Common use of Screening and Counseling Services Clause in Contracts

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: Abdominal aortic aneurism screening for men ages 65 to 75 years old who have ever smoked. Anxiety in Children and Adolescents: Screening ages 8 to 18 years old. Prediabetes and Type 2 diabetes mellitus screening for adults ages 35 to 70 years old who are overweight or obese. Screening for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and domestic violence and abuse. Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. Falls prevention screening for adults age 65 or older. Osteoporosis Coverage for services related to the treatment and appropriate management of osteoporosis when such services are determined to be Medically Necessary. Hepatitis B screenings for persons at high risk of infection. Hepatitis C screenings for adults ages 18 to 79 years old. Latent tuberculosis screening for high-risk populations. Lung cancer screenings for ages 50 to 80 years with a history of smoking. Preventive Physical Examinations. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication adults aged 40 to 75 years who have one or more cardiovascular risk factors. Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam. Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a low-density lipoprotein (LDL) level and a high-density lipoprotein (HDL) level. Periodic stool examination for the presence of blood for all persons 45-75 years of age. Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible sigmoidoscopy o Colonoscopy, and polyp removal when performed as a screening anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual colonoscopy – requires Prior Authorization o Double contrast barium enema After a colonoscopy, any pathology exam that’s required for a biopsy anesthesia a follow-up colonoscopy after a positive non-invasive stool-based screening test or direct visualization screening test. Smoking Cessation Program – refer to Smoking Cessation Counseling/Program in this Section. Screening to determine the need for vision and hearing correction in children. Periodic glaucoma eye test. Healthy Weight and Weight Gain in Pregnancy: Behavioral Counseling Interventions Hypertension in Adults: Screening adults 18 years or older without known hypertension. Syphilis infection screening in persons who are at an increased risk for infection and pregnant women. Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV, STIs, and counseling, as well as counseling for drug and tobacco use, healthy eating and other common health concerns. Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of tobacco use, and/or smoking control, nutrition, and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. Certain prescription drugs for preventive care, the treatment of illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old who have ever smoked. • Anxiety in Children and Adolescents: Screening ages 8 to 18 years old. • Prediabetes and Type 2 diabetes mellitus screening for adults ages 35 to 70 years old who are overweight or obese. • Screening for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and domestic violence and abuse. • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. Falls prevention screening for adults age 65 or older. • Osteoporosis Coverage for services related to the treatment and appropriate management of osteoporosis when such services are determined to be Medically Necessary. • Folic Acid for the Prevention of Neural Tube Defects: Preventive Medication • Breast Cancer: Medication Use to Reduce Risk • Falls prevention screening for adults age 65 or older. • Hepatitis B screenings for persons at high risk of infection. • Hepatitis C screenings for adults ages 18 to 79 years old. • Latent tuberculosis screening for high-risk populations. • Lung cancer screenings for ages 50 to 80 years with a history of smoking. • Preventive Physical Examinations. • Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication adults aged 40 to 75 years who have one or more cardiovascular risk factors. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a low-density lipoprotein (LDL) level and a high-density lipoprotein (HDL) level. • Periodic stool examination for the presence of blood for all persons 45-75 years of age. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible sigmoidoscopy o Colonoscopy, and polyp removal when performed as a screening ▪ anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual colonoscopy – requires Prior Authorization o Double contrast barium enema • After a colonoscopy, any pathology exam that’s required for a biopsy anesthesia a follow-up colonoscopy after a positive non-invasive stool-based screening test or direct visualization screening test. • Smoking Cessation Program – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction in children. • Periodic glaucoma eye test. • Healthy Weight and Weight Gain in In Pregnancy: Behavioral Counseling Interventions • Hypertension in Adults: Screening adults 18 years or older without known hypertension. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV, STIs, and counseling, as well as counseling for drug and tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of tobacco use, and/or smoking control, nutrition, and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Certain prescription drugs for preventive care, the treatment of illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: Abdominal aortic aneurism screening for men ages 65 to 75 years old who have ever smoked. Anxiety in Children and Adolescents: Screening ages 8 to 18 years old. Prediabetes and Type 2 diabetes mellitus screening for adults ages 35 to 70 years old who are overweight or obese. Screening for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and domestic violence and abuse. Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. Falls prevention screening for adults age 65 or older. Osteoporosis Coverage for services related to the treatment and appropriate management of osteoporosis when such services are determined to be Medically Necessary. Hepatitis B screenings for persons at high risk of infection. Hepatitis C screenings for adults ages 18 to 79 years old. Latent tuberculosis screening for high-risk populations. Lung cancer screenings for ages 50 to 80 years with a history of smoking. Preventive Physical Examinations. Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication adults aged 40 to 75 years who have one or more cardiovascular risk factors. Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam. Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a low-density lipoprotein (LDL) level and a high-density lipoprotein (HDL) level. Periodic stool examination for the presence of blood for all persons 45-75 years of age. Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible sigmoidoscopy o Colonoscopy, and polyp removal when performed as a screening anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual colonoscopy – requires Prior Authorization o Double contrast barium enema After a colonoscopy, any pathology exam that’s required for a biopsy anesthesia a follow-up colonoscopy after a positive non-invasive stool-based screening test or direct visualization screening test. Smoking Cessation Program – refer to Smoking Cessation Counseling/Program in this Section. Screening to determine the need for vision and hearing correction in children. Periodic glaucoma eye test. Healthy Weight and Weight Gain in In Pregnancy: Behavioral Counseling Interventions Hypertension in Adults: Screening adults 18 years or older without known hypertension. Syphilis infection screening in persons who are at an increased risk for infection and pregnant women. Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV, STIs, and counseling, as well as counseling for drug and tobacco use, healthy eating and other common health concerns. Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of tobacco use, and/or smoking control, nutrition, and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. Certain prescription drugs for preventive care, the treatment of illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old who have ever smoked. • Anxiety in Children and Adolescents: Screening ages 8 to 18 years old. • Prediabetes and Type 2 diabetes mellitus screening for adults ages 35 to 70 years old who are overweight or obese. • Screening for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and domestic violence and abuse. • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. • Falls prevention screening for adults age 65 or older. • Osteoporosis Coverage for services related to the treatment and appropriate management of osteoporosis when such services are determined to be Medically Necessary. • Hepatitis B screenings for persons at high risk of infection. • Hepatitis C screenings for adults ages 18 to 79 years old. • Latent tuberculosis screening for high-risk populations. • Lung cancer screenings for ages 50 to 80 years with a history of smoking. • Preventive Physical Examinations. • Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication adults aged 40 to 75 years who have one or more cardiovascular risk factors. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a low-density lipoprotein (LDL) level and a high-density lipoprotein (HDL) level. • Periodic stool examination for the presence of blood for all persons 45-75 years of age. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible sigmoidoscopy o Colonoscopy, and polyp removal when performed as a screening ▪ anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual colonoscopy – requires Prior Authorization o Double contrast barium enema • After a colonoscopy, any pathology exam that’s required for a biopsy anesthesia a follow-up colonoscopy after a positive non-invasive stool-based screening test or direct visualization screening test. • Smoking Cessation Program – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction in children. • Periodic glaucoma eye test. • Healthy Weight and Weight Gain in In Pregnancy: Behavioral Counseling Interventions • Hypertension in Adults: Screening adults 18 years or older without known hypertension. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV, STIs, and counseling, as well as counseling for drug and tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of tobacco use, and/or smoking control, nutrition, and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Certain prescription drugs for preventive care, the treatment of illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.details.‌‌‌

Screening and Counseling Services. Screenings and counseling services will provide coverage for evidence-based services that have a rating of A or B in the current recommendations of the U.S. Preventive Services Task Force for individuals in certain age groups or based on risk factors. Key screenings include but are not limited to: • Abdominal aortic aneurism screening for men ages 65 to 75 years old who have ever smoked. • Anxiety in Children and Adolescents: Screening ages 8 to 18 years old. • Prediabetes and Type 2 diabetes mellitus screening for adults ages 35 to 70 years old who are overweight or obese. • Screening for human immunodeficiency virus (HIV), sexually transmitted infections (STIs), and domestic violence and abuse. • Heart Artery Calcification scans are a computed tomography scan measuring coronary artery calcium for atherosclerosis and abnormal artery structure and function. These scans are Covered for individuals between the ages of 45-65 years. Refer to the Heart Artery Calcification section for more details. Falls prevention screening for adults age 65 or older. • Osteoporosis Coverage for services related to the treatment and appropriate management of osteoporosis when such services are determined to be Medically Necessary. • Falls prevention screening for adults age 65 or older. • Hepatitis B screenings for persons at high risk of infection. • Hepatitis C screenings for adults ages 18 to 79 years old. • Latent tuberculosis screening for high-risk populations. • Lung cancer screenings for ages 50 to 80 years with a history of smoking. • Preventive Physical Examinations. • Statin Use for the Primary Prevention of Cardiovascular Disease in Adults: Preventive Medication adults aged 40 to 75 years who have one or more cardiovascular risk factors. • Health appraisal exams, laboratory and radiological tests, and early detection procedures for the purpose of a routine physical exam. • Period glaucoma eye test. • Periodic tests to determine metabolic, blood hemoglobin, blood pressure, blood glucose level, and blood cholesterol level, or alternatively, a fractionated cholesterol level including a low-density lipoprotein (LDL) level and a high-density lipoprotein (HDL) level. • Periodic stool examination for the presence of blood for all persons 45-75 years of age. • Colorectal cancer screening in accordance with the evidence-based recommendations established by the United States Preventive Services Task Force for determining the presence of pre-cancerous or cancerous conditions and other health problems including: o Fecal occult blood testing (FOBT) o Flexible sigmoidoscopy o Colonoscopy, and polyp removal when performed as a screening ▪ anesthesia services are also at no Cost-Share to Covered members when performed as part of Colonoscopy screening o Virtual colonoscopy – requires Prior Authorization o Double contrast barium enema • After a colonoscopy, any pathology exam that’s required for a biopsy anesthesia a follow-up colonoscopy after a positive non-invasive stool-based screening test or direct visualization screening test. • Smoking Cessation Program – refer to Smoking Cessation Counseling/Program in this Section. • Screening to determine the need for vision and hearing correction in children. Periodic glaucoma eye test. • Healthy Weight and Weight Gain in In Pregnancy: Behavioral Counseling Interventions • Hypertension in Adults: Screening adults 18 years or older without known hypertension. • Syphilis infection screening in persons who are at an increased risk for infection and pregnant women. • Preventive screening services including screening for depression, diabetes, cholesterol, obesity, various cancers, HIV, STIs, and counseling, as well as counseling for drug and tobacco use, healthy eating and other common health concerns. • Health education and consultation from In-network Practitioners/Providers to discuss lifestyle behaviors that promote health and well-being including, but not limited to, the consequences of tobacco use, and/or smoking control, nutrition, and diet recommendations, and exercise plans. For Members 19 years of age or older, health education also includes information related to lower back protection, immunization practices, breast self-examination, testicular self-examination, use of seat belts in motor vehicles and other preventive healthcare practices. • Certain prescription drugs for preventive care, the treatment of illness, behavioral health, or substance use disorders will be Covered at No Charge to you, when obtained from a participating pharmacy. See your Plan’s Covered drug list for details.details.‌‌‌