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CMS drafts birth control mandate exemption process

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The Centers for Medicare & Medicaid Services (CMS) says nonprofit religious employers that object to providing birth control benefits should be able to certify that they are eligible for a mandate exemption themselves.

The organizations that self-certify would have to keep the self-certification on file, but they need not send self-certification forms to CMS, the U.S. Department of Health and Human Services (HHS), or other federal agencies, CMS officials say in a routine paperwork review document describing the self-certification process. Officials also filed review documents for a related model notice.

Eligible organizations would have to keep the self-certification form on file for six years, and they would have to make the form available for examination upon request. Officials say some commenters on a draft posted in 2013 thought HHS and other federal departments should require organizations to file the self-certification forms with the government. 

“The departments believe that the requirement to make the self-certification available for examination upon request appropriately balances regulators’, issuers, and plan participants’ and beneficiaries’…interest in verifying compliance and eligible organizations’ interest in avoiding undue inquiry into their character, mission or practices,” officials say.

The U.S. Supreme Court recently gave Wheaton College and 121 other nonprofit religious schools and hospitals permission to avoid complying with a HHS birth control benefits mandate while a suit over the mandate is in progress. HHS — the parent of CMS — has developed interim final regulations that let “eligible organizations” notify HHS that they are exempt from the mandate. HHS said it will work with the Employee Benefits Security Administration (EBSA) to provide free birth control benefits for enrollees in those organizations’ plans, without requiring any other payments from or actions by the eligible organizations.

See also: HHS proposes birth control mandate compromise

CMS — an arm of HHS — believes that Wheaton and the 121 other plaintiffs that joined in its suit will use the self-certification process, but it has no information about how many other organizations will use the eligibility self-certification process, officials say.

The Patient Protection and Affordable Care Act (PPACA) requires non-grandfathered major medical plans to cover a basic package of preventive services without imposing co-payments, deductibles or coinsurance payment requirements on the insureds. Kathleen Sebelius, the former HHS secretary, put a birth control benefits mandate in the package by accepting an HHS Health Resources and Services Administration (HRSA) recommendation for doing so.