The Center for Medicaid and CHIP Services (CMCS) announced on June 1, 2016 that Medicaid funds can now be used to help combat the Zika virus. This virus, transmitted through the bite of infected mosquitoes, causes fever, rashes and joint pain in adults. It is rarely a cause of death, but has serious health consequences on pregnant women and their unborn. In a five-page bulletin, the CMCS describes how individuals with eligibility for Medicaid can protect themselves from the virus, undergo tests to see if they have contracted it and receive treatment in case they do. Medicaid services will include the following:
- Mosquito repellents. State programs may cover the authorized prescription of mosquito repellents, such as those approved by the Environmental Protection Agency. Over-the-counter repellents are not eligible.
- Family planning counseling and contraception. Safe and responsible sexual practices are to be a key focus of informational programs, since the virus can pass from an infected pregnant woman to her fetus. The infection can lead to birth defects in the brain, eyes, auditory senses and physical growth. States will provide access to barrier method contraceptives and may also cover for oral contraceptives.
- Diagnostics. States must now also cover all medically necessary diagnostic services for detecting Zika and related health risks. In cases of pregnant women, diagnostics will range from a blood test for the mother, to an ultrasound checking the fetus’ condition, to further CAT scans and MRI testing on both mother and child, if necessary.
- Targeted case management. When a person is in need of treatment, states may provide an assessment, develop a personalized care plan, oversee referrals to specialists and monitor a case.
- Rehabilitation support. States also have the option to offer qualified patients with physical, occupational, speech and audio logic therapy.
- All prescribed drugs will be taken care of by the state. Medicines for Zika treatment would include antipyretic analgesics and electrolyte solutions.
- Long-term support. Medicaid may also be used for long-term recovery and rehabilitative care, including nursing home services.
Full details on the services are available on the official Medicaid website. Despite these new Medicaid provisions, hospitals may not yet expect significant impact on their systems for healthcare revenue cycle management. As of June 1, 2016, there have been zero cases of people acquiring Zika in the United States; all 618 individuals in the country diagnosed with the virus contracted it while traveling abroad. Nonetheless, with foreign travel bound to increase in the summer, healthcare providers and the public alike are encouraged to take precautionary measures and avoid the virus. Sources Medicaid Benefits Available for the Prevention, Detection and Response to the Zika Virus, Medicaid.gov Feds say Medicaid can pay for mosquito repellent to prevent Zika, usatoday.com CMS says states can fight Zika with Medicaid funds, modernhealthcare.com Zika Virus, cdc.gov Zika virus disease in the United States, 2015–2016, cdc.gov