The Centers for Medicare & Medicaid Services (CMS) last week announced its final decision to cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including women who are pregnant and Medicare beneficiaries of any age who voluntarily request the service. The decision is effective immediately.
Under the recently passed Medicare Improvements for Patients and Providers Act of 2008 (MIPPA), CMS now has the flexibility of adding to Medicare's list of covered preventive services, if certain requirements are met. Prior to this law, Medicare could only cover additional preventive screening tests when Congress authorized it to do so.
HHS Secretary Kathleen Sebelius said the decision was an important milestone. "Beginning with expanding coverage for HIV screening, we can now work proactively as a program to help keep Medicare beneficiaries healthy and take a more active role in evaluating the evidence for preventive services."
Read more after the jump.
Under MIPPA, CMS can consider whether Medicare should cover preventive
services that Congress has not already deemed as covered or non-covered
by law. Among other requirements, the new services must have been
"strongly recommended" or "recommended" by the U.S. Preventive Services
Task Force. For instance, the Task Force graded HIV screening as
"strongly recommended" for certain groups. More information about the
Task Force is available online at
http://www.ahrq.gov/clinic/uspstfix.htm.
"Every adult should know their HIV status," said Dr. Howard K. Koh, HHS
assistant secretary for health. "This decision by Medicare should help
promote screening and save lives."
CMS uses the national coverage determination (NCD) process to make
decisions on these types of preventive services. This process provides
transparency about the evidence that CMS considers when making its
decisions and allows opportunity for the public to comment on CMS'
proposals.
"Medicare's coverage of HIV screening tests is an important step forward
in protecting beneficiaries from the potentially devastating and
life-threatening complications of HIV and Acquired immunodeficiency
Syndrome (AIDS)," said CMS Acting Administrator Charlene Frizzera.
AIDS is diagnosed when an HIV-infected person's immune system becomes
severely compromised or a person becomes ill with an HIV-related
infection. Of the more than one million estimated to have the HIV
infection, the Centers for Disease Control and Prevention has estimated
that about a quarter of them do not realize they are infected. Without
treatment, AIDS develops within 8 to 10 years. While there is presently
no cure for HIV, screening can help identify infected patients so that
they can receive medical treatment that could help delay the onset of
AIDS for years.
