For several years, the Centers for Disease Control and Prevention (CDC) have been presenting the case for testing U.S. Baby Boomers for hepatitis C. People born from 1945 through 1965 account for approximately three fourths of all hepatitis C infections in this country. One in 30 Baby Boomers has hepatitis C. The majority of those with hepatitis C do not know they have it.
In June, the U.S. Preventive Services Task Force (USPSTF) issued recommendations to screen adults born between 1945 and 1965 for hepatitis C. This level of recommendation means that the test is a preventive service and has to be offered at no cost to the individual.
Despite the fact that these two prestigious organizations have sounded the call for testing Baby Boomers, these recommendations are not in place. Health insurance may not automatically pay for hepatitis C testing unless there is a risk factor, elevated liver enzymes, or other clear reason for the test. Requesting a hepatitis C test merely because of one’s birth year may mean that you have to pay for the test.
Some states are taking steps to change this, most notably New York. Effective 1 January 2014, the state’s Hepatitis C Testing Law states:
- A hepatitis C screening test must be offered to every individual born between 1945 and 1965 receiving health services as an inpatient or a hospital, or receiving primary care services in the outpatient department of hospital, or in a freestanding diagnostic and treatment center or from a physician, physician assistant, or nurse practitioner providing primary care.
- If an individual accepts the offer of the hepatitis C screening test and the screening test is reactive, the health care provider must offer the individual follow-up health care or refer the individual to a health care provider who can provide follow-up health care. The follow-up health care must include a hepatitis C diagnostic test.
The Centers for Medicare & Medicaid Services (CMS) is considering age-based hepatitis C screening. The deadline for public commentary is April 3, 2014.
If we test adults born between 1945 and 1965, we may identify 800,000 Baby Boomers who might slip through the cracks if we only did risk-based hepatitis C screening. Furthermore, we may save 120,000 lives.
The only question is why have we waited this long?