August 15, 2023
Effective August 7, 2023, carriers and PBMs must provide coverage for the single dispensing or furnishing of contraception intended to last for a duration of 12 months (as permitted by the covered person's prescription) and dispensed or furnished at one time unless requested otherwise by a covered person.
Carriers and PBMs are also:
- Prohibited from implementing utilization management practices that prevent compliance with the 12-month mandate.
- Required to allow for alternate prescribed contraception, if medically necessary.
- Required to provide coverage for over-the-counter contraception without a prescription and without prior authorization, step therapy, utilization management, or cost-sharing.
Employers should contact their carriers or PBMs for further information.