U.S. Medicare may pay for HIV testing

Americans enrolled in the Medicare health insurance program would be able to get screened for HIV under a draft government proposal to pay for the tests.

The Centers for Medicare and Medicaid Services (CMS), which oversees the program for the elderly and disabled, said on Wednesday there was enough evidence to show that such screening tests could help detect the infection sooner.

“CMS believes that there is now adequate evidence that voluntary HIV screening ... is reasonable and necessary for early detection of HIV and is appropriate for Medicare beneficiaries,” the agency said.

An estimated 1.1 million Americans are infected with the human immunodeficiency virus, or HIV, that causes AIDS, according to the U.S. Centers for Disease Control and Prevention. Each year an additional 56,000 are newly infected.

About 19 percent of U.S. residents with AIDS were 50 years old or older when they were diagnosed, U.S. Health and Human Services Secretary Kathleen Sebelius said in a statement.

“Knowing about their HIV status can help patients live longer, fuller lives as well as avoid unintentional transmission of the virus to others,” Sebelius said.

The move could be a big boost to makers of such tests given Medicare’s more than 45 million patients. While CMS said the tests should be available for those who are most at risk for the infection as well as pregnant women, the agency would not deny them to anyone who wanted to be checked.

Any Medicare patient who requests the test should be able to get it even if they are not considered at-risk “since this group is likely to include individuals not willing to disclose high-risk behaviors,” CMS said.

Such risk factors include having unprotected sex with multiple partners or using injectable drugs, among other behaviors, the agency said, citing widely recognized guidelines.

HIV tests have been available in the United States since 1985, but it was not until earlier this year that CMS was allowed by law to consider covering more preventive medical services.

CMS will take public comment on the decision for 30 days before making its final ruling, which is expected by December 8.

By Susan Heavey

Provided by ArmMed Media