On September 29, the Centers for Medicare & Medicaid Services (CMS) reported that the federal Departments of Health and Human Services, Labor, and the Treasury departments are seeking public input on the possibility of ensuring coverage and access to over-the-counter (OTC) preventive services without cost-sharing or a prescription from a healthcare provider. This Request for Information (RFI) invites comments on a range of OTC preventive items, such as contraceptives, smoking cessation products, folic acid used during pregnancy, and breastfeeding supplies.
Under the Affordable Care Act, many health plans must cover recommended preventive services at no cost to the consumer. Some of these services, though available without a prescription, currently require cost-sharing unless prescribed. The RFI aims to assess the potential challenges and benefits for various stakeholders, including consumers, insurers, pharmacies, and healthcare providers, in providing free coverage for recommended OTC preventive products without a prescription. These Departments emphasize their commitment to ensuring access to affordable preventive care for all.
The RFI aligns with this Administration's overarching goal to promote healthcare access and address health equity. Providing affordable, evidence-based preventive items and services is seen as crucial. This RFI acts in furtherance of the President’s existing executive orders on improving access to contraception, strengthening Medicaid and the Affordable Care Act, and enhancing access to quality healthcare coverage.
These Departments expect that feedback received in response to the RFI will inform their understanding of how requiring coverage for OTC preventive products, without cost-sharing or a prescription, may impact health equity, particularly in addressing systemic racism and historical inequities for women and LGBTQIA communities. The public has a 60-day window to provide comments for consideration.