The Centers for Medicare and Medicaid Services shifted gears on its reimbursement policy for both standard and rapid HIV tests, in an attempt to catch more undiagnosed cases in vulnerable populations.
The national insurer changing a statute to make it easier for people whose behavior puts them at greater risk of contracting the virus to get annual screening.
CMS said it will now reimburse physicians for annual HIV screening for the following populations:
- Men who have had sex with men after 1975;
- Men and women having unprotected sex with multiple partners;
- Past or present injection drug users;
- Men and women who exchange sex for money or drugs, or have sex partners who do;
- Individuals whose past or present sex partners were HIV-infected, bisexual or injection drug users;
- People being treated for sexually transmitted diseases;
- People with a history of blood transfusion between 1978 and 1985;
- People who request an HIV test, despite reporting no individual risk factors, since this group is likely to include individuals not willing to disclose high-risk behaviors.;
The moves are meant to increase patient awareness and to bolster prevention by broadening access to the tests. Previous coverage decisions did not take a patients’ lifestyle into consideration.
The agency estimates that more than 250,000 people living with HIV and AIDS go undiagnosed, the combined result of a lack of awareness, the reticence of patients to reveal HIV-risky behavior and general reimbursement roadblocks, which made physicians shy away from preventive testing.
CMS also cited new data from a National Social Life, Health, and Aging Project study showing that people are remaining sexually active later in life.
“It is know known that a majority of older adults regard sexuality as an important part of life and that many are sexually active, including 53 percent among those respondents 65-74 years of age and 26 percent among respondents 75-85 years of age,” according to the study.