Notice2023-21514
Notice of Request for Public Comments on a Draft Recommendation To Update the HRSA-Supported Women's Preventive Services Guideline Relating to Screening for Urinary Incontinence
Primary source
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Published
September 29, 2023
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
This notice seeks comments on a draft recommendation to update the HRSA-supported Women's Preventive Services Guidelines ("Guidelines") relating to Screening for Urinary Incontinence. This draft recommendation has been developed through a cooperative agreement, known as the Women's Preventive Services Initiative (WPSI), with the American College of Obstetricians and Gynecologists (ACOG), through which they convene health professionals to develop draft recommendations. Under applicable law, non-grandfathered group health plans and health insurance issuers must include coverage, without cost sharing, for certain preventive services, including those provided for in the HRSA-supported Guidelines. The Departments of Labor, Health and Human Services, and Treasury have previously issued regulations, which describe how group health plans and health insurance issuers apply the coverage requirements.
Full Text
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<title>Federal Register, Volume 88 Issue 188 (Friday, September 29, 2023)</title>
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[Federal Register Volume 88, Number 188 (Friday, September 29, 2023)]
[Notices]
[Pages 67318-67319]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-21514]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Notice of Request for Public Comments on a Draft Recommendation
To Update the HRSA-Supported Women's Preventive Services Guideline
Relating to Screening for Urinary Incontinence
AGENCY: Health Resources and Services Administration (HRSA), U. S.
Department of Health and Human Services.
ACTION: Notice.
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SUMMARY: This notice seeks comments on a draft recommendation to update
the HRSA-supported Women's Preventive Services Guidelines
(``Guidelines'') relating to Screening for Urinary Incontinence. This
draft recommendation has been developed through a cooperative
agreement, known as the Women's Preventive Services Initiative (WPSI),
with the American College of Obstetricians and Gynecologists (ACOG),
through which they convene health professionals to develop draft
recommendations. Under applicable law, non-grandfathered group health
plans and health insurance issuers must include coverage, without cost
sharing, for certain preventive services, including those provided for
in the HRSA-supported Guidelines. The Departments of Labor, Health and
Human Services, and Treasury have previously issued regulations, which
describe how group health plans and health insurance issuers apply the
coverage requirements.
DATES: Members of the public are invited to provide written comments no
later than October 30, 2023. All comments received on or before this
date will be reviewed and considered by WPSI and provided for further
consideration by HRSA in determining the recommended update that it
will support.
ADDRESSES: Members of the public who wish to provide comments can do so
by accessing the public comment 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#0176646d6d766e6c606f6260736441697372602f666e77"><span class="__cf_email__" data-cfemail="f483919898839b99959a97958691b49c868795da939b82">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: 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 group health plans and
health insurance issuers. HRSA established the Guidelines in 2011 based
on expert 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. Since 2011, there have been
advancements in science and gaps identified in these guidelines,
including a greater emphasis on practice-based clinical considerations.
Since 2016, HRSA has funded cooperative agreements with ACOG for WPSI
to convene a coalition representing clinicians, academics, and
consumer-focused health professional organizations to conduct a
rigorous review of current scientific evidence, solicit and consider
public input, and make recommendations to HRSA regarding updates to the
Guidelines to improve women's health across the lifespan. HRSA then
determines whether to support, in whole or in part, the recommended
updates to the Guidelines. WPSI consists of an Advisory Panel and two
expert committees, the Multidisciplinary Steering Committee and the
Dissemination and Implementation
[[Page 67319]]
Steering Committee, which are comprised of a broad coalition of
organizational representatives who are experts in disease prevention
and women's health issues. With oversight by the Advisory Panel, and
with input from the Multidisciplinary Steering Committee, WPSI examines
the evidence to develop new (and update existing) recommendations for
women's preventive services. WPSI's Dissemination and Implementation
Steering Committee takes HRSA-approved recommendations and disseminates
them through the development of implementation tools and resources for
both patients and practitioners.
WPSI 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, and external reviews. Additionally, HRSA requires
that WPSI incorporate processes to assure opportunity for public
comment, including participation by patients and consumers, in the
development of its recommendations to the updated Guidelines.
The Existing Guideline States
``Screening for Urinary Incontinence
WPSI recommends screening women for urinary incontinence annually.
Screening should ideally assess whether women experience urinary
incontinence and whether it impacts their activities and quality of
life. The Women's Preventive Services Initiative recommends referring
women for further evaluation and treatment if indicated.''
Draft Updated Clinical Recommendation for Public Comment
``Screening for Urinary Incontinence
The Women's Preventive Services Initiative recommends screening
women for urinary incontinence annually. Screening should assess
whether women experience urinary incontinence and whether it impacts
their activities and quality of life. If indicated, facilitating
further evaluation and treatment is recommended.''
Discussion of Draft Updated Clinical Recommendation
WPSI recommended several minor updates to the language of this
Guideline. First, the word ``ideally'' is recommended to be removed
from the second sentence for brevity, and its removal, if accepted by
HRSA, will not substantively change the existing guideline. Second, the
final sentence of the clinical recommendation recommends changing the
word ``referring'' to ``facilitating'' to reflect that clinicians in
practice, after screening for urinary incontinence, may decide to treat
or manage urinary incontinence as part of standard primary care
services or refer to specialists if specialist care is needed. Lastly,
WPSI recommended minor edits to the language of the Guideline for the
purposes of clarity. These minor edits have no substantive effect on
the requirement for coverage without cost-sharing.
Members of the public can view the complete updated draft
recommendation, which includes the implementation considerations and
research recommendations, by accessing the initiative's web page at
<a href="https://www.womenspreventivehealth.org/">https://www.womenspreventivehealth.org/</a>.
Carole Johnson,
Administrator.
[FR Doc. 2023-21514 Filed 9-28-23; 8:45 am]
BILLING CODE 4165-15-P
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