Proposed Rules – Expanding Preventive Contraceptive Coverage for 2026
· Oct 25, 2024
The agencies released proposed guidance that could go into effect for 2026 plan years if finalized. The proposed rules address expanding OTC contraceptive coverage and reasonable medical management techniques. A Fact Sheet for the proposed rules can be found here.
A summary of the Proposed Rules can be found below.
In addition, the proposed rules would require that all price comparison tools (internet-based, self-service tools for comparing the prices of all covered items and services required by the Transparency in Coverage rules) include a disclosure explaining that OTC contraceptive items are covered with no cost-sharing without requiring a prescription along with a phone number and hyperlink to where more information is available about the plan’s contraception coverage.
No action is needed at this time. IMA Compliance will be sure to publish any updates.
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