[Federal Register Volume 87, Number 211 (Wednesday, November 2, 2022)]
[Notices]
[Pages 66197-66198]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[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 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.

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: https://mchb.hrsa.gov/maternal-child-health-topics/child-health/bright-futures.html.

FOR FURTHER INFORMATION CONTACT: Bethany Miller, HRSA, Maternal and 
Child Health Bureau, email: [email protected], 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'' (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/human-immunodeficiency-virus-hiv-infection-screening), 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'' (https://doi.org/10.1542/peds.2021-055207).''

    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