[Federal Register Volume 88, Number 188 (Friday, September 29, 2023)]
[Notices]
[Pages 67318-67319]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2023-21514]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Health Resources and Services Administration


Notice of Request for Public Comments on a Draft Recommendation 
To Update the HRSA-Supported Women's Preventive Services Guideline 
Relating to Screening for Urinary Incontinence

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

ACTION: Notice.

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SUMMARY: This notice seeks comments on a draft recommendation to update 
the HRSA-supported Women's Preventive Services Guidelines 
(``Guidelines'') relating to Screening for Urinary Incontinence. This 
draft recommendation has been developed through a cooperative 
agreement, known as the Women's Preventive Services Initiative (WPSI), 
with the American College of Obstetricians and Gynecologists (ACOG), 
through which they convene health professionals to develop draft 
recommendations. Under applicable law, non-grandfathered group health 
plans and health insurance issuers must include coverage, without cost 
sharing, for certain preventive services, including those provided for 
in the HRSA-supported Guidelines. The Departments of Labor, Health and 
Human Services, and Treasury have previously issued regulations, which 
describe how group health plans and health insurance issuers apply the 
coverage requirements.

DATES: Members of the public are invited to provide written comments no 
later than October 30, 2023. All comments received on or before this 
date will be reviewed and considered by WPSI and provided for further 
consideration by HRSA in determining the recommended update that it 
will support.

ADDRESSES: Members of the public who wish to provide comments can do so 
by accessing the public comment web page at https://www.womenspreventivehealth.org/.

FOR FURTHER INFORMATION CONTACT: Kimberly Sherman, HRSA, Maternal and 
Child Health Bureau, telephone (301) 443-8283, email: 
[email protected].

SUPPLEMENTARY INFORMATION: Under section 1001(5) of the Patient 
Protection and Affordable Care Act, Public Law 111-148, which added 
section 2713 to the Public Health Service Act, 42 U.S.C. 300gg-13, the 
preventive care and screenings set forth in the Guidelines are required 
to be covered without cost-sharing by certain group health plans and 
health insurance issuers. HRSA established the Guidelines in 2011 based 
on expert recommendations by the Institute of Medicine, now known as 
the National Academy of Medicine, developed under a contract with the 
Department of Health and Human Services. Since 2011, there have been 
advancements in science and gaps identified in these guidelines, 
including a greater emphasis on practice-based clinical considerations. 
Since 2016, HRSA has funded cooperative agreements with ACOG for WPSI 
to convene a coalition representing clinicians, academics, and 
consumer-focused health professional organizations to conduct a 
rigorous review of current scientific evidence, solicit and consider 
public input, and make recommendations to HRSA regarding updates to the 
Guidelines to improve women's health across the lifespan. HRSA then 
determines whether to support, in whole or in part, the recommended 
updates to the Guidelines. WPSI consists of an Advisory Panel and two 
expert committees, the Multidisciplinary Steering Committee and the 
Dissemination and Implementation

[[Page 67319]]

Steering Committee, which are comprised of a broad coalition of 
organizational representatives who are experts in disease prevention 
and women's health issues. With oversight by the Advisory Panel, and 
with input from the Multidisciplinary Steering Committee, WPSI examines 
the evidence to develop new (and update existing) recommendations for 
women's preventive services. WPSI's Dissemination and Implementation 
Steering Committee takes HRSA-approved recommendations and disseminates 
them through the development of implementation tools and resources for 
both patients and practitioners.
    WPSI bases its recommended updates to the Guidelines on review and 
synthesis of existing clinical guidelines and new scientific evidence, 
following the National Academy of Medicine standards for establishing 
foundations for and rating strengths of recommendations, articulation 
of recommendations, and external reviews. Additionally, HRSA requires 
that WPSI incorporate processes to assure opportunity for public 
comment, including participation by patients and consumers, in the 
development of its recommendations to the updated Guidelines.

The Existing Guideline States

``Screening for Urinary Incontinence

    WPSI 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.''

Draft Updated Clinical Recommendation for Public Comment

``Screening for Urinary Incontinence

    The Women's Preventive Services Initiative recommends screening 
women for urinary incontinence annually. Screening should assess 
whether women experience urinary incontinence and whether it impacts 
their activities and quality of life. If indicated, facilitating 
further evaluation and treatment is recommended.''

Discussion of Draft Updated Clinical Recommendation

    WPSI recommended several minor updates to the language of this 
Guideline. First, the word ``ideally'' is recommended to be removed 
from the second sentence for brevity, and its removal, if accepted by 
HRSA, will not substantively change the existing guideline. Second, the 
final sentence of the clinical recommendation recommends changing the 
word ``referring'' to ``facilitating'' to reflect that clinicians in 
practice, after screening for urinary incontinence, may decide to treat 
or manage urinary incontinence as part of standard primary care 
services or refer to specialists if specialist care is needed. Lastly, 
WPSI recommended minor edits to the language of the Guideline for the 
purposes of clarity. These minor edits have no substantive effect on 
the requirement for coverage without cost-sharing.
    Members of the public can view the complete updated draft 
recommendation, which includes the implementation considerations and 
research recommendations, by accessing the initiative's web page at 
https://www.womenspreventivehealth.org/.

Carole Johnson,
Administrator.
[FR Doc. 2023-21514 Filed 9-28-23; 8:45 am]
BILLING CODE 4165-15-P