CMS Invites Comments on Proposed Decision Regarding Coverage of Hepatitis C Screening

Content From: Michelle Moses-Eisenstein, M.P.H., Public Health Analyst, Office of HIV/AIDS and Infectious Disease Policy, U.S. Department of Health and Human ServicesPublished: March 07, 20142 min read


cms logoThis week, the Centers for Medicare and Medicaid Services (CMS) released their proposed decision memo for the National Coverage Analysis (NCA) on Medicare coverage for Hepatitis C virus (HCV) screening in adults. They find that “the evidence is adequate to conclude that screening for Hepatitis C Virus (HCV), consistent with the grade B recommendationsExit Disclaimer by the U.S. Preventive Services Task Force, is reasonable and necessary for the prevention or early detection of an illness or disability and is appropriate for individuals entitled to benefits under Part A or enrolled under Part B.” The proposed decision memo then discusses CMS’ proposal to cover HCV screening in primary care settings for Medicare beneficiaries who meet either of the following conditions:

  1. High risk for HCV – defined as “persons with a current or past history of illicit injection drug use; and persons who have a history of receiving a blood transfusion prior to 1992. Repeat screening for high risk persons is covered annually only for persons who have had continued illicit injection drug use since the prior negative screening test.”
  2. Persons born from 1945-1965, who do not meet the ‘high risk’ definition above, are eligible for a single screening test.

CMS is accepting public comments on the proposed decision memo until April 3, 2014. Instructions on submitting public comments can be found here. You can also submit a public comment directly from the page containing the proposed decision memo using the “Comment” buttons found at the top and bottom of the page. The expected NCA completion date is June 2, 2014.