Notice2022-23845
Notice of Request for Public Comment on Proposed Update to the Bright Futures Periodicity Schedule as Part of the HRSA-Supported Preventive Services Guidelines for Infants, Children, and Adolescents
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Published
November 2, 2022
Issuing agencies
Health and Human Services DepartmentHealth Resources and Services Administration
Abstract
This notice seeks public comment on a proposed update to the Periodicity Schedule of the Bright Futures Recommendations for Pediatric Preventive Health Care ("Bright Futures Periodicity Schedule"), as part of the HRSA-supported preventive service guidelines for infants, children, and adolescents. Please see https:// mchb.hrsa.gov/maternal-child-health-topics/child-health/bright- futures.html for additional information. Specifically, the proposed update to the Bright Futures Periodicity Schedule is to extend the upper age range for the existing universal Human Immunodeficiency Virus (HIV) screening recommendation. In the Bright Futures Periodicity Schedule, a "dot" with an "arrow" indicates a "range during which a service may be provided." In the current Bright Futures Periodicity Schedule, the age range recommended for which adolescents may be provided universal screening for HIV is between the 15-year visit and 18-year visit. The proposed update to the Bright Futures Periodicity Schedule would indicate that the recommended age range for which adolescents may be provided universal screening for HIV is between the 15-year visit and 21-year visit. The proposed update also includes an accompanying footnote to provide updated information from the American Academy of Pediatrics (AAP) about more frequent screening for youth assessed as at high risk of HIV infection.
Full Text
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<title>Federal Register, Volume 87 Issue 211 (Wednesday, November 2, 2022)</title>
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[Federal Register Volume 87, Number 211 (Wednesday, November 2, 2022)]
[Notices]
[Pages 66197-66198]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2022-23845]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Health Resources and Services Administration
Notice of Request for Public Comment on Proposed Update to the
Bright Futures Periodicity Schedule as Part of the HRSA-Supported
Preventive Services Guidelines for Infants, Children, and Adolescents
AGENCY: Health Resources and Services Administration (HRSA), Department
of Health and Human Services (HHS).
ACTION: Notice.
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SUMMARY: This notice seeks public comment on a proposed update to the
Periodicity Schedule of the Bright Futures Recommendations for
Pediatric Preventive Health Care (``Bright Futures Periodicity
Schedule''), as part of the HRSA-supported preventive service
guidelines for infants, children, and adolescents. 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. Specifically, the proposed
update to the Bright Futures Periodicity Schedule is to extend the
upper age range for the existing universal Human Immunodeficiency Virus
(HIV) screening recommendation.
In the Bright Futures Periodicity Schedule, a ``dot'' with an
``arrow'' indicates a ``range during which a service may be provided.''
In the current Bright Futures Periodicity Schedule, the age range
recommended for which adolescents may be provided universal screening
for HIV is between the 15-year visit and 18-year visit. The proposed
update to the Bright Futures Periodicity Schedule would indicate that
the recommended age range for which adolescents may be provided
universal screening for HIV is between the 15-year visit and 21-year
visit. The proposed update also includes an accompanying footnote to
provide updated information from the American Academy of Pediatrics
(AAP) about more frequent screening for youth assessed as at high risk
of HIV infection.
DATES: Members of the public are invited to provide written comments no
later than December 2, 2022. All comments received on or before this
date will be reviewed and considered by the Bright Futures Periodicity
Schedule Working Group and provided for further consideration by HRSA
in determining the recommended updates that it will support.
ADDRESSES: Members of the public interested in providing comments can
do so by accessing the public comment web page at: <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 FURTHER INFORMATION CONTACT: Bethany Miller, HRSA, Maternal and
Child Health Bureau, email: <a href="/cdn-cgi/l/email-protection#73313e1a1f1f1601331b0100125d141c05"><span class="__cf_email__" data-cfemail="1c5e51757070796e5c746e6f7d327b736a">[email protected]</span></a>, telephone: (301) 945-
5156.
