Administration Proposes Rules on OTC Contraception and Utilization Management in Preventive Care

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On October 21, the Departments of Health and Human Services (HHS), Labor, and the Treasury (the Departments) issued a proposed rule on permissible utilization management techniques for preventive services and the required coverage of over-the-counter (OTC) contraceptives without cost-sharing, in non-grandfathered group health plans or individual or group health insurance coverage (the Departments refer to utilization management as “medical management”). Comments on the proposed rule are due December 27, 60 days after its anticipated October 28 publication in the Federal Register. Given the timing, there is a low likelihood the rule could be finalized prior to the end of President Biden’s term.

In addition to the proposed rule, the Departments issued updated Frequently Asked Questions on preventive services. Additionally, the Internal Revenue Service released guidance indicating that condoms qualify as a deductible medical expense and that OTC contraceptives and certain other benefits can be covered by high deductible health plans prior to meeting the plan’s deductible.
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