I 

114TH CONGRESS 

1ST SESSION H. R. 2355 

To provide for a national public outreach and education campaign to raise 

public awareness of women’s preventive health, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MAY 15, 2015 

Mr. BERA introduced the following bill; which was referred to the Committee 

on Energy and Commerce 

A BILL 

To provide for a national public outreach and education 

campaign to raise public awareness of women’s preventive health, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Women’s Preventive 

5 Health Awareness Campaign’’. 

6 SEC. 2. FINDINGS. 

7 Congress makes the following findings: 

8 (1) Well-woman visits are the foundation on 

9 which women’s preventive care is built. Such visits 

10 include not only specific screening tests, but also a 


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1 medical history, physical examination, evaluation 

2 and counseling, and, as indicated, vaccinations. 

3 (2) Well-woman visits facilitate increased access 

4 to health care that is shown to identify chronic dis5 ease risk factors, promote well-being, and decrease 

6 the likelihood or delay the onset of a targeted dis7 ease or condition. 

8 (3) Heart disease, stroke, and other cardio9 vascular diseases are the number one cause of death 

10 in American women, responsible for 1 in every 4 fe11 male deaths. 

12 (4) Women are more likely than men to have 

13 forgone needed health care due to cost; 1 in 5 

14 women postponed preventive services in the past 

15 year due to cost. 

16 (5) Between 2002 and 2010, screening mam17 mography rates among women in the United States 

18 who were 50 years of age to 64 years of age declined 

19 from about 79 percent to 73 percent. 

20 (6) In 2010, only 45 percent of 18- to 64-year21 olds in the United States reported having ever re22 ceived an HIV test. 

23 (7) Among sexually active females in the United 

24 States ages 16–25 years of age, only 44.7 percent 

25 were screened for Chlamydia. 


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1 (8) The proportion of women in the United 

2 States 22 years of age to 30 years of age who re3 ported never having had a Pap test increased from 

4 6.6 percent in 2000 to 9.0 percent in 2010 despite 

5 current recommendations that they receive a Pap 

6 test every three years. 

7 (9) In 2007, 29.3 percent of women in the 

8 United States delivering a live birth did not receive 

9 any prenatal care in the first trimester, even though 

10 first trimester prenatal care is recommended. 

11 (10) During the 2013–2014 flu season, almost 

12 48 percent of pregnant women did not receive rec13 ommended vaccination against influenza. 

14 (11) Over half (51 percent) of the 6.6 million 

15 pregnancies in the United States each year are unin16 tended. Multiple studies have shown that improved 

17 access to birth control significantly improves the 

18 health of women and their families, as it is directly 

19 linked to improved maternal and infant health out20 comes. Women that plan their pregnancies are more 

21 likely to access prenatal care, improving their own 

22 health and the health of their children. 

23 (12) Between 2006 and 2010, one-third of all 

24 pregnancies were conceived within 18 months of a 


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1 previous birth, an interval that is potentially harmful 

2 to the health of the mother. 

3 (13) Improved access to family planning also 

4 saves money. For every $1.00 invested in family 

5 planning, taxpayers save more than $5.00 in Med6 icaid-related expenses. 

7 SEC. 3. WOMEN’S PREVENTIVE HEALTH AWARENESS CAM8 PAIGN. 

9 Part P of title III of the Public Health Service Act 

10 (42 U.S.C. 280g et al.) is amended by adding at the end 

11 the following new section: 

12 ‘‘SEC. 399V–6. WOMEN’S PREVENTIVE HEALTH AWARENESS 

13 CAMPAIGN. 

14 ‘‘(a) IN GENERAL.—The Secretary shall provide for 

15 the planning and implementation of a national public out16 reach and education campaign to raise public awareness, 

17 including provider awareness, of women’s preventive 

18 health. Such campaign shall include the media campaign 

19 under subsection (b) and the website under subsection (c) 

20 and shall provide for the dissemination of information 

21 that— 

22 ‘‘(1) describes the guidelines for women’s pre23 ventive services, including the cervical cancer rec24 ommendations updated in 2012, by the United 

