The U.S. Departments of Treasury, Labor (DOL) and Health and Human Services (HHS) have issued interim final regulations and Frequently Asked Questions and Answers on the cost-free coverage of preventive services under the Affordable Care Act (ACA). Although the regulations address many preventive care subjects, all of the attention has focused on the changes to the rules for cost-free contraceptive coverage and the accommodations provided to certain organizations for religious reasons.

HHS, DOL and the Treasury Department released final regulations in 2013 that provided an exemption from the ACA contraceptive coverage requirement for “religious organizations.” Last year the U.S. Supreme Court, in Burwell v. Hobby Lobby, Inc., extended the contraceptive coverage exemption to private, closely held corporations. The new regulations lay out the specific process through which an eligible for-profit corporation may assert a religious objection to the contraceptive coverage requirement.

To raise this objection, the corporation must take steps similar to those that apply to an objecting nonprofit religious organization. The new regulations include changes clarifying that process, which requires an entity to formalize its objection through an act of corporate governance, such as a resolution of the board of trustees, and to undertake a self-certification process that may involve the completion of a government form or the provision of a written statement that provides specified information, regarding the basis for its religious accommodation, information about the plan, and contact information for the plan’s health insurers and third-party administrators.

Some religious groups have voiced objections to the process set forth in the regulations, and it is possible that yet more litigation over the ACA will follow.

As the federal health care reform effort gained steam, Ballard Spahr attorneys established the Health Care Reform Initiative to monitor and analyze legislative developments. With federal health care reform now a reality, our attorneys are assisting health care entities and employers in understanding the relevant changes and planning for the future. They also have launched the Health Care Reform Dashboard, an online resource center for news and analysis on developments under the Affordable Care Act.

If you have questions about preventive care services, contact Jean C. Hemphill at 215.864.8539 or, Edward I. Leeds at 215.864.8419 or, or Alisa M. Gifford at 215.864.8516 or