SUPPLEMENTARY INFORMATION: The Bright Futures Periodicity Schedule is
maintained through a national cooperative agreement, the Bright Futures
Pediatric Implementation Program, with the AAP. If accepted by HRSA,
the proposed update to the Bright Futures Periodicity Schedule will
provide additional clinical guidance to providers and, under the Public
Health Service Act and pertinent regulations, would require non-
grandfathered group health plans and health insurance issuers to
provide coverage without cost-sharing of such updated preventive care
and screenings.
When its preventive care and screening recommendations have been
[[Page 66198]]
accepted by HRSA, the Bright Futures Periodicity Schedule is part of
the HRSA-supported preventive service guidelines for infants, children,
and adolescents. The development of the Periodicity Schedule is
maintained through a national cooperative agreement, the Bright Futures
Pediatric Implementation Program, with AAP. Under Section 2713 of the
Public Health Service Act (42 U.S.C. 300gg-13) and pertinent
regulations, non-grandfathered group health plans and health insurance
issuers must provide coverage, without cost sharing, for certain
preventive services for plan years (in the individual market, policy
years) that begin on or after the date that is 1 year after the date
the recommendation or guideline is issued. These include HRSA-supported
preventive health services provided for in the Bright Futures
Periodicity Schedule as part of the HRSA-supported preventive services
guidelines for infants, children, and adolescents.
Through the cooperative agreement with the AAP, the Bright Futures
Pediatric Implementation Program is required to administer a process
for developing and regularly recommending, as needed, updates to the
Bright Futures Periodicity Schedule through a process that includes a
comprehensive, objective, and transparent review of available evidence
that incorporates opportunity for public comment. Accordingly, the
Program reviews the evidence to determine whether updates are needed,
develops recommended updates, seeks and considers public comments, and
makes recommendations to HRSA.
The AAP convenes a panel of pediatric primary care experts, the
Bright Futures Periodicity Schedule Working Group, to review the latest
evidence, develop draft recommended updates, seek and consider public
comment, and propose updates to the Bright Futures Periodicity
Schedule. Comments received from the public will be reviewed and
discussed by the Bright Futures Periodicity Schedule Working Group.
The proposed update to the Bright Futures Periodicity Schedule
would indicate that the recommended age range for which adolescents may
be provided universal screening for HIV is between the 15-year visit
and 21-year visit. In the current Bright Futures Periodicity Schedule,
the age range recommended for which adolescents may be offered
universal screening for HIV is between the 15-year visit and 18-year
visit. Early detection of an infection with HIV in adolescents and
young adults can lead to improved health outcomes and reduce the
further spread of HIV by individuals who are not yet aware they are
infected. Universal screening is a type of screening that a provider
may recommend without first identifying a specific risk factor or
symptom.
The current and proposed update to HIV screening is reflected in
the chart below:
[GRAPHIC] [TIFF OMITTED] TN02NO22.001
All such screenings (universal and risk-based) within this age
range are within the scope of the guideline. The proposed update also
includes an accompanying footnote to provide updated information from
the AAP about more frequent screening for youth assessed as at high
risk of HIV infection. The full footnote reads:
``Screen adolescents for HIV at least once between the ages of
15 and 21 making every effort to preserve confidentiality of the
adolescent, as per ``Human Immunodeficiency Virus (HIV) Infection:
Screening'' (<a href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening">https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening</a>), and after initial screening, youth at increased risk of
HIV infection should be retested annually or more frequently, as per
``Adolescents and Young Adults: The Pediatrician's Role in HIV
Testing and Pre- and Postexposure HIV Prophylaxis'' (<a href="https://doi.org/10.1542/peds.2021-055207">https://doi.org/10.1542/peds.2021-055207</a>).''
Authority: 2713(a)(3) of the Public Health Service Act, 42 U.S.C.
300gg-13(a)(3).
Carole Johnson,
Administrator.
[FR Doc. 2022-23845 Filed 11-1-22; 8:45 am]
BILLING CODE 4165-15-P
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