The Title X family planning program guarantees access to confidential family planning services for the millions of individuals it serves every year. Increasingly, patients seen in Title X-funded settings are gaining health insurance coverage through Medicaid or commercial health plans, at the same time that insurance coverage for contraceptive services has expanded. An increase in insured patients presents an opportunity for publicly funded family planning providers to access new revenue streams for previously uncompensated care, but also poses challenges for providers seeking to maintain Title X’s strong patient confidentiality protections while maximizing reimbursement from third-party payers for services and supplies provided in Title X settings.


NFPRHA undertook a multi-year, federally funded research project, Confidential & Covered, to help Title X providers offer care that is confidential and receive payment that does not breach privacy. The project was designed to identify policies and practices to mitigate revenue loss at Title X-funded health centers due to the provision of confidential health services. Confidential & Covered partnered with the Center for Adolescent Health & the Law, the George Washington University’s Milken Institute School of Public Health, and the University of California, San Francisco’s Bixby Center for Global Reproductive Health to conduct research on insurance use and confidentiality through the payment process.

All research findings and publications from the project are available below.

 NFPRHA's Position


NFPRHA supports policies that fully take into account the proliferation of technology in health care, insurance communication and medical record-keeping when seeking to ensure access to confidential services, protect interactions between patient and provider, and help patients feel comfortable using their coverage. NFPRHA supports maintaining state and federal protections regarding confidentiality of minors.




The Impact of Health Systems Changes on the Title X Network WebinarNFPRHA, Guttmacher Institute, and Altarum Institute recorded a webinar detailing the final research findings from the each project under the ACA Collaborative and present a summary of available resources. The OPA-moderated webinar, accompanying transcript, and webinar slides are now available on the Family Planning National Training Center website (2017).

Funding for this project was provided by the Office of Population Affairs (Grant Number 1 FPRPA006059-01-00). The views expressed by this project do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply official endorsement by the U.S. Government.

For additional resources & information, access NFPRHA fact sheets and federal comments by issue or read NFPRHA's publications and recent press statements.

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