Notice2021-17826
Updated HRSA-Supported Women's Preventive Services Guidelines: Well-Women Preventive Visits, Counseling for Sexually Transmitted Infections, and Breastfeeding Services and Supplies
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Published
August 20, 2021
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
This notice seeks comments on an updated draft recommendation for Well-Woman Preventive Visits, Counseling for Sexually Transmitted Infections, and Breastfeeding Services and Supplies, as part of the HRSA-supported Women's Preventive Services Guidelines. This updated draft recommendation has been developed through a national cooperative agreement, the Women's Preventive Services Initiative (WPSI), by the American College of Obstetricians and Gynecologists (ACOG). Under the Public Health Service Act, as added by the Patient Protection and Affordable Care Act, non-grandfathered group health plans and non- grandfathered group and individual health insurance issuers must include coverage, without cost sharing, for certain preventive services under that section, including those provided for in the HRSA-supported Women's Preventive Services Guidelines (Guidelines).
Full Text
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<title>Federal Register, Volume 86 Issue 159 (Friday, August 20, 2021)</title>
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[Federal Register Volume 86, Number 159 (Friday, August 20, 2021)]
[Notices]
[Pages 46856-46857]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-17826]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Updated HRSA-Supported Women's Preventive Services Guidelines:
Well-Women Preventive Visits, Counseling for Sexually Transmitted
Infections, and Breastfeeding Services and Supplies
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: This notice seeks comments on an updated draft recommendation
for Well-Woman Preventive Visits, Counseling for Sexually Transmitted
Infections, and Breastfeeding Services and Supplies, as part of the
HRSA-supported Women's Preventive Services Guidelines. This updated
draft recommendation has been developed through a national cooperative
agreement, the Women's Preventive Services Initiative (WPSI), by the
American College of Obstetricians and Gynecologists (ACOG). Under the
Public Health Service Act, as added by the Patient Protection and
Affordable Care Act, non-grandfathered group health plans and non-
grandfathered group and individual health insurance issuers must
include coverage, without cost sharing, for certain preventive services
under that section, including those provided for in the HRSA-supported
Women's Preventive Services Guidelines (Guidelines).
DATES: Members of the public are invited to provide written comments no
later than September 20, 2021. All comments received on or before this
date will be reviewed and considered by the WPSI Multidisciplinary
Steering Committee.
ADDRESSES: Members of the public interested in providing comments on
the draft recommendation statements can do so by accessing the
initiative's web page at <a href="https://www.womenspreventivehealth.org/">https://www.womenspreventivehealth.org/</a>.
FOR FURTHER INFORMATION CONTACT: Kimberly Sherman, HRSA, Maternal and
Child Health Bureau, telephone (301) 443-8283, email:
<a href="/cdn-cgi/l/email-protection#1562707979627a78747b76746770557d6766743b727a63"><span class="__cf_email__" data-cfemail="7700121b1b00181a161914160512371f05041659101801">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The HRSA-supported Women's Preventive
Services Guidelines were originally established in 2011 based on a
study and recommendations by the Institute of Medicine, now known as
the National Academy of Medicine, commissioned by HHS. Since then,
there have been advancements in science and gaps identified in these
guidelines, including a greater emphasis on practice-based clinical
considerations. In March 2016, HRSA awarded a 5-year cooperative
agreement to convene a coalition representing clinicians, academics,
and consumer-focused health professional organizations to conduct a
rigorous review of current scientific evidence and recommend updates to
existing guidelines. The ACOG was awarded the cooperative agreement and
formed the WPSI, which consists of an Advisory Panel and two expert
committees; the Multidisciplinary Steering Committee (MSC) and the
Dissemination and Implementation Steering Committee, to improve adult
women's health across the lifespan by engaging a coalition of health
professional organizations to review evidence and recommend updates to
the HRSA-supported Women's Preventive Services Guidelines. HRSA would
then decide whether or not to support, in whole or
[[Page 46857]]
in part, the recommended updates to the Guidelines.
In March 2021, ACOG was awarded a subsequent cooperative agreement
to further review and recommend updates to the Guidelines. As the award
recipient, starting on March 1, 2021, ACOG has engaged in a process to
consider and review new information developed by a multidisciplinary
group of women's health professional organizations. Following
recommendations by ACOG, HRSA will decide whether to support, in whole
or in part, the recommended updates to the guidelines.
As part of this cooperative agreement, ACOG is required to base its
recommended updates to the Guidelines on review and synthesis of
existing clinical guidelines and new scientific evidence. The National
Academy of Medicine standards for establishing foundations for and
rating strengths of recommendations, articulation of recommendations,
as well as external reviews are to be met in developing these
guidelines. Additionally, processes are to be incorporated to assure
opportunity for public input and transparency, including participation
by patients and consumers, in the development of the updated Guideline
recommendations.
This notice solicits comments from the public on the draft
recommendation statements for the Well-Woman Preventive Visits,
Counseling for Sexually Transmitted Infections, and Breastfeeding
Services and Supplies. The updated draft clinical recommendation
statements are provided below:
Well Woman Preventive Visits
The MSC has updated the clinical recommendation statement to
reflect that recommended services may be completed at a single visit or
as part of a series of preventive health visits that take place over
time to obtain the necessary services. Well Women Visits have also been
further defined to include pre-pregnancy, prenatal, and interpregnancy
visits.
``The WPSI recommends that women receive at least one preventive
care visit per year beginning in adolescence and continuing across
the lifespan to ensure the provision of all recommended preventive
services. These services may be completed at a single visit or as
part of a series of visits that take place over time to obtain all
necessary services depending on a woman's age, health status,
reproductive health needs, pregnancy status, and risk factors. Well
women visits include pre-pregnancy, prenatal, and interpregnancy
visits. The primary purpose of well-woman visits is the delivery and
coordination of all recommended preventive services as determined by
age and risk factors.''
Counseling for Sexually Transmitted Infections
The MSC has made minor updates to the counseling for sexually
transmitted infections statement to include a review of a women's
sexual history, and modified the risk factor list by stating that risk
factors are ``not limited to'' the areas indicated.
``The WPSI recommends directed behavioral counseling by a health
care provider or other appropriately trained individual for sexually
active adolescent and adult women at an increased risk for sexually
transmitted infections (STIs).
The WPSI recommends that health care providers review a woman's
sexual history and risk factors to help identify those at an
increased risk of STIs. Risk factors include but are not limited to
age younger than 25 years, a recent history of an STI, a new sex
partner, multiple partners, a partner with concurrent partners, a
partner with an STI, and a lack of or inconsistent condom use. For
adolescents and women not identified as high risk, counseling to
reduce the risk of STIs should be considered, as determined by
clinical judgment.''
Breastfeeding Services and Supplies
The MSC has updated the clinical recommendation to include
consultative services that will optimize successful initiation and
maintenance of breastfeeding.
``The WPSI recommends comprehensive lactation support services
(including consultation, counseling, education, and breastfeeding
equipment and supplies) during the antenatal, perinatal, and
postpartum periods to optimize the successful initiation and
maintenance of breastfeeding.''
Members of the public can view each complete updated draft
recommendation statement by accessing the initiative's web page at
<a href="https://www.womenspreventivehealth.org/">https://www.womenspreventivehealth.org/</a>.
Diana Espinosa,
Acting Administrator.
[FR Doc. 2021-17826 Filed 8-19-21; 8:45 am]
BILLING CODE 4165-15-P
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