Notice2023-28970
Update to the Health Resources and Services Administration-Supported Women's Preventive Services Guidelines Relating to Screening for Urinary Incontinence
Primary source
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Published
January 4, 2024
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
A Federal Register notice published on September 29, 2023, detailed and sought public comment on recommendations under development by the Women's Preventive Services Initiative (WPSI), regarding updates to the HRSA-supported Women's Preventive Services Guidelines (Guidelines). The proposed updates specifically related to Screening for Urinary Incontinence. WPSI convenes health professionals to develop draft recommendations for HRSA's consideration. Two public comments were received and considered as detailed below. On December 28, 2023, HRSA accepted as final WPSI's recommended updates to the Screening for Urinary Incontinence guideline. Under applicable law, non-grandfathered group health plans and health insurance issuers offering non- grandfathered group and individual health insurance coverage 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 the Treasury have previously issued regulations describing how group health plans and health insurance issuers apply the coverage requirements. Please see https://www.hrsa.gov/womens-guidelines for additional information.
Full Text
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<title>Federal Register, Volume 89 Issue 3 (Thursday, January 4, 2024)</title>
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[Federal Register Volume 89, Number 3 (Thursday, January 4, 2024)]
[Notices]
[Pages 472-473]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-28970]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Update to the Health Resources and Services Administration-
Supported Women's Preventive Services Guidelines Relating to Screening
for Urinary Incontinence
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services.
ACTION: Notice.
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SUMMARY: A Federal Register notice published on September 29, 2023,
detailed and sought public comment on recommendations under development
by the Women's Preventive Services Initiative (WPSI), regarding updates
to the HRSA-supported Women's Preventive Services Guidelines
(Guidelines). The proposed updates specifically related to Screening
for Urinary Incontinence. WPSI convenes health professionals to develop
draft recommendations for HRSA's consideration. Two public comments
were received and considered as detailed below. On December 28, 2023,
HRSA accepted as final WPSI's recommended updates to the Screening for
Urinary Incontinence guideline. Under applicable law, non-grandfathered
group health plans and health insurance issuers offering non-
grandfathered group and individual health insurance coverage 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
the Treasury have previously issued regulations describing how group
health plans and health insurance issuers apply the coverage
requirements. Please see <a href="https://www.hrsa.gov/womens-guidelines">https://www.hrsa.gov/womens-guidelines</a> for
additional information.
FOR FURTHER INFORMATION CONTACT: Kimberly Sherman, HRSA, Maternal and
Child Health Bureau, telephone: (301) 443-8283, email:
<a href="/cdn-cgi/l/email-protection#ceb9aba2a2b9a1a3afa0adafbcab8ea6bcbdafe0a9a1b8"><span class="__cf_email__" data-cfemail="ccbba9a0a0bba3a1ada2afadbea98ca4bebfade2aba3ba">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: Under the Patient Protection and Affordable
Care Act, Public Law 111-148, 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 2016, HRSA has funded cooperative agreements with
the American College of Obstetricians and Gynecologists for the Women's
Preventive Services Initiative (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
adult women's health across the lifespan. HRSA then determines whether
to support, in whole or in part, the recommended updates to the
Guidelines.
WPSI includes an Advisory Panel and two expert committees, the
Multidisciplinary Steering Committee and the Dissemination and
Implementation 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 the updated Guidelines.
WPSI proposed and HRSA has accepted recommended updates to the
Guideline relating to Screening for Urinary Incontinence, which now
reads, ``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 Recommended Updated Guideline Relating to Screening
for Urinary Incontinence: WPSI recommended minor updates to the
previous Guideline language. The first change is removal of the word
``ideally'' from the second sentence, for clarity. Removal of the word
``ideally'' does not substantively change the Guideline. The second
change is in the final sentence, 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. The change in language
from ``referring'' to ``facilitating'' does not substantively change
the Guideline. Lastly, WPSI recommended minor editorial revisions to
the language of the Guideline, for clarity. These minor editorial
revisions have no substantive effect on the Guideline.
A Federal Register notice published on September 29, 2023, sought
public comment on these proposed updates (88 FR 67318).\1\ WPSI
considered all public comments as part of its deliberative
[[Page 473]]
process and provided the comments to HRSA for its consideration. Two
respondents provided comments during the public comment period. One
commenter suggested improving reimbursement by including billing codes
for screening and counseling. This comment falls outside the scope of
the Guidelines. The other commenter suggested adding the word ``co-
morbidities'' to a WPSI list of potential research topics. This comment
was not accepted as it does not address the recommendation itself, but
rather supporting materials.
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\1\ See <a href="https://www.federalregister.gov/documents/2023/09/29/2023-21514/notice-of-request-for-public-comments-on-a-draft-recommendation-to-update-the-hrsa-supported-womens">https://www.federalregister.gov/documents/2023/09/29/2023-21514/notice-of-request-for-public-comments-on-a-draft-recommendation-to-update-the-hrsa-supported-womens</a>.
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After consideration of public comment, WPSI submitted the
recommended updates for Screening for Urinary Incontinence as detailed
above. On December 28, 2023, the HRSA Administrator accepted WPSI's
recommendations and, as such, updated the Women's Preventive Services
Guidelines. Non-grandfathered group health plans and health insurance
issuers offering group or individual health insurance coverage must
cover without cost-sharing the services and screenings listed on the
updated Women's Preventive Services Guidelines for plan years (in the
individual market, policy years) that begin 1 year after this date.
Thus, for most plans, this update will take effect for purposes of the
Section 2713 coverage requirement in 2025. Additional information
regarding the Women's Preventive Services Guidelines can be accessed at
the following link: <a href="https://www.hrsa.gov/womens-guidelines">https://www.hrsa.gov/womens-guidelines</a>.
Authority: Section 2713(a)(4) of the Public Health Service Act, 42
U.S.C. 300gg-13(a)(4).
Carole Johnson,
Administrator.
[FR Doc. 2023-28970 Filed 1-3-24; 8:45 am]
BILLING CODE 4165-15-P
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