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Improving lead testing among CHIP members

October 31, 2014

Some of our Pennsylvania Children?s Health Insurance Program (CHIP) population may reside in homes that place them at risk for elevated blood lead levels (EBLL). Therefore, we would like to take this opportunity to remind your practice how to identify our CHIP members so you can evaluate the need for testing.

During 2013, the Pennsylvania Insurance Department reiterated to health plans the importance of lead testing for CHIP members. Independence shared with practitioners the Centers for Disease Control and Prevention?s (CDC) updated recommendation for prevention of lead poisoning and a new reference level of 5?g/dL to identify children and environments associated with lead-exposure hazards.

In accordance with the Pennsylvania Insurance Department and Healthcare Effectiveness Data and Information Set (HEDIS®) specification, all children currently enrolled in the CHIP program should receive a test for EBLL. Children who are enrolled in CHIP follow the same guidelines for lead testing as children who are enrolled in the Medicaid program; therefore, they should receive at least one lead capillary or venous blood test on or before their second birthday.

Identifying CHIP members

All CHIP members are issued an Independence member ID card with the words ?PA KIDS? written on the front. See the sample CHIP ID card below.

What practices can do: Lead testing vs. screening

While the terminologies are sometimes used interchangeably, lead screening is not the same as lead testing:

  • Lead testing: Described as one or more lead capillary or venous blood test for lead poisoning. Practitioners are asked to conduct lead testing for children enrolled in the CHIP program between ages 9 to 12 months and again at 24 months and thereafter based on risk. All CHIP members should be tested for EBLL regardless of risk level.
  • Lead screening: Described as an assessment or questionnaire regarding a child?s health or living environment. Screening should be performed starting at 6 months, then again at 9 and 18 months, then annually from ages 3 to 6 with testing as appropriate.

Your personal recommendation has tremendous influence on the parents/guardians of your pediatric patients and their decision to seek lead testing information for their children. Therefore, we respectfully ask for your practice?s participation in ensuring that all CHIP members receive lead testing as appropriate.

Resources

Use the following resources for additional information regarding lead testing recommendations:

  • CDC: www.cdc.gov/nceh/lead/nlppw.htm
  • Philadelphia Department of Public Health: 215-685-2788 (Philadelphia residents)
  • National Lead Information Center: 1-800-424-LEAD (non-Philadelphia residents)
  • National Lead Poisoning Prevention Week campaign toolkit: This toolkit was developed by the CDC, along with the Environmental Protection Agency and the Department of Housing and Urban Development, to encourage information-sharing, collaboration, and promotion of lead poisoning prevention activities. To download the toolkit, go to www2.epa.gov/lead/lead-poisoning-prevention-week-2014
  • National Center for Healthy Housing: www.nchh.org
  • U.S. Department of Housing and Urban Development: www.HUD.gov
  • United States Consumer Product Safety Commission: www.cpsc.gov

HEDIS is a registered trademark of the National Committee for Quality Assurance (NCQA). Used with permission.


This content was prepared for the Provider News Center and may not be reproduced in any way without the express written permission of Independence Blue Cross. Independence Blue Cross is an independent licensee of the Blue Cross and Blue Shield Association.
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