Women's Preventive Health Awareness Campaign

Summary: Women's Preventive Health Awareness Campaign This bill amends the Public Health Service Act to require the Department of Health and Human Services (HHS) to provide for a national public outreach and educational campaign, including a website, to raise awareness of women's preventive health. The campaign must describe guidelines for women's preventive services, promote well-woman visits, explain the women's preventive services that are covered by health insurance without patient cost sharing, and address health disparities. Well-woman visits that a health care provider determines a woman needs in order to obtain all necessary preventive services must be covered by health insurance without patient cost sharing. Health insurers may limit coverage of women's preventive services where guidelines do not specify the frequency, method, treatment, or setting for the services. Cost sharing for a preventive health service provided by an out-of-network provider shall not be imposed if a woman does not have an in-network provider with the capacity to provide the service. For a preventive health service that varies based on the patient's risk of disease, a woman must be treated as being at high risk for a disease if she has a family history of the disease or if a health care provider determines she is at high risk. Requirements are described for women's preventive services coverage of breast cancer susceptibility screening, HIV testing, breastfeeding support, and contraception. HHS must enter into an agreement with the Institute of Medicine (or another entity) to study and recommend the appropriate billing codes for a well-woman visit.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Women's Preventive Health Awareness 
Campaign''.

SEC. 2. FINDINGS.

    Congress makes the following findings:
            (1) Well-woman visits are the foundation on which women's 
        preventive care is built. Such visits include not only specific 
        screening tests, but also a medical history, physical 
        examination, evaluation and counseling, and, as indicated, 
        vaccinations.
            (2) Well-woman visits facilitate increased access to health 
        care that is shown to identify chronic disease risk factors, 
        promote well-being, and decrease the likelihood or delay the 
        onset of a targeted disease or condition.
            (3) Heart disease, stroke, and other cardiovascular 
        diseases are the number one cause of death in American women, 
        responsible for 1 in every 4 female deaths.
            (4) Women are more likely than men to have forgone needed 
        health care due to cost; 1 in 5 women postponed preventive 
        services in the past year due to cost.
            (5) Between 2002 and 2010, screening mammography rates 
        among women in the United States who were 50 years of age to 64 
        years of age declined from about 79 percent to 73 percent.
            (6) In 2010, only 45 percent of 18- to 64-year-olds in the 
        United States reported having ever received an HIV test.
            (7) Among sexually active females in the United States ages 
        16-25 years of age, only 44.7 percent were screened for 
        Chlamydia.
            (8) The proportion of women in the United States 22 years 
        of age to 30 years of age who reported never having had a Pap 
        test increased from 6.6 percent in 2000 to 9.0 percent in 2010 
        despite current recommendations that they receive a Pap test 
        every three years.
            (9) In 2007, 29.3 percent of women in the United States 
        delivering a live birth did not receive any prenatal care in 
        the first trimester, even though first trimester prenatal care 
        is recommended.
            (10) During the 2013-2014 flu season, almost 48 percent of 
        pregnant women did not receive recommended vaccination against 
        influenza.
            (11) Over half (51 percent) of the 6.6 million pregnancies 
        in the United States each year are unintended. Multiple studies 
        have shown that improved access to birth control significantly 
        improves the health of women and their families, as it is 
        directly linked to improved maternal and infant health 
        outcomes. Women that plan their pregnancies are more likely to 
        access prenatal care, improving their own health and the health 
        of their children.
            (12) Between 2006 and 2010, one-third of all pregnancies 
        were conceived within 18 months of a previous birth, an 
        interval that is potentially harmful to the health of the 
        mother.
            (13) Improved access to family planning also saves money. 
        For every $1.00 invested in family planning, taxpayers save 
        more than $5.00 in Medicaid-related expenses.

SEC. 3. WOMEN'S PREVENTIVE HEALTH AWARENESS CAMPAIGN.

