Data / Federal rules / 2024-24675
Enhancing Coverage of Preventive Services Under the Affordable Care Act
The Health and Human Services Department published this proposed rule in the Federal Register on October 28, 2024. Comments closed on December 27, 2024.
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What the agency says
This document sets forth proposed rules that would amend the regulations regarding coverage of certain preventive services under the Public Health Service Act. Specifically, this document proposes rules that would provide that medical management techniques used by non- grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage with respect to such preventive services would not be considered reasonable unless the plan or issuer provides an easily accessible, transparent, and sufficiently expedient exceptions process that would allow an individual to receive coverage without cost sharing for the preventive service that is medically necessary with respect to the individual, as determined by the individual's attending provider, even if such service is not generally covered under the plan or coverage. These proposed rules also contain separate requirements that would apply to coverage of contraceptive items that are preventive services under the Public Health Service Act. Specifically, these proposed rules would require 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 require 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, this document proposes to require a disclosure pertaining to coverage and cost-sharing requirements for 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. These proposed rules would not modify Federal conscience protections related to contraceptive coverage for employers, plans and issuers.
Key facts
- Document number
- 2024-24675
- Type
- Proposed rule
- Action
- Proposed rule
- Agency
- Treasury Department; Internal Revenue Service; Labor Department; Employee Benefits Security Administration; Health and Human Services Department
- Published
- October 28, 2024
- Comments due
- December 27, 2024
- Dates
- To be assured consideration, comments must be received at one of the addresses provided below by December 27, 2024.
- Docket
- REG-110878-24; CMS 9887-P
- Regulation ID (RIN)
- 0938-AV57; 1210-AC25; 1545-BR35
- Code of Federal Regulations
- 26 CFR 54; 29 CFR 2590; 45 CFR 147
- Topics
- Employee benefit plans; Excise taxes; Health care; Health insurance; Pensions; Reporting and recordkeeping requirements
- Pages
- 46
Other documents from the Health and Human Services Department
Everything from the Health and Human Services Department · Rules on employee benefit plans · Rules on excise taxes · Rules on health care · Published in October 2024
Read from the Federal Register API, last updated 2026-10-23. The document on federalregister.gov is the official record; dates and dockets can change through later corrections. Free to reuse with credit to SpecStream under CC BY 4.0.