Notice2023-23396
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
October 24, 2023
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 services guidelines for infants, children, and adolescents.
Full Text
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<title>Federal Register, Volume 88 Issue 204 (Tuesday, October 24, 2023)</title>
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[Federal Register Volume 88, Number 204 (Tuesday, October 24, 2023)]
[Notices]
[Pages 73034-73035]
From the Federal Register Online via the Government Publishing Office [<a href="http://www.gpo.gov">www.gpo.gov</a>]
[FR Doc No: 2023-23396]
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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.
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 services
guidelines for infants, children, and adolescents.
DATES: Members of the public are invited to provide written comments on
the proposed update no later than November 24, 2023. 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.
[[Page 73035]]
ADDRESSES: Members of the public interested in providing comments can
do so by accessing the public comment web page at: <a href="http://www.aap.org/en/forms/bright-futures-american-academy-of-pediatrics-recommendations-preventive-health-care/">www.aap.org/en/forms/bright-futures-american-academy-of-pediatrics-recommendations-preventive-health-care/</a>.
FOR FURTHER INFORMATION CONTACT: Savannah Kidd, M.S., M.F.T.; Senior
Public Health Analyst; Division of Child, Adolescent, and Family
Health; Maternal and Child Health Bureau; HRSA; email: <a href="/cdn-cgi/l/email-protection#36657d5f5252765e44455718515940"><span class="__cf_email__" data-cfemail="40130b29242400283233216e272f36">[email protected]</span></a>,
telephone: 301-287-2601.
SUPPLEMENTARY INFORMATION: The Bright Futures Periodicity Schedule is
maintained through a cooperative agreement, the Infant, Child, and
Adolescent Preventive Services Program, for which the American Academy
of Pediatrics (AAP) is the current recipient. When its preventive care
and screening recommendations have been accepted by HRSA, the Bright
Futures Periodicity Schedule is part of the HRSA-supported preventive
services guidelines for infants, children, and adolescents. 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 under 42 U.S.C.
300gg-13(a)(3).
Through the Infant, Child, and Adolescent Preventive Services
cooperative agreement, the AAP is required to administer a process for
developing and regularly recommending, as needed, updates to the Bright
Futures Periodicity Schedule through a comprehensive, objective, and
transparent review of available evidence that incorporates opportunity
for public comment. Accordingly, AAP reviews the evidence to determine
whether updates are needed, develops recommended updates, seeks and
considers public comments, and makes recommendations to HRSA. The
proposed update to the Bright Futures Periodicity Schedule includes
additions to existing footnotes, which provide up-to-date information
and recommendations to providers but will not change the clinical
recommendations and associated requirement for coverage without cost-
sharing under section 2713 of the Public Health Service Act. The
footnotes that AAP proposes to be revised are as follows:
1. Footnote 4, relating to the first week well-child visit, also
called the 3-5 Day Visit, will be revised with an updated reference
that aligns with the Bright Futures recommendation regarding providers
helping families that choose to breastfeed.
2. Footnote 5, relating to Body Mass Index, is the Clinical
Practice Guideline for the Evaluation and Treatment of Children and
Adolescents with Obesity (<a href="https://doi.org/10.1542/peds.2022-060640">https://doi.org/10.1542/peds.2022-060640</a>)
published in the January 2023 issue of Pediatrics. This updated
reference aligns with the Bright Futures recommendation regarding
measuring body mass index starting at the 24-month visit through the
21-year visit and provides non-stigmatizing recommendations for
evaluating and treating children who are experiencing weight gains.
3. Footnote 14, relating to Behavioral/Social/Emotional Screening,
is the U.S. Preventive Services Task Force Recommendation Statement,
Screening for Anxiety in Children and Adolescents (<a href="https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-anxiety-children-adolescents">https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-anxiety-children-adolescents</a>) published in the October 2022 issue of
the Journal of the American Medical Association. This additional
reference aligns with the Bright Futures recommendation to use
screening instruments to better identify children experiencing anxiety,
followed by a confirmatory diagnostic assessment and follow-up.
4. Footnote 15, relating to Tobacco, Alcohol, or Drug Use
Assessment, is the Centers for Disease Control and Prevention's
Evidence-Based Strategies for Preventing Opioid Overdose: What's
Working in the United States (<a href="https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf">https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf</a>) and the National Institute on
Drug Abuse's policy brief, Naloxone for Opioid Overdose: Life-Saving
Science (<a href="https://nida.nih.gov/publications/naloxone-opioid-overdose-life-saving-science">https://nida.nih.gov/publications/naloxone-opioid-overdose-life-saving-science</a>). The proposed footnote aligns with the Bright
Futures recommendation to assess patients for substance use with a
validated screening tool. These additional references also describe the
utility of prescribing Naloxone if there is concern for substance or
opioid use.
5. Footnote 21, relating to Newborn Bilirubin Screening, is
Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks
of Gestation (<a href="https://doi.org/10.1542/peds.2022-058859">https://doi.org/10.1542/peds.2022-058859</a>), published in
the August 2022 issue of Pediatrics. This reference aligns with the
Bright Futures recommendation for universal bilirubin screening for all
newborn infants between 24 and 28 hours after birth.
6. Footnote 35, relating to Oral Health, is Maintaining and
Improving the Oral Health of Young Children (<a href="https://doi.org/10.1542/peds.2022-060417">https://doi.org/10.1542/peds.2022-060417</a>), published in the December 2022 issue of Pediatrics.
This reference aligns with the Bright Futures recommendation that every
child has a dental home by 1 year of age. Additionally, the updated
reference encourages providers to screen for social determinants of
health, as well as access to medical and dental care, as they influence
oral health status and oral health inequities.
With respect to Footnote 15, HRSA welcomes comment on the evidence
regarding the effect of prescribing Naloxone in the setting of a
primary care preventive visit on preventing or reducing opioid
overdoses and opioid overdose deaths.
Authority: Section 2713(a)(3) of the Public Health Service Act, 42
U.S.C. 300gg-13(a)(3).
Carole Johnson,
Administrator.
[FR Doc. 2023-23396 Filed 10-23-23; 8:45 am]
BILLING CODE 4165-15-P
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