Notice2021-26700
Additional Comment Period for Updated HRSA-Supported Women's Preventive Services Guidelines Statement on Breastfeeding Services and Supplies
Primary source
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Published
December 10, 2021
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
On August 20, 2021, HRSA published a notice soliciting public comments regarding proposed updated draft recommendations to the HRSA- Supported Women's Preventive Services Guidelines (Guidelines) in the areas of Well-Women Preventive Visits, Counseling for Sexually Transmitted Infections, and Breastfeeding Services and Supplies, which, when accepted by HRSA, are required to be covered without cost-sharing by certain health insurance issuers under the Public Health Service Act. The updated draft recommendation statements were developed through a national cooperative agreement, the Women's Preventive Services Initiative (WPSI), by the American College of Obstetricians and Gynecologists (ACOG). Since the publication of that notice, WPSI has further updated its recommendation statement on Breastfeeding Services and Supplies. HRSA encourages members of the public to review this revised updated recommendation statement and provide comments for consideration.
Full Text
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<title>Federal Register, Volume 86 Issue 235 (Friday, December 10, 2021)</title>
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[Federal Register Volume 86, Number 235 (Friday, December 10, 2021)]
[Notices]
[Pages 70509-70510]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2021-26700]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Additional Comment Period for Updated HRSA-Supported Women's
Preventive Services Guidelines Statement on Breastfeeding Services and
Supplies
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
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SUMMARY: On August 20, 2021, HRSA published a notice soliciting public
comments regarding proposed updated draft recommendations to the HRSA-
Supported Women's Preventive Services Guidelines (Guidelines) in the
areas of Well-Women Preventive Visits, Counseling for Sexually
Transmitted Infections, and Breastfeeding Services and Supplies, which,
when accepted by HRSA, are required to be covered without cost-sharing
by certain health insurance issuers under the Public Health Service
Act. The updated draft recommendation statements were developed through
a national cooperative agreement, the Women's Preventive Services
Initiative (WPSI), by
[[Page 70510]]
the American College of Obstetricians and Gynecologists (ACOG). Since
the publication of that notice, WPSI has further updated its
recommendation statement on Breastfeeding Services and Supplies. HRSA
encourages members of the public to review this revised updated
recommendation statement and provide comments for consideration.
DATES: Members of the public are invited to provide written comments no
later than December 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#9cebf9f0f0ebf3f1fdf2fffdeef9dcf4eeeffdb2fbf3ea"><span class="__cf_email__" data-cfemail="1760727b7b60787a767974766572577f65647639707861">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: HRSA established the Guidelines in 2011
based on a study and 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. 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
health insurance issuers. Since 2011, there have been advancements in
science and gaps identified in these guidelines, including a greater
emphasis on practice-based clinical considerations. Accordingly, since
March 2016, HRSA has supported cooperative agreements with ACOG to
convene a coalition representing clinicians, academics, and consumer-
focused health professional organizations to conduct a rigorous review
of current scientific evidence and make recommendations to HRSA
regarding updates to the Guidelines to improve adult women's health
across the lifespan. HRSA then decides whether to support, in whole or
in part, the recommended updates to the Guidelines. Under the
cooperative agreement, ACOG formed WPSI, consisting of an Advisory
Panel and two expert committees, the Multidisciplinary Steering
Committee (MSC) and the Dissemination and Implementation Steering
Committee (DISC), which are comprised of a broad coalition of
organizational representatives who are experts in disease prevention
and women's health issues. Through oversight by the Advisory Panel, MSC
supports the development and implementation of the Guidelines through
the review of existing evidence and recommendation development.
Specifically, the MSC examines the evidence to develop new and update
existing recommendations for women's preventive services. DISC takes
the HRSA-approved recommendations, developed by the MSC, and works to
disseminate them through the development of implementation tools and
resources for both patients and practitioners.
In March 2021, ACOG engaged in a process to consider and review new
information and evidence to determine whether to recommend updates to
the Guidelines. ACOG 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, as well as external reviews.
Additionally, ACOG incorporates processes to assure opportunity for
public comment, including participation by patients and consumers, in
the development of the updated Guideline recommendations.
This notice solicits comments from the public on a revised draft
recommendation statement on Breastfeeding Supplies and Services. The
updated draft recommendation statement that was published on August 20,
2021 and the revised recommendation statement that HRSA recently
received from ACOG are provided below. WPSI will consider and, as
necessary, incorporate additional public comment in its recommendation
statement. HRSA will then decide whether to support, in whole or in
part, the recommended updates to the Guidelines.
Clinical Recommendation Statement as Published on August 20, 2021
The MSC updated clinical recommendation included consultative
services to 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.''
Revised Clinical Recommendation Statement
The MSC has made two further updates to the clinical recommendation
statement for breastfeeding. The first addresses provider type in the
provision of breastfeeding services to reflect that breastfeeding
education can be provided by clinicians and through peer support
services. The second update moves a paragraph on breastfeeding
equipment and supplies from the implementation section of the guideline
into the clinical recommendation component, making it a substantive
addition to the Guidelines with corresponding effect under Section
2713. As revised, the clinical recommendation statement provides: ``The
WPSI recommends comprehensive lactation support services (including
consultation; counseling; education by clinicians and peer support
services; and breastfeeding equipment and supplies) during the
antenatal, perinatal, and postpartum periods to optimize the successful
initiation and maintenance of breastfeeding. Breastfeeding equipment
and supplies include, but are not limited to, double electric breast
pumps (including pump parts and maintenance) and breast milk storage
supplies. Access to double electric pumps should be a priority to
optimize breastfeeding and should not be predicated on prior failure of
a manual pump. Breastfeeding equipment may also include equipment and
supplies as clinically indicated to support dyads with breastfeeding
difficulties and those who need additional services.''
Members of the public can view the complete revised 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. 2021-26700 Filed 12-9-21; 8:45 am]
BILLING CODE 4165-15-P
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