    Part P of title III of the Public Health Service Act (42 U.S.C. 
280g et al.) is amended by adding at the end the following new section:

``SEC. 399V-6. WOMEN'S PREVENTIVE HEALTH AWARENESS CAMPAIGN.

    ``(a) In General.--The Secretary shall provide for the planning and 
implementation of a national public outreach and education campaign to 
raise public awareness, including provider awareness, of women's 
preventive health. Such campaign shall include the media campaign under 
subsection (b) and the website under subsection (c) and shall provide 
for the dissemination of information that--
            ``(1) describes the guidelines for women's preventive 
        services, including the cervical cancer recommendations updated 
        in 2012, by the United States Preventive Services Task Force, 
        by the American College of Obstetricians and Gynecologists 
        (ACOG), and by the American Cancer Society, the American 
        Society for Colposcopy and Cervical Pathology, and the American 
        Society for Clinical Pathology;
            ``(2) promotes well-woman visits for health assessments 
        which include screenings, evaluations, counseling, 
        immunizations, and prenatal visits, as appropriate;
            ``(3) explains the women's preventive services that are 
        required under section 2713 to be covered without cost-sharing 
        by a group health plan or a health insurance issuer offering 
        group or individual health insurance coverage that is not a 
        grandfathered plan (as defined in section 1251(e) of the 
        Patient Protection and Affordable Care Act); and
            ``(4) addresses health disparities in the area of women's 
        prevention.
    ``(b) Media Campaign.--
            ``(1) In general.--Not later than 1 year after the date of 
        the enactment of this section, as part of the campaign under 
        subsection (a), the Secretary shall establish and implement a 
        national media campaign.
            ``(2) Requirement of campaign.--The campaign implemented 
        under paragraph (1)--
                    ``(A) shall disseminate information about the 
                updated guidelines for women's preventive services 
                described in subsection (a)(1), promote well-woman 
                visits described in subsection (a)(2), and provide 
                information on the women's preventive services 
                described in subsection (a)(3); and
                    ``(B) may include the use of television, radio, 
                Internet, and other commercial marketing venues.
    ``(c) Website.--As part of the campaign under subsection (a), the 
Secretary shall, in consultation with private sector experts or through 
contract with a private entity including a medical association or non-
profit organization, maintain and update an Internet website to provide 
information and resources about the updated guidelines for women's 
preventive services described in subsection (a)(1), promote well-woman 
visits, and provide information on the women's preventive services 
described in subsection (a)(3).
    ``(d) Funding.--The Secretary may use, out of any funds otherwise 
made available to the Department of Health and Human Services, such 
sums as may be necessary to carry out this section.''.

SEC. 4. CLARIFICATION OF COVERAGE FOR WOMEN'S PREVENTIVE HEALTH 
              SERVICES.

