On October 3, 2023, the DOL, HHS, and IRS (the departments) issued a request for information (RFI) regarding the application of preventive services requirements under the ACA to over-the-counter (OTC) preventive items and services available without a prescription.
The RFI focuses on four key areas of information:
- Gathering input from the public regarding the costs and benefits of requiring non-grandfathered group health plans to cover OTC preventive items and services without a prescription and without cost-sharing.
- Seeking comment on any potential challenges associated with providing such coverage.
- Understanding how providing such coverage may benefit consumers.
- Assessing any potential burdens plans or health insurance issuers may face if required to provide such coverage.
While the ACA already requires non-grandfathered group health plans and health insurance issuers offering non-grandfathered group or individual health insurance coverage to cover preventive items and services, most of these preventive services require a healthcare provider to either provide a prescription or directly furnish the service. However, some preventive products are available to consumers OTC, which do not need a prescription from a provider. Examples include some tobacco cessation products, prenatal and breastfeeding supplies, and some oral contraceptives. Most health plans currently do not cover these OTC preventive products without a prescription.
Therefore, the departments have requested comments to better understand how requiring coverage of OTC preventive products may affect health plans and participants. Comments can be submitted no later than 5:00 p.m. ET on December 4, 2023.
Federal Register: Request for Information; Coverage of Over-the-Counter Preventive Services ยป