AEGiS-ATN: Urgent: Medicaid Rule Changes, Comments Due November 30 AIDS Treatment NewsImportant note: Information in this article was accurate in 1998. The state of the art may have changed since the publication date.
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Urgent: Medicaid Rule Changes, Comments Due November 30

AIDS TREATMENT NEWS Issue #307, November 20, 1998
John S. James


Proposed new Federal rules could prevent all state Medicaid programs (MediCal in California) from funding medical tests which are not FDA approved; this would include the ultrasensitive viral load test (even though it costs no more than the approved viral load test), and HIV resistance testing as it moves into the standard of care. Until now, states have had some flexibility on whether or not to cover these tests.

What happened is that a Federal law for balancing the budget required Medicaid to rewrite its rules; 500 pages of new rules on Medicaid managed care were produced. Many of the changes are good, but nowhere do they acknowledge the existing Federal documents which establish a standard of HIV/AIDS care. AIDS advocates believe that the best approach now is to get the new rules to acknowledge the Federal standard, instead of going through the 500 pages to try getting changes piecemeal. While these rules will only apply to Medicaid managed care, they will be persuasive for other programs.

Public comments are due by 5:00 p.m. Monday November 30 in Baltimore. An original and three copies must be delivered, not emailed or faxed, so usually they would need to be shipped by November 27.

More information, including how to submit comments, is being sent to Project Inform's Treatment Action Network, and will be posted on the Project Inform Web site, http://www.projinf.org. If it is not on the site when you need it, or if you do not have Web access, you can call Anne Donnelly at Project Inform, 415-558-8669 ext. 208.


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