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1 ican College of Obstetricians and Gynecologists 

2 (ACOG), and by the American Cancer Society, the 

3 American Society for Colposcopy and Cervical Pa4 thology, and the American Society for Clinical Pa5 thology; 

6 ‘‘(2) promotes well-woman visits for health as7 sessments which include screenings, evaluations, 

8 counseling, immunizations, and prenatal visits, as 

9 appropriate; 

10 ‘‘(3) explains the women’s preventive services 

11 that are required under section 2713 to be covered 

12 without cost-sharing by a group health plan or a 

13 health insurance issuer offering group or individual 

14 health insurance coverage that is not a grand15 fathered plan (as defined in section 1251(e) of the 

16 Patient Protection and Affordable Care Act); and 

17 ‘‘(4) addresses health disparities in the area of 

18 women’s prevention. 

19 ‘‘(b) MEDIA CAMPAIGN.— 

20 ‘‘(1) IN GENERAL.—Not later than 1 year after 

21 the date of the enactment of this section, as part of 

22 the campaign under subsection (a), the Secretary 

23 shall establish and implement a national media cam24 paign. 


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1 ‘‘(2) REQUIREMENT OF CAMPAIGN.—The cam2 paign implemented under paragraph (1)— 

3 ‘‘(A) shall disseminate information about 

4 the updated guidelines for women’s preventive 

5 services described in subsection (a)(1), promote 

6 well-woman visits described in subsection 

7 (a)(2), and provide information on the women’s 

8 preventive services described in subsection 

9 (a)(3); and 

10 ‘‘(B) may include the use of television, 

11 radio, Internet, and other commercial mar12 keting venues. 

13 ‘‘(c) WEBSITE.—As part of the campaign under sub14 section (a), the Secretary shall, in consultation with pri15 vate sector experts or through contract with a private enti16 ty including a medical association or non-profit organiza17 tion, maintain and update an Internet website to provide 

18 information and resources about the updated guidelines 

19 for women’s preventive services described in subsection 

20 (a)(1), promote well-woman visits, and provide informa21 tion on the women’s preventive services described in sub22 section (a)(3). 

23 ‘‘(d) FUNDING.—The Secretary may use, out of any 

24 funds otherwise made available to the Department of 


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1 Health and Human Services, such sums as may be nec2 essary to carry out this section.’’. 

3 SEC. 4. CLARIFICATION OF COVERAGE FOR WOMEN’S PRE4 VENTIVE HEALTH SERVICES. 

5 Section 2713 of the Public Health Service Act (42 

6 U.S.C. 300gg–13) is amended by adding at the end the 

7 following new subsection: 

8 ‘‘(d) CLARIFICATION OF COVERAGE FOR WOMEN’S

9 PREVENTIVE HEALTH SERVICES.—In applying subsection 

10 (a), with respect to women, the following shall apply: 

11 ‘‘(1) Well-woman visits, in addition to such 

12 well-woman visits recommended in the Health Re13 sources and Services Administration guidelines shall 

14 be treated as described in paragraph (4) of such 

15 subsection, with respect to a woman, if a health care 

16 provider determines that such woman requires such 

17 additional well-woman visits to obtain all necessary 

18 preventive services recommended under such guide19 lines and under this section, depending on the wom20 an’s health status, health needs, and other risk fac21 tors. 

22 ‘‘(2) The entirety of any such well-woman visit 

23 shall be treated as described in such paragraph (4) 

24 and any additional facility fee or office visit fee shall 

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1 section to provide for coverage of such visit without 

2 the imposition of any cost sharing requirement. 

3 ‘‘(3) If a recommendation or guideline pursuant 

4 to subsection (a) with respect to a preventive service 

5 does not specify the frequency, method, treatment, 

6 or setting for the provision of such service, the plan 

7 or issuer involved may use reasonable medical man8 agement techniques to determine any coverage limi9 tations with respect to frequency, method, treat10 ment, or setting for the provision of such service. 

