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Official AAP Letters on Practice Issues |
This is a collection of official letters from the American Academy of Pediatrics about
important pediatric practice issues, including providing information to
carriers about new vaccine codes and ensuring proper understanding,
interpretation and use of the Current Procedural Terminology (CPT) work of
medical nomenclature.
Find more Documents & Forms in the Practice Toolbox
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AAP Letter: AAP Notifies National Payers Regarding Increase in Vaccine Costs
Official AAP letter to the national payers, dated February 11, 2009, urging payers to increase payments to correspond with the vaccine cost increases noting that pediatricians cannot be expected to absorb the cost increases while waiting several months for carriers to update their fee schedules.
AAP Letter: AAP objects to influenza immunization as HEDIS measure
Official AAP letter to the National Committee on Quality Assurance (NCQA), dated November 25, 2008, urging the NCQA to reconsider its intent to incorporate influenza immunizations as a Healthcare Effectiveness Data Information Set (HEDIS) measure beginning 2010.
AAP Letter: AAP Notifies National Payers Regarding Developmental Screenings
Official AAP letter to national payers, dated November 3, 2008, clarifies the recommendations for autism and developmental screening and urges carrier coverage and payment for screenings reported using CPT code 96110.
AAP Letter: AAP Encourages Payers to Update Their Claims Systems for Recognition of the Revised Code Numbers
Official AAP letter to national payers, dated October 23, 2008, to encourage payers to update their claims systems for recognition of the revised code numbers before January 1, 2009.
AAP Letter: AAP Notifies National Payers on Assistive Technology
Official AAP letter to national payers, dated August 29, 2008, notified national carriers, benefit plan consultants and business groups on health informing them of the AAP clinical report Prescribing Assistive-Technology Systems.
AAP Letter: AAP Notified National Carriers of the Prevnar® Price Increase
Official AAP letter to national payers, dated August 13, 2008, notified national carriers of the Prevnar® price increase and urged payers to update their payments in a more timely fashion.
AAP Letter: AAP Notified National Carriers about the Business Case for Breastfeeding
Official AAP letter to national payers, dated July 25, 2008, notified national carriers about initiatives to promote employer support of breatfeeding women. It describes two groups that advocate for insurance coverage of and payment for breastfeeding-related services and equipment in support of the recommendation that infants be exclusively breastfed through the first six months.
AAP Letter: UnitedHealthcare Regarding Apnea Monitoring
Official AAP letter to UnitedHealthcare, dated February 26, 2008, objecting to the carrier's coverage policy for home apnea monitoring for infants and its provisions for terminating monitoring.
AAP Letter: Merck Price Increase for Vaccines
Official AAP letter to medical directors, dated February 13, 2008, notifying national carriers of the increase in the price of Merck vaccines. The letter urged payers to update their fee schedules immediately to reflect the increase costs to pediatricians.
AAP Letter: Hib Vaccine Supply Disruption and Revised Recommendations
Official AAP letter to medical directors, dated January 31, 2008, notifying of the revised recommendations for Hib vaccines as a result of supply disruptions. The letter also advocated for pay for performance measures to account for factors outside of the physicians control, such as disruptions in vaccine availability.
AAP Letter: Payers Notified of Recommendations for Live, Attenuated Influenza Vaccine (LAIV)
Official AAP letter to medical directors, dated December 20, 2007, notifying national carriers of the recent expansion of the recommendations by the Advisory Committee on Immunization Practices (ACIP) for the use of the live, attenuated influenza vaccine (LAIV) to include children 2 to 4 years of age.
AAP Letter: Inappropriate Bundling of Preventive and Problem-Oriented Evaluation and Management (E/M) Visits
Official AAP letter to national carriers and all Blue Cross Blue Shield Plans, dated September 27, 2007. The AAP joined with several other specialty societies in this letter to carriers advocating for payment for preventive and problem-oriented evaluation and management (E/M) visits reported for the same patient on the same day.
AAP Letter: AAP Responds to Coventry Health Care, Inc.
This letter, dated September 19, 2007, urges Coventry Health Care, Inc. to provide adequate payment to physicians for vaccines.
AAP Letter: AAP Responds to Carriers Regarding EHRs and Electronic Prescribing
This letter, dated August 28, 2007, urges payers to support systems to include functions relevant to the pediatric patient.
AAP Letter: Timely Updating of Claims Adjudication Systems for Prevnar Price Increase
Official AAP letter to health plan medical directors, dated August 15, 2007, encouraging timely updates to claims adjudication systems to cover the August 2007 price increase of Prevnar.
AAP Letter: AAP Responds to Great-West on Vaccine Payments
This letter to Great-West is in response to their letter responding to AAP's first communication with them regarding inadequate vaccine payment. It specifically addresses vaccines as a cost center.
AAP Letter: Appropriate Payment for Vaccines and Immunization Administration (Great-West Healthcare)
Official AAP letter to Great-West Healthcare, dated April 2, 2007, providing background and rationale for adequate payment for immunizations.
AAP Letter: Appropriate Payment for Vaccines and Immunization Administration (Excellus Blue Cross Blue Shield)
Official AAP letter to Excellus Blue Cross Blue Shield, dated March 19, 2007, providing background and rationale for adequate payment for immunizations.
AAP Letter: Developmental Screening and Testing
A letter written by the AAP to insurance carriers in March 2007 providing background and rationale for covering all required developmental screening procedures.
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