GLEH Housing for Gay and Lesbian Seniors

Medicare now covers HIV screenings

by Karen Ocamb - LGBT POV

Tuesday, December 08, 2009

The Centers for Medicare & Medicaid Services just its decision to cover HIV screening for Medicare beneficiaries. The decision is effective immediately.

HHS Secretary Kathleen Sebelius said in a statement:

"Today’s decision marks an important milestone in the history of the Medicare program. 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."

Michael WeinsteinAIDS Healthcare Foundation President Michael Weinstein reacted immediately:

“We commend this decision by CMS to have Medicare cover HIV screening, a move which is certain to save lives; however, the population served by Medicaid in many ways is at far higher risk, and we would urge CMS to have Medicaid quickly follow suit and also cover HIV screening.

One quarter of the 1.1 million people in the US living with HIV currently do not know their HIV status. By knocking down a potential roadblock to testing for people who are at increased risk, CMS is making it easier for the Medicare beneficiaries they serve to get tested and linked to care and services, if necessary. It’s crucial that at-risk Medicaid recipients also have such ready access to HIV testing services.”

Ruth Tittle, CEO Capitol Drugs, Inc. and Board Member, Gay Lesbian Elder Housing in Los Angeles said:

"The decision by The Centers for Medicare & Medicaid Services to expand HIV screening to Medicare beneficiaries is an incredibly progressive step that is long overdue. As we continue to see the growing and troubling rise in the number of HIV infections among older adults aged 50 and above, this decision will help us to begin to address the issue of HIV infection among seniors that has gone unnoticed for so long. A vitally necessary nest step will be to appropriately educate Medicare providers to take advantage of this newly covered preventive service and to prepare them for the inevitable increase in HIV/AIDS cases they will see in order to equip these providers and treat this vulnerable population appropriately.

In 2005, the CDC reports that those aged 50 and above accounted for 15% of all new HIV/AIDS diagnosis. In 2006 the proportion of those over 50 infected rose to 25%, an 8% increase from 2001."

Michael Adams, Executive Director of SAGE, the world’s oldest and largest non-profit agency dedicated to serving LGBT seniors, said:

"This decision will promote more HIV screening by vulnerable populations, including older adults and will save lives. Approximately 29% of people with HIV and AIDS are over the age of 50 and 10-15% of new diagnoses are also in people over the age of 50. Despite those figures, a 2006 CDC study found that adults 65 and older had the lowest HIV testing rates 11.4%, compared to 53.3% of adults 25-34. Testing and infection rates in older adults have been virtually ignored in the United States, as have prevention and education messages targeting older adults.

As the oldest and largest LGBT aging organization in the country, SAGE is proud to be part of a New York City initiative to increase education and prevention messages in the older adult population, and we will continue to advocate at the city, state and national level to continue this work. We will continue this work by advocating that the Centers for Disease Control and Prevention (CDC) remove its age-cap for routine testing, which currently guidelines recommending that all individuals between 13 and 64 years of age be screened for HIV regardless of recognized risk factors. We believe there is no reason to cap the age at 64, and that routine HIV screening happen throughout the course of an adult’s life."

Here is part of the Centers for Medicare & Medicaid Services press release distributed by the White House:

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.

Sebelius:

"Today’s decision marks an important milestone in the history of the Medicare program,” said HHS Secretary Kathleen Sebelius. “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."

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.

"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.

More information about Medicare’s new HIV screening benefit is available in CMS’ final decision memorandum. Read the final decision online.

Here is the press release from AIDS Healthcare Foundation:

LOS ANGELES (December 8, 2009) AIDS Healthcare Foundation (AHF), the largest global AIDS organization, today lauded the Centers for Medicare and Medicaid (CMS), for its decision earlier today to cover HIV testing for Medicare beneficiaries who may be at increased risk for HIV exposure (MSM, IDU) as well as women who are pregnant, and beneficiaries of any age that request to be tested. The decision is effective immediately.

“We commend this decision by CMS to have Medicare cover HIV screening, a move which is certain to save lives; however, the population served by Medicaid in many ways is at far higher risk, and we would urge CMS to have Medicaid quickly follow suit and also cover HIV screening,” said Michael Weinstein, President of AIDS Healthcare Foundation “One quarter of the 1.1 million people in the US living with HIV currently do not know their HIV status. By knocking down a potential roadblock to testing for people who are at increased risk, CMS is making it easier for the Medicare beneficiaries they serve to get tested and linked to care and services, if necessary. It’s crucial that at-risk Medicaid recipients also have such ready access to HIV testing services.”

According to a CMS press statement announcing the expansion of HIV screening coverage, “The Centers for Medicare & Medicaid Services (CMS) today 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. The decision is effective immediately.”

SAGE Commends HHS on New Policy That Allows Medicare Coverage for HIV Screening of Older People press release:

December 8, 2009, New York, NY’s Services and Advocacy for Gay, Lesbian, Bisexual & Transgender Elders (SAGE) commends today¹s announcement by The Centers for Medicare & Medicaid Services (CMS) of its decision to cover Human Immunodeficiency Virus (HIV) infection screening for Medicare beneficiaries who are at increased risk for the infection, including Medicare beneficiaries of any age who voluntarily request the service.

The following statement related to the decision can be attributed to Michael Adams, Executive Director of SAGE:

“This decision will promote more HIV screening by vulnerable populations, including older adults and will save lives. Approximately 29% of people with HIV and AIDS are over the age of 50 and 10-15% of new diagnoses are also in people over the age of 50. Despite those figures, a 2006 CDC study found that adults 65 and older had the lowest HIV testing rates 11.4%, compared to 53.3% of adults 25-34. Testing and infection rates in older adults have been virtually ignored in the United States, as have prevention and education messages targeting older adults.

As the oldest and largest LGBT aging organization in the country, SAGE is proud to be part of a New York City initiative to increase education and prevention messages in the older adult population, and we will continue to advocate at the city, state and national level to continue this work. We will continue this work by advocating that the Centers for Disease Control and Prevention (CDC) remove its age-cap for routine testing, which currently guidelines recommending that all individuals between 13 and 64 years of age be screened for HIV regardless of recognized risk factors. We believe there is no reason to cap the age at 64, and that routine HIV screening happen throughout the course of an adult’s life.”

More information about Medicare’s new HIV screening benefit is available in CMS’ final decision memorandum. Read the final decision.

Link: Original Article