[Federal Register Volume 88, Number 204 (Tuesday, October 24, 2023)]
[Notices]
[Pages 73034-73035]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[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: www.aap.org/en/forms/bright-futures-american-academy-of-pediatrics-recommendations-preventive-health-care/.

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 (https://doi.org/10.1542/peds.2022-060640) 
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 (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/screening-anxiety-children-adolescents) 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 (https://www.cdc.gov/drugoverdose/pdf/pubs/2018-evidence-based-strategies.pdf) and the National Institute on 
Drug Abuse's policy brief, Naloxone for Opioid Overdose: Life-Saving 
Science (https://nida.nih.gov/publications/naloxone-opioid-overdose-life-saving-science). 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 (https://doi.org/10.1542/peds.2022-058859), 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 (https://doi.org/10.1542/peds.2022-060417), 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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