Common use of Preventive Services Clause in Contracts

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Benefits include: 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- specific antigen (PSA) tests. 2. Colorectal Cancer Screening Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society. 3. Pap Smears Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoice.

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Benefits include: 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- specific antigen (PSA) tests. 2. Colorectal Cancer Screening Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society. 3. Pap Smears Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoiceCareFirst.

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Services. Benefits include: 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically Screening. Medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- examinations including prostate-specific antigen (PSA) teststests and digital rectal exams: a) For men who are between forty (40) and seventy-five (75) years of age; b) When used for the purpose of guiding patient management in monitoring the response to prostate cancer treatment; c) When used for staging in determining the need for a bone scan for patients with prostate cancer; or, SAMPLE d) When used for male Members who are at high risk for prostate cancer. 2. Colorectal Cancer Screening Screening. Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society, including any medically appropriate pre-procedure consultation as well as any pathology examination on a polyp biopsy occurring during this preventive procedure. 3. Pap Smears Smears. Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoice.

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Services. Benefits include: 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically Screening. Medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- examinations including prostate-specific antigen (PSA) teststests and digital rectal exams: a) For men who are between forty (40) and seventy-five (75) years of age; b) When used for the purpose of guiding patient management in monitoring the response to prostate cancer treatment; c) When used for staging in determining the need for a bone scan for patients with prostate cancer; or, d) When used for male Members who are at high risk for prostate cancer. 2. Colorectal Cancer Screening Screening. Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society. 3. Pap Smears Smears. Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoice.

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Benefits include: 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- specific antigen (PSA) tests. 2. Colorectal Cancer Screening Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society.. SAMPLE 3. Pap Smears Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoice.

Preventive Services. In addition to the benefits listed in this provision, CareFirst BlueChoice will provide benefits for health exams and other services for the prevention and detection of disease, at intervals appropriate to the Member’s age, sex, and health status, in accordance with the Patient Protection and Affordable Care Act, as amended, and the Health Care and Education Reconciliation Act of 2010, as amended, as well as CareFirst BlueChoice preventive guidelines. At a minimum, benefits for preventive services listed in this provision will be provided once per Benefit Period. Benefits will be provided for evidence-based items or services that have in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force (USPSTF). This includes benefits for preventive maternity care. CareFirst BlueChoice will update new recommendations to the preventive benefits listed in this provision at the schedule established by the Secretary of Health and Human Services. Benefits for preventive care include the following: A. Cancer Screening Services Services. Benefits include:: SAMPLE 1. Prostate Cancer Screening Benefits are available when rendered in accordance with the most current American Cancer Society’s guidelines and include a medically Screening. Medically recognized diagnostic examination, annual digital rectal examinations, and the prostate- examinations including prostate-specific antigen (PSA) teststests and digital rectal exams: a) For men who are between forty (40) and seventy-five (75) years of age; b) When used for the purpose of guiding patient management in monitoring the response to prostate cancer treatment; c) When used for staging in determining the need for a bone scan for patients with prostate cancer; or, d) When used for male Members who are at high risk for prostate cancer. 2. Colorectal Cancer Screening Screening. Colorectal cancer screening provided in accordance with the latest guidelines issued by the American Cancer Society, including any medically appropriate pre-procedure consultation as well as any pathology examination on a polyp biopsy occurring during this preventive procedure. 3. Pap Smears Smears. Benefits are available for pap smears, including tests performed using FDA approved gynecological cytology screening technologies, at intervals appropriate to the Member’s age and health status, as determined by CareFirst BlueChoice.