[Federal Register Volume 85, Number 4 (Tuesday, January 7, 2020)]
[Notices]
[Pages 722-723]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2020-00035]


-----------------------------------------------------------------------

DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Update to the Women's Preventive Services Guidelines

AGENCY: Health Resources and Services Administration (HRSA), Department 
of Health and Human Services (HHS).

ACTION: Notice.

-----------------------------------------------------------------------

SUMMARY: On December 17, 2019, HRSA approved an update to the HRSA-
supported Women's Preventive Services Guidelines (Guidelines) that 
addresses health needs specific to women. The Guidelines are based on 
clinical recommendations from the Women's Preventive Services 
Initiative. Preventive care and screenings for women provided for in 
comprehensive guidelines supported by HRSA are required to be covered 
without cost-sharing by non-grandfathered group health plans and health 
insurance

[[Page 723]]

issuers offering non-grandfathered group or individual health insurance 
coverage. This 2019 update adds one additional service--Screening for 
Anxiety--to the HRSA-supported Women's Preventive Services Guidelines 
to the 11 preventive services that were last updated in 2017. The 11 
services included in the 2017 update are: 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, Well-Woman Preventive Visits, 
Screening for Diabetes Mellitus after Pregnancy, and Screening for 
Urinary Incontinence. 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: Ada Determan, Maternal and Child 
Health Bureau at email: [email protected] or (301) 945-3057.

SUPPLEMENTARY INFORMATION: The updated 2019 HRSA-supported Women's 
Preventive Services Guidelines and information related to guideline 
development and implementation can be found on https://www.hrsa.gov/womens-guidelines-2019/index.html. Information regarding the new 
preventive service approved by the HRSA Administrator for inclusion in 
the comprehensive guidelines is set out below:

Screening for Anxiety

    The Women's Preventive Services Initiative recommends screening for 
anxiety in adolescent and adult women, including those who are pregnant 
or postpartum. Optimal screening intervals are unknown and clinical 
judgement should be used to determine screening frequency. Given the 
high prevalence of anxiety disorders, lack of recognition in clinical 
practice, and multiple problems associated with untreated anxiety, 
clinicians should consider screening women who have not been recently 
screened.

HRSA-Supported Women's Preventive Services Guidelines

    The HRSA-supported Women's Preventive Services Guidelines were 
originally established in 2011 based on recommendations from the 
Institute of Medicine, now known as the National Academy of Medicine 
(NAM), developed under a contract with HHS. 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 to perform this work.
    Under section 2713 of the Public Health Service Act, 42 U.S.C. 
300gg-13, 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 11 preventive 
services last updated in 2017 as well as the one new service added in 
this update) beginning with the first plan year (in the individual 
market, policy year) that begins on or after December 17, 2020.

    Dated: December 30, 2019.
Thomas J. Engels,
Administrator.
[FR Doc. 2020-00035 Filed 1-6-20; 8:45 am]
 BILLING CODE 4165-15-P