The U.S. Preventive Services Task Force (USPSTF) finalized its recommendation yesterday, April 29 2013, in strong support of routine HIV testing for ALL adolescents and adults ages 15 through 65. Until now, the Task Force recommended testing only for people who are at risk for HIV and pregnant women.
“This marks a monumental shift in how HIV in the United States can be prevented, diagnosed and treated,” commented Carl Schmid, Deputy Executive Director of The AIDS Institute. He added, “It will also favorably impact the reimbursement of HIV testing across payers which removes one of the barriers to HIV testing.”
Grades issued by the USPSTF are often the basis for payers to cover preventive services. This is even more significant under the Affordable Care Act (ACA), which bases reimbursement for many preventive services by private insurers, Medicare and Medicaid on USPSTF grades. For example, under ACA, most private plans will be required to cover all Grade A and B USPSTF services without cost-sharing. The USPSTF had previously given routine HIV screening a “C” grade; now it will be an “A.”
With this grade change, all primary payers, including Medicaid and Medicare, will be required or incentivized to cover routine HIV screening.
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