preventive Services Guidelines includes those that
were accepted by the Acting HRSA Administrator on December 20, 2016, as
well as two new services, Screening for Diabetes Mellitus After
Pregnancy and Screening for Urinary Incontinence. For a complete
listing and detailed information about the December 20, 2016, updates,
please see https://www.federalregister.gov/documents/2016/12/27/2016-31129/updating-the-hrsa-supported-womens-preventive-services-guidelines. In addition, the December 20, 2016, updates, including
information related to coverage of contraceptive services and exemption
for objecting organizations from requirements related to the provision
of contraceptive services, can be found at https://www.hrsa.gov/womens-guidelines-2016/index.html. Information regarding the two new services
that were accepted by the HRSA Administrator on December 29, 2017, is
set out below:
1. Screening for Diabetes Mellitus After Pregnancy
The Women's Preventive Services Initiative recommends women with a
history of gestational diabetes mellitus (GDM) who are not currently
pregnant and who have not previously been diagnosed with type 2
diabetes mellitus should be screened for diabetes mellitus. Initial
testing should ideally occur within the first year postpartum and can
be conducted as early as 4-6 weeks postpartum.
Women with a negative initial postpartum screening test result
should be rescreened at least every 3 years for a minimum of 10 years
after pregnancy. For women with a positive postpartum screening test
result, testing to confirm the diagnosis of diabetes is indicated
regardless of the initial test (e.g., oral glucose tolerance test,
fasting plasma glucose, or hemoglobin A1c). Repeat testing is indicated
in women who were screened with hemoglobin A1c in the first six months
postpartum regardless of the result (see Implementation Considerations
below).
2. Screening for Urinary Incontinence
The Women's Preventive Services Initiative recommends screening
women for urinary incontinence annually. Screening should ideally
assess whether women experience urinary incontinence and whether it
impacts their activities and quality of life. The Women's Preventive
Services Initiative recommends referring women for further evaluation
and treatment if indicated.
HRSA-Supported Women's Preventive Services Guidelines
The HRSA-supported Women's Preventive Services Guidelines were
originally established in 2011 based on recommendations from an HHS
commissioned study by the Institute of Medicine, now known as the
National
[[Page 8488]]
Academy of Medicine (NAM). Since then, there have been advancements in
science and gaps identified in the existing guidelines, including a
greater emphasis on practice-based clinical considerations. To address
these, HRSA awarded a 5-year cooperative agreement in March 2016 to
convene a coalition of clinician, academic and consumer-focused health
professional organizations and conduct a scientifically rigorous review
to develop recommendations for updated Women's Preventive Services
Guidelines in accordance with the model created by the NAM Clinical
Practice Guidelines We Can Trust. The American College of Obstetricians
and Gynecologists was awarded the cooperative agreement and formed an
expert panel called the Women's Preventive Services Initiative.
Under section 2713 of the Public Health Service Act, non-
grandfathered group health plans and issuers of non-grandfathered group
and individual health insurance coverage are required to cover
specified preventive services without a copayment, coinsurance,
deductible, or other cost sharing, including preventive care and
screenings for women as provided for in comprehensive guidelines
supported by HRSA for this purpose. Non-grandfathered group health
plans and health insurance issuers offering non-grandfathered group or
individual coverage (generally, plans or policies created or sold after
March 23, 2010, or older plans or policies that have been changed in
certain ways since that date) are required to provide coverage without
cost sharing for preventive services listed in the updated HRSA-
supported guidelines (which include the nine preventive services set
out in the 2016 update, as well as the two services added in this
update) beginning with the first plan year (in the individual market,
policy year) that begins on or after December 29, 2018.
Dated: February 20, 2018.
George Sigounas,
Administrator.
[FR Doc. 2018-03840 Filed 2-26-18; 8:45 am]
BILLING CODE 4165-15-P