On July 10, 2015, final regulations on the Affordable Care Act’s (ACA) women’s preventive care coverage requirement were released. The ACA requires non-grandfathered health plans to provide coverage for preventive health services for women, including contraceptives, without imposing cost-sharing requirements.
The final rule finalizes an accommodation for eligible nonprofit organizations and for-profit businesses that have religious objections to providing contraceptive coverage to female employees.
Organizations that are eligible for the accommodation will not be directly involved in providing contraceptive coverage to female employees. Instead, contraceptive services will be paid for directly by an independent third party, such as an insurance company or third-party administrator (TPA).
Organizations and employers seeking exemption from the contraceptive coverage requirement must either self-certify that they meet the eligibility criteria or notify HHS in writing of their religious objection to providing contraceptive coverage (instead of providing the self-certification to the plan’s issuer or TPA).
The final rules define the for-profit businesses that are eligible for the accommodation based on ownership structure, and they outline the documentation that must be adopted to qualify for the exemption. The rules also require for-profit businesses to make their self-certification or notice of objection available for examination upon request.
The final rules also contain clarifications on several topics, including the scope of recommended preventive services, the treatment of office visits, the services delivered by out-of-network providers, the permitted reasonable medical management techniques, the cost-sharing for other services and the timing of changes