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Government considers funding extra STD tests for seniors, disabled

Updated: 12:09 p.m.

Seniors and people with disabilities who receive health care through Medicare* might have an additional service covered in the near future: testing for sexually transmitted diseases such syphilis, gonorrhea and hepatitis B, according to a Reuters report. Centers for Medicare and Medicaid Services (CMS) is due to decide on the measure within the next nine to 12 months.

Government-funded health insurance already covers HIV testing, but now CMS is looking into paying for additional STD exams, in an effort to promote preventative care and reduce the amount spent on costly treatments for people who do become infected.

CMS spokesperson Don McLeod said that under the Affordable Care Act, Medicare has to cover what other private insurers cover if the government deems these procedures appropriate and necessary. Cost of the increased coverage is never factored into CMS’ determination, he said.

“Somebody else has to worry about how to pay for it.”

The tests up for consideration -– chlamydia, gonorrhea, hepatitis B and syphilis -– target people considered to be high risk for these diseases: women, pregnant women and people with disabilities.

The Centers for Disease Control and Prevention estimates:

  • Approximately 1.2 million chlamydial infections were reported in 2008, though the disease is frequently under-reported because many people don’t know they have chlamydia and do not seek testing. In women, untreated infections can increase the risk of HIV, cause pelvic inflammatory disease, and lead to infertility or pregnancies outside the uterus.
  • More than 700,000 Americans contract new gonorrheal infections each year, but only about half of these infections are reported to the CDC. A pregnant women with gonorrhea can give birth to a baby who is blind or has a life-threatening blood infection.
  • In 2007, there were an estimated 43,000 new hepatitis B virus infections in the U.S., and an estimated 800,000 to 1.4 million Americans have chronic hepatitis B.
  • More than 36,000 cases of syphilis were reported in 2006. Reported cases of congenital syphilis in newborns increased from 339 in 2005 to 349 in 2006. Pregnant women with syphilis are at greater risk at giving birth to stillborns. Rates have increased in men every year between 2000 and 2006 from 2.6 to 5.7 percent. In 2006, 64 percent of reported syphilis cases were among men who have sex with men.

According to Reuters, since 2009 CMS has had the power to add coverage for preventive services; currently Medicare covers pap smears and pelvic exams and tests for colorectal cancer and diabetes.

Furthering preventative care, the Department of Health and Human Services announced Thursday that it will allocate $100 million to states that offer incentives to Medicaid beneficiaries who adopt healthy habits, as part of the Affordable Care Act. For instance, a state could establish a set of goals -– such as quitting smoking or losing weight -– and people who meet those goals could be offered direct cash incentives, gift cards, reduced Medicaid program fees or even services not normally available through Medicaid.

“With the right incentives, we believe that people can change their behaviors and stop smoking or lose weight,” said CMS Administrator Dr. Donald Berwick, in a press release. “Not only can preventive programs help to improve individuals’ health, by keeping people healthy we can also lower the nation’s overall health care costs.”

The Centers for Medicare & Medicaid Services is now inviting proposals from states to compete for grant awards for this legislatively mandated Medicaid Incentives for Prevention of Chronic Diseases Program. The program will target behaviors that cause some of the most critical chronic conditions Americans face: smoking (kills 430,000 people a year, according to HHS), obesity, heart disease, and diabetes. States’ notices of intent are due April 4; applications are due May 2.

Seniors and people with disabilities who receive health care through Medicare* might have an additional service covered in the near future: testing for sexually transmitted diseases such syphilis, gonorrhea and hepatitis B, according to a Reuters report. Centers for Medicare and Medicaid Services (CMS) is due to decide on the measure within the next nine to 12 months.

*Earlier we stated that additional STD coverage could be extended to Medicare and Medicaid beneficiaries, but only Medicare beneficiaries would be affected.

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