11 ‘‘(4) If a preventive service to which this section 

12 is applicable is furnished to a woman by a health 

13 care provider who is not within the provider network 

14 of the group health plan or health insurance cov15 erage in which the woman is enrolled and there is 

16 no health care provider who is within such network 

17 who has the capacity to provide the service, then 

18 such service furnished by such out-of-network pro19 vider shall be covered under such plan or coverage 

20 without the imposition of any cost sharing require21 ment. 

22 ‘‘(5) Nothing in this section or any regulation 

23 implementing this section shall be construed as re24 quiring that each preventive health service to which 

25 this section applies be provided in a separate visit. 


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1 Efficient care delivery and the delivery of multiple 

2 prevention and screening services at a single visit 

3 shall be permissible under this section and such reg4 ulations as a reasonable medical management tech5 nique. 

6 ‘‘(6) In determining the categorization of a 

7 service under this section as having a rating of ‘A’ 

8 or ‘B’ in the recommendations of the United States 

9 Preventive Services Task Force, a woman who is at 

10 high risk for a disease by reason of the family or 

11 personal history of such woman with respect to such 

12 disease, shall be treated in the same manner as a 

13 woman identified at high risk for such disease by 

14 reason of being among a population at high risk for 

15 such disease. 

16 ‘‘(7) In applying paragraph (6), in the case that 

17 a health care provider determines that a woman is 

18 at high risk for a disease such woman shall be treat19 ed as at high risk for such disease. 

20 ‘‘(8) 

21 ‘‘The recommendation applied pursuant to 

22 subsection (a) for genetic counseling and eval23 uation for routine breast cancer susceptibility 

24 gene (BRCA) shall be treated as including a 

25 recommendation for both genetic counseling 


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1 and BRCA testing, if appropriate, for a woman 

2 as determined by the health care provider of 

3 such woman. 

4 ‘‘(9) The recommendation applied pursuant to 

5 subsection (a) for annual HIV counseling and 

6 screening for all sexually active women, shall be 

7 treated as applying to testing as well as screening. 

8 ‘‘(10) The recommendation applied pursuant to 

9 subsection (a) for breast-feeding support shall be 

10 treated as including comprehensive prenatal and 

11 postnatal lactation support, counseling, and rental or 

12 purchase of equipment for the duration of breast13 feeding, subject to reasonable medical management. 

14 ‘‘(11) The guidelines supported under sub15 section (a)(4) shall be treated as including the rec16 ommendation of one form of contraception in each 

17 of the methods identified by the Food and Drug Ad18 ministration in its current Birth Control Guide as 

19 well as clinical services needed for provision of such 

20 contraceptive method, including patient education 

21 and counseling. 

22 ‘‘(12) In applying paragraph (11), within each 

23 method described in such paragraph, a group health 

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1 pose cost sharing on some items and services to en2 courage an individual to use specific items and serv3 ices within the chosen contraceptive method, such as 

4 for purposes of discouraging the use of brand name 

5 pharmacy items over generic pharmacy items or for 

6 purposes of encouraging the use of one of several 

7 intrauterine devices with progestin approved by the 

8 Food and Drug Administration. 

9 ‘‘(13) Services related to follow-up and manage10 ment of side effects, counseling for continued adher11 ence, and device removal, subject to reasonable med12 ical management, shall be treated as described in 

13 paragraph (4) of such subsection.’’. 

14 SEC. 5. INSTITUTE OF MEDICINE STUDY AND REPORT. 

15 (a) STUDY.—The Secretary of Health and Human 

16 Services shall enter into an agreement with the Institute 

17 of Medicine (or, if the Institute declines to enter into such 

18 an agreement, another appropriate entity) to conduct a 

19 study to provide recommendations on the appropriate bill20 ing codes that should be included in a well-woman visit 

21 described in subsection (d)(1) of section 2713 of the Pub22 lic Health Service Act (42 U.S.C. 300gg–13), as added 

23 by section 4. 

24 (b) REPORT.—The Secretary shall ensure that not 

25 later than 12 months after the date of the enactment of 


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1 this Act a report containing the recommendations under 

2 subsection (a), including a comprehensive list of codes de3 scribed in such subsection, is submitted to Congress. 

Æ 


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