CMS National Coverage Determination: Hepatitis B Screening

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The Centers for Medicare and Medicaid Services (CMS) has released a proposed decision memo for adding hepatitis B screening as a covered Medicare preventive service. CMS is proposing to 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.

CMS is now accepting public comments in response to its proposed decision. The deadline to submit comments is August 6, 2016. You can read this decision memo here. You can submit public comments by clicking the "comment" button at the top of the decision memo.

This process is the result of advocacy by NVHR, the Association of Asian Pacific Community Health Organizations (AAPCHO), Hep B United, the Hepatitis B Foundation, and the National Task Force on Hepatitis B. In May, 2015, we submitted a formal request to CMS asking for the initiation of National Coverage Determination process to add hepatitis B screening as a covered Medicare preventive service. CMS initiated this process in January, 2016. CMS will review public comments and release a final decision later in the year (most likely October or November).

NVHR encourages organizations and individuals to submit comments in support of the CMS proposal. Adding hepatitis B screening as a covered Medicare preventive service would significantly improve efforts to identify people living with hepatitis B and link them to lifesaving care and treatment.

We also recommend that these comments include a request to expand coverage beyond the primary care setting. By limiting coverage to primary care, CMS would be 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. CMS must hear from the community about the need for hepatitis B screening to be a covered service in a variety of health care settings.

For more information, or if you need assistance with developing your comments, please contact Ryan Clary.