Permanent birth control to be covered under PPACA
In August 2011, the U.S. Department of Health and Human Services (HHS) mandated that permanent birth control be a covered procedure under the Patient Protection and Affordable Care Act of 2010 (PPACA). The decision followed a report from the Institute of Medicine (IOM) that recommended the coverage of additional preventive health services to promote women’s health. Under the PPACA, health plans must cover services listed in the HHS comprehensive list of preventive services at no cost to patients.
The approved preventive services in the HHS guidelines anticipated to have the greatest impact on adoption of the Essure procedure include:
All U.S. Food and Drug Administration approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity(1)
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
New, non-grandfathered private health plans must cover the guidelines on women’s preventive services with no cost sharing in plan years starting on or after August 1, 2012. Plans will retain the flexibility to control costs and promote efficient delivery of care. For more information see http://www.hhs.gov/news/press/2011pres/08/20110801b.html.
(1) Group 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
The Guttmacher Institute advances sexual and reproductive health in the United States and worldwide through an interrelated program of social science research, policy analysis and public education designed to generate new ideas, encourage enlightened public debate and promote sound policy and program development. For more information see www.guttmacher.org