On Friday, President Obama announced that the administration would compromise on the preventive services final rule. The final rule, an update to the interim final rule released in August, would have required religiously affiliated entities to cover contraceptive care without any cost-sharing requirements. The new final rules mandate that nonprofit organizations affiliated with religious institutions that do not cover contraception based on their beliefs will not have to include it in their coverage. However, health insurers that provide the policies used by those nonprofit religious affiliates, which include educational institutions, hospitals, and charities, are required to offer separate insurance policy “riders” that cover contraceptive care at no additional cost. The announcement came after many Catholic organizations and Republicans had strongly objected to the original final rule that the Department of Health and Human Services had announced on January 20th.

On December 16, 2011, the HHS Center for Consumer Information and Insurance Oversight (CCIIO) released an Essential Health Benefits Bulletin, whose purpose is to “provide information and solicit comments on the regulatory approach that the Department of Health and Human Services (HHS) plans to propose to define essential health benefits under section 1302 of the Affordable Care Act.” Comments on the Bulletin can be sent directly to EssentialHealthBenefits@cms.hhs.gov and will be accepted until January 31, 2011

The U.S. Department of Health and Human Services (HHS) has issued a pre-rule informational Bulletin which lays out its proposed approach for determining the Essential Benefits package required of all qualified health plans (QHPs) under the Affordable Care Act (ACA). HHS deferred to States' judgment by allowing a State to create a benchmark essential benefits package from a currently-available plan within the State, as long as the package includes benefits from the ten benefit categories laid out in the ACA. HHS proposes that States choose the benchmark plan from a list of plan types:

• One of the three largest small group plans in the State by enrollment
• One of the three largest State employee health plans by enrollment
• One of the three largest federal employee health plan options by enrollment
• The largest HMO plan offered in the State’s commercial market by enrollment

If a State does not select a benchmark plan, HHS intends to propose that the default benchmark be the benefits package from the largest small group plan within the State. For more information on Essential Benefits, click here.

The U.S. Department of Health and Human Services (HHS) has issued an amended version of the previous Interim Final Rule on the coverage of preventive services by group health plans and health insurance issuers under the Affordable Care Act (ACA). The amended rule reflects recent recommendations by the Institute of Medicine (IOM) regarding particular preventive services for women that should be covered at no cost by insurance companies. Services include screening and counseling for certain sexually transmitted infections, screening for gestational diabetes, and among others, counseling and contraception to prevent unintended pregnancies. The Internal Revenue Service has also issued an amended rule that reflects the coverage of these preventive services. *** On August 3, 2011, HHS issued an amendment to the amended IFR, further clarifying the expemption of religious organizations from the contraception coverage requirement. For more information on prevention, click here.