Notice2022-00461
Updates to the Bright Futures Periodicity Schedule
Primary source
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Published
January 12, 2022
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
Effective December 30, 2021, HRSA accepted recommended updates to the Bright Futures Periodicity Schedule, a HRSA-supported guideline for infants, children and adolescents for purposes of ensuring that non-grandfathered group and individual health insurance issuers provide coverage without cost sharing under the Public Health Service Act. The updates to the Bright Futures Periodicity Schedule are: A new category for sudden cardiac arrest and sudden cardiac death risk assessment, a new category for hepatitis B virus infection risk assessment, addition of suicide risk as an element of universal depression screening for children ages 12-21, and updated category title from "Psychosocial/ Behavioral Assessment" to "Behavioral/Social/Emotional Screening," with no revision to the ages in which the screening occurs (newborn to 21 years). Finally, two clarifying references related to dental fluoride varnish and fluoride supplementation have been added, with no associated recommended changes to clinical practice or health insurance coverage. Please see https://mchb.hrsa.gov/maternal-child-health- topics/child-health/bright-futures.html for additional information.
Full Text
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<title>Federal Register, Volume 87 Issue 8 (Wednesday, January 12, 2022)</title>
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[Federal Register Volume 87, Number 8 (Wednesday, January 12, 2022)]
[Notices]
[Pages 1762-1763]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-00461]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Updates to the Bright Futures Periodicity Schedule
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: Effective December 30, 2021, HRSA accepted recommended updates
to the Bright Futures Periodicity Schedule, a HRSA-supported guideline
for infants, children and adolescents for purposes of ensuring that
non-grandfathered group and individual health insurance issuers provide
coverage without cost sharing under the Public Health Service Act. The
updates to the Bright Futures Periodicity Schedule are: A new category
for sudden cardiac arrest and sudden cardiac death risk assessment, a
new category for hepatitis B virus infection risk assessment, addition
of suicide risk as an element of universal depression screening for
children ages 12-21, and updated category title from ``Psychosocial/
Behavioral Assessment'' to ``Behavioral/Social/Emotional Screening,''
with no revision to the ages in which the screening occurs (newborn to
21 years). Finally, two clarifying references related to dental
fluoride varnish and fluoride supplementation have been added, with no
associated recommended changes to clinical practice or health insurance
coverage. Please see <a href="https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html">https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html</a> for additional information.
FOR FURTHER INFORMATION CONTACT: Savannah Kidd, M.S. MFT, HRSA/Maternal
and Child Health Bureau by calling 301-287-2601 or by emailing at
<a href="/cdn-cgi/l/email-protection#cc9f87a5a8a88ca4bebfade2aba3ba"><span class="__cf_email__" data-cfemail="97c4dcfef3f3d7ffe5e4f6b9f0f8e1">[email protected]</span></a>.
SUPPLEMENTARY INFORMATION: The Bright Futures program has been funded
by HRSA since 1990. A primary focus of this program is for the funding
recipient to maintain and recommend updates to the Bright Futures
Guidelines for Health Supervision of Infants, Children and Adolescents,
a set of materials and tools that provide theory-based and evidence-
driven guidance for all preventive care screenings and well-child
visits. One component of these tools is the Bright Futures Periodicity
Schedule, a chart that identifies the recommended screenings,
assessments, physical examinations, and procedures to be delivered
within preventive checkups at each age milestone. Over the program's
existence, the Bright Futures Periodicity Schedule has become the
accepted schedule within the United States for preventive health
services through the course of a child's development.
Section 2713 of the Public Health Service Act (42 U.S.C. 300gg-13),
added by the Patient Protection and Affordable Care Act (Pub. L. 111-
148), requires that non-grandfathered group health plans and health
insurance issuers offering
[[Page 1763]]
group or individual health insurance coverage provide coverage without
cost-sharing for certain preventive health services. Section 2713(a)(3)
describes such services for infants, children, and adolescents as
``evidence-informed preventive care and screenings provided for in the
comprehensive guidelines supported by the Health Resources and Services
Administration.'' HHS, along with the Departments of Treasury and
Labor, issued an Interim Final Rule on July 19, 2010 (75 FR 41726-
41760) that identified two specific resources as the comprehensive
guidelines supported by HRSA for infants, children, and adolescents to
be covered by insurance without cost sharing by non-grandfathered group
health plans and health insurance issuers: (1) The Bright Futures
Periodicity Schedule and (2) the Recommended Uniform Screening Panel of
the Advisory Committee on Heritable Disorders in Newborns and Children.
The Interim Final Rule provided that a future change to these
comprehensive guidelines is considered to be issued for purposes of
Section 2713 on the date on which it is accepted by the HRSA
Administrator or, if applicable, adopted by the Secretary of HHS.
A public comment period was announced and occurred from September
13, 2021, through October 13, 2021 (86 FR 50894, September 13,
2021),\1\ to allow public comment on the proposed recommended updates
affecting clinical practice and health insurance coverage requirements.
A total of 27 respondents gave 57 comments during the public comment
period. The Bright Futures grantee, the American Academy of Pediatrics,
received and considered the public comments. The annual report (Tab A)
provides a description of the comments, including a detailed tabulation
of each comment.
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\1\ See <a href="https://www.federalregister.gov/documents/2021/09/13/2021-19630/opportunity-for-comments-on-proposed-updates-to-the-bright-futures-periodicity-schedule-as-part-of">https://www.federalregister.gov/documents/2021/09/13/2021-19630/opportunity-for-comments-on-proposed-updates-to-the-bright-futures-periodicity-schedule-as-part-of</a>.
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On December 30, 2021, the HRSA Administrator accepted the American
Academy of Pediatrics' recommended several updates to the Bright
Futures Periodicity Schedule. The Bright Futures recommendations
included recommended clinical practice updates, along with revisions to
the footnotes on the Bright Futures Periodicity Schedule that do not
require changes to clinical practice or health insurance coverage. The
updates to the Bright Futures Periodicity Schedule are: (1) A new
category for sudden cardiac arrest and sudden cardiac death risk
assessment, (2) a new category for hepatitis B virus infection risk
assessment, (3) addition of suicide risk as an element of universal
depression screening for children ages 12-21, and (4) updated category
title from ``Psychosocial/Behavioral Assessment'' to ``Behavioral/
Social/Emotional Screening,'' with no revision to the ages in which the
screening occurs (newborn to 21 years). Finally, two clarifying
references related to dental fluoride varnish and fluoride
supplementation have been added with no associated recommended changes
to clinical practice. In light of these updates, all non-grandfathered
group health plans and health insurance issuers offering group or
individual health insurance coverage must cover without cost-sharing
the services and screenings listed on the updated Bright Futures
Periodicity Schedule for plan years (in the individual market, policy
years) that begin in 2023, which can be accessed at the following link:
<a href="https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html">https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html</a>.
Diana Espinosa,
Acting Administrator.
[FR Doc. 2022-00461 Filed 1-11-22; 8:45 am]
BILLING CODE 4165-15-P
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