[Federal Register Volume 90, Number 9 (Wednesday, January 15, 2025)]
[Proposed Rules]
[Pages 3728-3729]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2025-00774]
[[Page 3728]]
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DEPARTMENT OF THE TREASURY
Internal Revenue Service
26 CFR Part 54
[REG-110878-24]
RIN 1545-BR35
DEPARTMENT OF LABOR
Employee Benefits Security Administration
29 CFR Part 2590
RIN 1210-AC25
DEPARTMENT OF HEALTH AND HUMAN SERVICES
45 CFR Part 147
[CMS-9887-WN]
RIN 0938-AV57
Enhancing Coverage of Preventive Services Under the Affordable
Care Act
AGENCY: Internal Revenue Service, Department of the Treasury; Employee
Benefits Security Administration, Department of Labor; Centers for
Medicare & Medicaid Services, Department of Health and Human Services.
ACTION: Withdrawal of notice of proposed rulemaking.
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SUMMARY: This document withdraws a notice of proposed rulemaking that
appeared in the Federal Register on October 28, 2024, regarding
coverage of certain preventive services under the Affordable Care Act.
DATES: As of January 15, 2025, the notice of proposed rulemaking that
appeared in the Federal Register on October 28, 2024, at 89 FR 85750 is
withdrawn.
ADDRESSES: Comments received on the proposed rule can be viewed at
https://www.regulations.gov/docket/HHS_FRDOC_0001/document.
FOR FURTHER INFORMATION CONTACT: Regan Rusher, Internal Revenue
Service, Department of the Treasury, at (202) 317-5500. Matthew
Meidell, Employee Benefits Security Administration, Department of
Labor, at (202) 693-8335. Rebecca Miller, Employee Benefits Security
Administration, Department of Labor, at (202) 693-8335. Geraldine
Doetzer, Centers for Medicare & Medicaid Services, Department of Health
and Human Services at (667) 290-8855.
SUPPLEMENTARY INFORMATION: Section 2713 of the Public Health Service
Act (PHS Act), as added by the Affordable Care Act and incorporated
into the Employee Retirement Income Security Act and the Internal
Revenue Code, requires non-grandfathered group health plans and health
insurance issuers offering non-grandfathered group or individual health
insurance coverage to provide coverage of certain recommended
preventive services without imposing any cost-sharing requirements.
Section 2715A of the PHS Act provides that non-grandfathered group
health plans and health insurance issuers offering non-grandfathered
group or individual health insurance coverage must comply with section
1311(e)(3) of the Affordable Care Act, which addresses transparency in
health coverage and imposes certain reporting and disclosure
requirements for health plans that are seeking certification as
qualified health plans to be offered on an American Health Benefits
Exchange (generally referred to as an Exchange).
On October 28, 2024, the Departments of the Treasury, Labor, and
Health and Human Services (collectively, the Departments) issued
proposed rules under PHS Act sections 2713 and 2715A titled,
``Enhancing Coverage of Preventive Services Under the Affordable Care
Act.'' \1\ The proposed rules sought to address ongoing complaints and
reports of noncompliance with section 2713 of the PHS Act and its
implementing regulations. These complaints and reports indicate that
participants, beneficiaries, and enrollees face barriers when
attempting to use their coverage to access recommended preventive
services without cost sharing. As a result of these concerns, the
Departments proposed to amend the regulations governing coverage of
recommended preventive services to ensure that participants,
beneficiaries, and enrollees would be able to access the full range of
recommended preventive services to which they are entitled, with
particular focus on strengthening coverage requirements with respect to
recommended contraceptive items for women.
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\1\ 89 FR 85750 (Oct. 28, 2024).
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The proposed rules would have required plans and issuers that
utilize reasonable medical management techniques with respect to any
recommended preventive services to provide an easily accessible,
transparent, and sufficiently expedient exceptions process that allows
an individual to receive coverage without cost sharing for the
preventive service according to the frequency, method, treatment, or
setting that is medically necessary for them, as determined by the
individual's attending provider. The proposed rules would also have
required plans and issuers to cover certain recommended over-the-
counter contraceptive items without requiring a prescription and
without imposing cost-sharing requirements. In addition, the proposed
rules would have required plans and issuers to cover certain
recommended contraceptive items that are drugs and drug-led combination
products without imposing cost-sharing requirements, unless a
therapeutic equivalent of the drug or drug-led combination product is
covered without cost sharing. Finally, the proposed rules would have
required plans and issuers to provide a disclosure pertaining to
coverage and cost-sharing requirements for recommended over-the-counter
contraceptive items in plans' and issuers' Transparency in Coverage
internet-based self-service tools or, if requested by the individual,
on paper.
The Departments requested comments on all aspects of the proposed
rules, as well as on a number of specific issues. The comment period on
the proposed rules closed on December 27, 2024, and the Departments
received 268 comments to review. The comments addressed a range of
issues, including operational and cost issues related to the
Departments' contraceptive coverage proposals.
The Departments have determined it is appropriate to withdraw the
proposed rules at this time, focusing instead on other matters. For
example, the Departments have identified Cost Sharing Under the
Affordable Care Act (RIN 0938-AV59); Requirements Related to Advanced
Explanation of Benefits and Other Provisions Under the Consolidated
Appropriations Act, 2021 (RIN 0938-AU98); Independent Dispute
Resolution Operations (RIN 0938-AV15); Requirements Related to Air
Ambulance Services, Agent and Broker Disclosures, and Provider
Enforcement (RIN 0938-AU61); and Provider Nondiscrimination
Requirements for Group Health Plans and Health Insurance Issuers in the
Group and Individual Markets (RIN 0938-AU64) in their respective Fall
2024 Regulatory Agendas, as potential matters on which to focus.
Moreover, should the Departments decide in the future that it is a
priority to move forward with rulemaking regarding all or a subset of
the preventive services coverage requirements of PHS Act section 2713,
the Departments want to ensure that they will have the benefit of the
most up-to-date facts and information on the basis of any specific
proposals that they determine to put forward at such time.
[[Page 3729]]
For these independently sufficient reasons, the Departments are
withdrawing the proposed rules, and may propose new rules in the
future, as appropriate to meet these goals.
This withdrawal action does not limit the Departments' ability to
make new regulatory proposals in the areas addressed by the withdrawn
proposed rules, including new proposals that may be substantially
identical or similar to those described therein. In addition, this
withdrawal action does not affect the Departments' ongoing application
of existing statutory and regulatory requirements or their
responsibility to faithfully administer the statutory requirements the
proposed rules would have implemented if finalized.
Douglas W. O'Donnell,
Deputy Commissioner, Internal Revenue Service.
Lisa M. Gomez,
Assistant Secretary, Employee Benefits Security Administration,
Department of Labor.
Xavier Becerra,
Secretary, Department of Health and Human Services.
[FR Doc. 2025-00774 Filed 1-13-25; 4:15 pm]
BILLING CODE 4830-01;-P; 4510-29-P; 4120-;01-P