December 27, 2024 Submitted via Regulations.gov

The time it takes to obtain a prescription—and sometimes, the total lack of clinic availability on weekends—can materially reduce the efficacy of covering this form of contraception.14 Due to these and other barriers (e.g., low levels of trust in the health care system), members of vulnerable communities still struggle to access reliable and affordable contraception and continue to experience poor. [...] For example, in response to your 2023 RFI regarding coverage of OTC preventive services,53 Northwest Health Law Advocates referred to a case in which a Washington managed care organization denied a claim for an OTC emergency contraceptive, which should have been covered because the generic version of the drug wasn’t available.54 The patient in that case paid out-of-pocket because, due to the time-. [...] Power to Decide’s analysis revealed that many consumers “view a denial letter as an authoritative statement,” so that “[o]nly the most knowledgeable and determined consumers [are] able to successfully navigate a path to the no-cost coverage they are owed.”57 This is despite the fact that plans deny contraception coverage requests at an error rate of up to 80%, and are especially likely to issue er. [...] In the NPRM, the Departments express their intention to “strike a balance between ensuring participants, beneficiaries, and enrollees do not face undue barriers to accessing their coverage of recommended preventive services as required by law and allowing plans and issuers to contain costs, promote efficient delivery of care, and minimize risks of fraud, waste, and abuse.”66 We offer several recom. [...] As we outlined above, the socioeconomic and health equity value of this NPRM comes from its ability to mitigate the barriers of cost, privacy, and convenience, which currently lead to inequities in contraceptive access and thereby contribute to poor health and social outcomes for vulnerable groups.