Navigation Links
Academy of Managed Care Pharmacy (AMCP) Helps Explain Health Care Law's Contraception Coverage Provision

ALEXANDRIA, Va., Aug. 13, 2012 /PRNewswire-USNewswire/ -- Millions of Americans are now able to obtain their birth control products at no out-of-pocket costs under a provision in the Affordable Care Act (ACA) that requires employers and insurers to offer contraceptive coverage and certain other preventive health services with no patient copayment, coinsurance or deductible. Government rules, however, may allow for some restrictions on which birth control products can be obtained, including condoms and brand name contraceptives, according to the Academy of Managed Care Pharmacy (AMCP).

The contraceptive-coverage provision, which started Aug. 1, will take effect for individual policy holders as their health benefits renew over the next 12 months.

The Academy, meanwhile, has asked for guidance from the Department of Health and Human Services (HHS) to further clarify the provision as it relates to over-the-counter (OTC) contraceptives.

According to HHS's March 21, 2012, interim guidelines, coverage is required without patient cost sharing, for "all Food and Drug Administration (FDA) approved contraceptive methods, sterilization procedures, and patient education and counseling for all women with reproductive capacity," as prescribed by a provider.

A footnote in the HHS guidelines, however, indicates: "this excludes items and services such as vasectomies and condoms."

Although the footnote provides some guidance on the issue, the Academy has asked HHS to further clarify the regulations to state that health plans be mandated only to cover products that require a prescription by a duly licensed health care provider. AMCP also has asked HHS to clearly state in the regulations themselves that coverage of OTC products is not mandated, rather than simply mention these exclusions in a footnote.

The Academy supports this exclusion, said AMCP Chief Executive Officer Edith A. Rosato, RPh, IOM. "Coverage of all FDA-approved contraceptives, including OTC contraceptives, would not be a prudent course of action," she said. "OTC contraceptives are typically purchased on-demand rather than through prescription channels that involve physicians, pharmacists, and health plans as payers."

On another point of clarification, the HHS rules allow for some prudent restrictions on access to expensive brand-name contraceptives, according to AMCP.

The HHS guidance indicates "…nothing prevents a plan or issuer from using reasonable medical management techniques to determine the frequency, method, treatment, or setting for an item or service…to the extent not specified in the recommendation or guideline."

Rosato said, "The Academy is pleased that health plans may use appropriate medical management, including formulary decision-making processes, to determine the most appropriate array of oral contraceptive products to be included for coverage. This would allow health plans to select generic contraceptives over more expensive brand name products to fulfill this requirement."

More than 90 oral contraceptive options are currently available, according to the American Congress of Obstetricians and Gynecologists, and many of the brand-name products have generic alternatives. Generics are up to 70 percent less expensive than branded varieties.

"Mandated coverage of branded contraceptives with no copay is unnecessary since many generic contraceptive options are available, and all approved contraceptives are comparably effective," Rosato said. "Effective use of health care resources can minimize overall medical costs, improve patient access to more affordable care and provide an improved quality of life."

To read AMCP's June 13, 2012, comment letter to HHS on this topic, visit

About AMCP

The Academy of Managed Care Pharmacy (AMCP) is a national professional association of pharmacists and other health care practitioners who serve society by the application of sound medication management principles and strategies to improve health care for all. The Academy's more than 6,500 members develop and provide a diversified range of clinical, educational and business management services and strategies on behalf of the more than 200 million Americans covered by a managed care pharmacy benefit. AMCP will celebrate its 25th anniversary in 2013. More news and information about AMCP can be obtained on its website, at

SOURCE Academy of Managed Care Pharmacy
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. Beverly Hills Dentist, Dr. Zadeh, Receives 2011 Mastership Award from the Academy of General Dentistry
2. American Academy of Pain Medicine Applauds FDA Action to Enhance Patient Safety on Prescribing Opioids; Offers AAPM Safe Opioid Prescribing Course as Educational Model
3. Safe in Common to Exhibit at American Academy of Nurse Practitioners 27th National Conference
4. Interim results of VITOBA™ (VImpaT® added to One Baseline AED) Study Presented at the 64th Annual Meeting of the American Academy of Neurology
5. American Academy of Family Physicians Foundation Launches Cities for Life
6. Academy of Managed Care Pharmacy (AMCP) Installs 2012-2013 Board of Directors
7. New Managed Markets E-Learning Courses From Pharmaceutical Institute Offer a Complete Public Payer Perspective
8. Texas Medicaid Managed-Care Problems Gaining National Attention
9. Foundation for Managed Care Pharmacy (FMCP) Presents Awards for 2012 National P&T Competition and Best Posters
10. Online Pharmacy Domain Policy Changes Announced by ICANN Registrar Corp.
11. URAC sets standards for community pharmacy, advances dialogue about pharmacists as medication experts
Post Your Comments:
(Date:11/24/2015)... , Nueva York , 24 ... Devices (ABD), fabricante del Avery Breathing Pacemaker System, ... Jonzon , MD; Ph.D. como consultor clínico. ...   --> Foto - ... El doctor Jonzon es un fisiólogo y ...
(Date:11/24/2015)...  DILON Diagnostics and GE Healthcare are pleased to ... to distribute GE,s Discovery NM750b Molecular Breast Imaging system ... distribution agreement will provide Dilon,s experienced distribution network access ... is considered an initial step in an ongoing exploration ... and their patients. --> ...
(Date:11/24/2015)... -- Sectra (STO: SECT B) announces that ... multi-year agreement to deploy Breast Imaging PACS in ... the Breast Center a future-proof platform capable of expanding with ... announces that Breast Center of Acadiana has entered ... PACS in its two freestanding imaging centers. This investment will ...
Breaking Medicine Technology:
(Date:11/24/2015)... Port Richey, FL (PRWEB) , ... November 24, 2015 , ... ... it deems a growing epidemic as deaths from prescription opioids in the United States ... heroin and cocaine. In 2013 alone, opioids were involved in 37 percent of all ...
(Date:11/24/2015)... ... November 24, 2015 , ... American Family Care (AFC), ... opening of a holiday pop-up clinic located in Metro Atlanta’s North Point Mall. The ... new and different way. The location is scheduled to operate through Dec. 24. , ...
(Date:11/24/2015)... ... November 24, 2015 , ... Cold Shoulder , LLC launched their Pro Vest, the latest ... hit their goal of $20,000 in under 10 hours. , The campaign, ... PRO Weight Loss Vest to the market. , The PRO Vest provides consumers with a ...
(Date:11/24/2015)... Baltimore, M.D. (PRWEB) , ... November 24, 2015 ... ... a new award for its exceptional customer service: the TrustDale certification. The award ... experience. The Baltimore stone honing , tile and grout, and hard surface ...
(Date:11/24/2015)... ... November 24, 2015 , ... Dr. Kevin Day, local family chiropractor ... stress less this holiday season. During the Indiana winter months, Vitamin D deficiency ... the team at AlignLife want to help provide the tools needed to combat it ...
Breaking Medicine News(10 mins):