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GAO-24-106960 1 (2024-09-30)

handle is hein.gao/gaoqzm0001 and id is 1 raw text is: Why This Matters Key Takeaways Is coverage for menstrual products a Medicaid benefit? Lack of access to affordable menstrual products (e.g., tampons, pads, menstrual cups, and period underwear) may affect school participation, employment, and mental and physical health. Advocates for increasing access to menstrual products have highlighted this issue as a public health concern. Public assistance programs that serve low-income individuals, such as Medicaid, may not routinely cover the cost of menstrual products.' Within broad federal requirements, states have flexibility in how they design and administer their Medicaid programs, including options to provide services that address health- related needs. For example, states may contract with health plans to deliver Medicaid benefits to beneficiaries-an arrangement known as managed care- and the plans may elect to provide additional services. We were asked to examine states' coverage of menstrual products in their Medicaid programs. This report describes circumstances under which state Medicaid programs may cover menstrual products, as well as Medicaid managed care plans' coverage of these products across states. * Coverage for menstrual products is not a Medicaid benefit. However, Medicaid managed care plans may voluntarily cover some costs of menstrual products as an extra service for eligible enrollees. * We found that 25 states had at least one Medicaid managed care plan that covered a range of over-the-counter or personal care items, including menstrual products, or covered menstrual products specifically up to a set quantity or dollar amount. This coverage was not offered by all the plans in each of these states. * Centers for Medicare & Medicaid Services (CMS) officials reported that state Medicaid programs have other options to provide coverage of menstrual products, including seeking federal approval to cover the costs of menstrual products as part of a demonstration project, though no state has done so. No. Menstrual products are not a mandatory or optional Medicaid benefit.2 Federal law specifies Medicaid benefits that must be provided under state Medicaid plans (referred to as mandatory benefits) and benefits that states may choose to provide (referred to as optional benefits) for eligible beneficiaries. For example, mandatory benefits include inpatient and outpatient hospital services; physicians' services; laboratory and x-ray services; and early and periodic screening, diagnostic, and treatment services for eligible individuals aged 20 and under, among other benefits. Optional benefits include private duty nursing services, dental services, prescription drugs, and case management services, among others. Page 1 GAO-24-106960 Medicaid Coverage of Menstrual Products Page 1 GAO-24-106960 Medicaid Coverage of Menstrual Prod ucts

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