    Section 2713 of the Public Health Service Act (42 U.S.C. 300gg-13) 
is amended by adding at the end the following new subsection:
    ``(d) Clarification of Coverage for Women's Preventive Health 
Services.--In applying subsection (a), with respect to women, the 
following shall apply:
            ``(1) Well-woman visits, in addition to such well-woman 
        visits recommended in the Health Resources and Services 
        Administration guidelines shall be treated as described in 
        paragraph (4) of such subsection, with respect to a woman, if a 
        health care provider determines that such woman requires such 
        additional well-woman visits to obtain all necessary preventive 
        services recommended under such guidelines and under this 
        section, depending on the woman's health status, health needs, 
        and other risk factors.
            ``(2) The entirety of any such well-woman visit shall be 
        treated as described in such paragraph (4) and any additional 
        facility fee or office visit fee shall be in violation of the 
        requirement under such subsection to provide for coverage of 
        such visit without the imposition of any cost sharing 
        requirement.
            ``(3) If a recommendation or guideline pursuant to 
        subsection (a) with respect to a preventive service does not 
        specify the frequency, method, treatment, or setting for the 
        provision of such service, the plan or issuer involved may use 
        reasonable medical management techniques to determine any 
        coverage limitations with respect to frequency, method, 
        treatment, or setting for the provision of such service.
            ``(4) If a preventive service to which this section is 
        applicable is furnished to a woman by a health care provider 
        who is not within the provider network of the group health plan 
        or health insurance coverage in which the woman is enrolled and 
        there is no health care provider who is within such network who 
        has the capacity to provide the service, then such service 
        furnished by such out-of-network provider shall be covered 
        under such plan or coverage without the imposition of any cost 
        sharing requirement.
            ``(5) Nothing in this section or any regulation 
        implementing this section shall be construed as requiring that 
        each preventive health service to which this section applies be 
        provided in a separate visit. Efficient care delivery and the 
        delivery of multiple prevention and screening services at a 
        single visit shall be permissible under this section and such 
        regulations as a reasonable medical management technique.
            ``(6) In determining the categorization of a service under 
        this section as having a rating of `A' or `B' in the 
        recommendations of the United States Preventive Services Task 
        Force, a woman who is at high risk for a disease by reason of 
        the family or personal history of such woman with respect to 
        such disease, shall be treated in the same manner as a woman 
        identified at high risk for such disease by reason of being 
        among a population at high risk for such disease.
            ``(7) In applying paragraph (6), in the case that a health 
        care provider determines that a woman is at high risk for a 
        disease such woman shall be treated as at high risk for such 
        disease.
            ``(8)
                    ``The recommendation applied pursuant to subsection 
                (a) for genetic counseling and evaluation for routine 
                breast cancer susceptibility gene (BRCA) shall be 
                treated as including a recommendation for both genetic 
                counseling and BRCA testing, if appropriate, for a 
                woman as determined by the health care provider of such 
                woman.
            ``(9) The recommendation applied pursuant to subsection (a) 
        for annual HIV counseling and screening for all sexually active 
        women, shall be treated as applying to testing as well as 
        screening.
            ``(10) The recommendation applied pursuant to subsection 
        (a) for breast-feeding support shall be treated as including 
        comprehensive prenatal and postnatal lactation support, 
        counseling, and rental or purchase of equipment for the 
        duration of breast-feeding, subject to reasonable medical 
        management.
            ``(11) The guidelines supported under subsection (a)(4) 
        shall be treated as including the recommendation of one form of 
        contraception in each of the methods identified by the Food and 
        Drug Administration in its current Birth Control Guide as well 
        as clinical services needed for provision of such contraceptive 
        method, including patient education and counseling.
            ``(12) In applying paragraph (11), within each method 
        described in such paragraph, a group health plan or health 
        insurance issuer may utilize reasonable medical management 
        techniques and may impose cost sharing on some items and 
        services to encourage an individual to use specific items and 
        services within the chosen contraceptive method, such as for 
        purposes of discouraging the use of brand name pharmacy items 
        over generic pharmacy items or for purposes of encouraging the 
        use of one of several intrauterine devices with progestin 
        approved by the Food and Drug Administration.
            ``(13) Services related to follow-up and management of side 
        effects, counseling for continued adherence, and device 
        removal, subject to reasonable medical management, shall be 
        treated as described in paragraph (4) of such subsection.''.

SEC. 5. INSTITUTE OF MEDICINE STUDY AND REPORT.

    (a) Study.--The Secretary of Health and Human Services shall enter 
into an agreement with the Institute of Medicine (or, if the Institute 
declines to enter into such an agreement, another appropriate entity) 
to conduct a study to provide recommendations on the appropriate 
billing codes that should be included in a well-woman visit described 
in subsection (d)(1) of section 2713 of the Public Health Service Act 
(42 U.S.C. 300gg-13), as added by section 4.
    (b) Report.--The Secretary shall ensure that not later than 12 
months after the date of the enactment of this Act a report containing 
the recommendations under subsection (a), including a comprehensive 
list of codes described in such subsection, is submitted to Congress.