CMS Releases Final Medicare Hepatitis B Screening Coverage Determination

 
 
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On September 29, 2016, the Centers for Medicare and Medicaid Services (CMS) released its final decision memo for adding hepatitis B screening as a covered Medicare preventive service. CMS will now cover hepatitis B screening at no cost to Medicare beneficiaries who are at high risk as defined by the United States Preventive Services Task Force. To be covered by Medicare, the test would need to be ordered by the beneficiary's primary care physician or practitioner within the context of a primary care setting and performed by an eligible Medicare provider. You can read this decision memo here

This coverage is the result of advocacy by NVHR, the Association of Asian Pacific Community Health Organizations, Hep B United, the Hepatitis B Foundation, and the National Task Force on Hepatitis B: Focus on Asian and Pacific Islander Americans. In May, 2015, we submitted a formal request to CMS asking for the initiation of a National Coverage Determination process to add hepatitis B screening as a covered Medicare preventive service. CMS initiated this process in January, 2016 and completed its work after nine months of deliberation and two public comment periods.

The CMS decision is a vital new tool in implementing U.S. Preventive Services Task Force and Centers for Disease Control and Prevention hepatitis B screening recommendations. However, by limiting coverage to primary care, CMS is creating barriers to hepatitis B screening in other vital health care settings, such as emergency departments. Similar restrictions have created significant challenges in hepatitis C screening and other covered preventive services. NVHR will work with our advocacy partners to identify strategies to overcome these barriers, including urging the new Administration to direct CMS to expand settings for viral hepatitis screening.  

For more information, please contact Ryan Clary.