HIV Screening to Be Included in Medicare Expansion

In a decision that became effective immediately, the Centers for Medicare & Medicaid Services (CMS) announced Tuesday that it would cover the cost of HIV testing for Medicare beneficiaries at increased risk of infection. This includes pregnant women as well as beneficiaries of any age who request the test.

"Today's decision marks an important milestone in the history of the Medicare program," said Kathleen Sebelius, secretary of the Department of Health and Human Services. "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."

Prior to the passage of the Medicare Improvements for Patients and Providers Act of 2008, CMS needed the approval of Congress to add preventive screening tests. Under MIPPA, CMS can evaluate whether Medicare should cover preventive services that Congress has not already classified by law as covered or non-covered. The new services must have been "strongly recommended" or "recommended" by the US Preventive Services Task Force. HIV screening for certain groups has been "strongly recommended" by the Task Force.

"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 [AIDS]," said CMS Acting Administrator Charlene Frizzera.

For more on the CMS policy change, visit www.cms.hhs.gov/mcd/viewdecisionmemo.asp?from2=viewdecisionmemo.asp&id=229&.

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