June 3, 2021
Premera recently updated its preventive care benefits. These changes are in response to new federal recommendations from the U.S. Preventive Services Task Force (USPSTF), Advisory Committee on Immunization Practices (ACIP), and Bright Futures/American
Academy of Pediatrics (AAP).
The following benefit changes are effective June 1, 2021:
Screenings
Unhealthy Drug Use
The USPSTF now recommends that primary care providers screen adults for unhealthy drug use. Screening refers to asking patients about their drug use, not testing biological specimens. It should be implemented when services for accurate diagnosis, effective
treatment, and appropriate care can be offered or referred.
Lung Cancer
Screening recommendations for lung cancer now include people who are younger and who have smoked fewer cigarettes. Adults aged 50 to 80 years who have a 20 pack per year smoking history and currently smoke or have quit within the past 15 years should
be screened for lung cancer with low-dose computed tomography (CT) every year. It can be discontinued once a person has not smoked for 15 years or develops a health problem that substantially limits life expectancy or the ability or willingness to
have curative lung surgery.
Vaccines
Ebola
ACIP recommends pre-exposure vaccination with Ervebo for adults aged 18 years who are at highest risk for potential occupational exposure to Ebola because they are responding to an outbreak, work as healthcare personnel at federally designated Ebola treatment
centers in the United States, or work as laboratorians or other staff at biosafety level 4 facilities in the United States.
Meningococcal
ACIP has updated its meningococcal vaccines recommendations to include administration of booster doses of serogroup B meningococcal (MenB) vaccine for persons at increased risk for serogroup B meningococcal disease.
Hepatitis A
New and updated recommendations for the Hepatitis A virus (HAV) vaccine include all children and adolescents aged 2–18 years who have not previously been vaccinated, all persons aged 1 year or older infected with human immunodeficiency virus (HIV), persons
with chronic liver disease, and pregnant women who are identified to be at risk for HAV infection during pregnancy. Additionally, during HAV outbreaks, vaccination is recommended for persons aged 1 year or older who are at risk for HAV infection or
severe disease from HAV. Vaccination of persons who receive blood products for clotting disorders (e.g., hemophilia) is no longer recommended.
DTaP-IPV-Hib-HepB
ACIP added a newly approved hexavalent vaccine to prevent diphtheria, tetanus, pertussis, polio, Haemophilus influenzae type b, and hepatitis B (DTaP-IPV-Hib-HepB) to the federal Vaccines for Children program. It’s recommended for use in children aged
6 weeks through 4 years and is indicated for the primary vaccination series in infants at ages 2, 4, and 6 months.
DTaP/Tdap/Td vaccine
To increase provider point-of-care flexibility, ACIP recommendations have been updated to allow either tetanus and diphtheria toxoids (Td) vaccine or Tdap to be used for the decennial Td booster, tetanus prophylaxis for wound management, and for additional
required doses in the catch-up immunization schedule if a person has received at least one Tdap dose.
Bright Futures Periodicity Schedule
The Bright Futures/American Academy of Pediatrics Recommendations for Preventive Pediatric Health Care are updated annually. This year, there are updates to the developmental screening, autism spectrum disorder screening, and hepatitis C virus infection
screening procedure.
More Information
Find more information in the medical
policy and coding section.