Medicare now covers HIV tests

The number of beneficiaries with the infection increased by 80% from 1997 to 2003.

By — Posted Dec. 23, 2009

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The Centers for Medicare & Medicaid Services announced Dec. 8 that Medicare will cover HIV screening services, effective immediately.

Testing will be covered for Medicare beneficiaries who are at increased risk for HIV, as well as for those who request the service.

Under the Medicare Improvements for Patients and Providers Act of 2008, lawmakers gave CMS the flexibility to add to Medicare's list of covered preventive services. Before MIPPA, Medicare could cover additional screenings only when Congress authorized it to do so.

According to the Kaiser Family Foundation, the number of Medicare beneficiaries with HIV increased by 80% between 1997 and 2003, from 42,520 to 76,500. In fiscal year 2008, Medicare spending on HIV totaled $4.5 billion, representing 39% of federal spending on HIV care.

The decision was hailed as a milestone by Health and Human Services 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."

The Centers for Disease Control and Prevention estimates 1.1 million people in the U.S. have HIV, with about 25% not realizing they're infected. Without treatment, AIDS generally develops within eight to 10 years.

In 2006, the CDC called for widespread HIV screening, and the American Medical Association recommends that physicians routinely test adult patients.

At its Annual Meeting in June, the AMA also called for the development and adoption of a single, national plan to address the HIV/AIDS epidemic. Under a resolution adopted at the meeting, the AMA will work with the White House's Office of National AIDS Policy and other relevant bodies to develop such a program.

"Every adult should know their HIV status," said Howard K. Koh, MD, HHS assistant secretary for health. "This decision by Medicare should help promote screening and save lives."

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