Health Care Reform Provisions Related to Women’s Health
By Nancy Campbell, Greg Gautam and Kim Magyar
On April 2, 2010, Snell & Wilmer published a Health Care Reform Alert which provided employers with a timeline summarizing key features of the Patient Protection and Affordable Care Act as amended by the Health Care & Education Affordability Reconciliation Act (collectively, the “Act”). To help our clients and friends understand the specifics of the Act, Snell & Wilmer’s Health Care Reform Team is publishing a series of Alerts that touch on select provisions of the Act. This Alert discusses certain provisions of the Act that relate to women’s health issues.
Women’s Preventive Care Coverage
Section 2713 of the Act requires employer sponsored group health plans that are adopted after March 23, 2010 to provide certain preventive coverage without cost to covered employees (e.g., no copayment or co-insurance). Among other things, the preventive coverage must include comprehensive preventive care and screenings for women. According to Senator Barbara Mikulski (D-MD), the author of the women’s preventive care amendment, services for women will include certain osteoporosis screenings, cervical cancer screenings, annual mammograms for women over 40, pregnancy and postpartum depression screenings, screenings for domestic violence, and annual women’s health screening and family planning services. The Act directs the Health Resources and Services Administration to adopt guidelines specifying the preventive care that will be available to women. This provision is effective for plan years beginning on or after September 23, 2010 (i.e. January 1, 2011 for calendar year plans).
Access to Obstetrical and Gynecological Care
Section 2719A of the Act provides that group health plans cannot require women to obtain pre-authorization or referrals from a plan, or any person (including primary care providers) prior to receiving obstetrical or gynecological care from participating health care professionals that specialize in obstetrics or gynecology. This provision is effective for plan years beginning on or after September 23, 2010 (i.e. January 1, 2011 for calendar year plans). This provision of the Act does not apply to plans in existence as of March 23, 2010.
Employers Must Provide Reasonable Break Time for Nursing Mothers
Section 4207 of the Act amends the Fair Labor Standards Act to require employers with 50 or more employees to provide, at a minimum, unpaid, reasonable break time for nursing mothers until their infants are up to one year old. Employers with less than 50 employees are not subject to this requirement if providing reasonable breaks would impose an undue hardship by causing the employer “significant difficulty or expense.” Although the Act does not define what constitutes “reasonable break time,” it does provide that the breaks must be given each time an employee needs to express milk. The Act also requires employers to provide a private location, other than a restroom, for mothers to express milk. The location must be shielded from view and free from intrusion from co-workers and the public. The Act does not specify the effective date of this provision so it appears that it became effective on March 23, 2010.
If you have questions about the subject of this Alert or would like more information on the Act, you may contact the authors, your Snell & Wilmer attorney, any member of Snell & Wilmer's Health Care Reform Team listed below, or any of the members of the Snell & Wilmer Employee Benefits Group.
[Back to Top]