CMS Opens NCAs for Depression, STI Screenings

The Centers for Medicare & Medicaid Services (CMS) has opened separate national coverage analyses (NCAs) for screenings of depression and sexually transmitted infections (STIs), including high-intensity behavioral counseling (HIBC) to prevent STIs. The agency is considering adding these screenings to the list of preventive services already covered by Medicare, such as Pap smear and screening pelvic exams, screening mammograms, colorectal cancer screening tests, and diabetes screening tests.

NCA for STI Screening and HIBC Counseling

The USPSTF has recommended HIBC to prevent STIs for all sexually active adolescents and for adults at increased risk for STIs with a grade B rating since October 2008.

The NCA on screening for STIs and HIBC includes:

  • Screening for chlamydial infection for all sexually active women aged 24 and younger and for older women who are at increased risk;
  • Screening for gonorrhea infection in all sexually active women, if they are at increased risk;
  • Screening for hepatitis B virus infection in pregnant women at their first prenatal visit;
  • Screening persons with an increased risk for syphilis infection; and
  • HIBC for the prevention of STIs for all sexually active adolescents and for adults at increased risk for STIs.

HIV screening is not included in this NCA because it is already covered by Medicare.

This review was opened Feb. 24, at which time a 30-day comment period began. CMS is soliciting recommendations on the appropriate frequency of these services and those qualified to provide them, based on documentation from medical literature, current practice guidelines or U.S. Preventive Services Task Force (USPSTF) recommendations.

The proposed decision memo due date is Aug. 24, and the expected completion date is Nov. 22.

NCA for Depression Screening

The USPSTF has recommended depression screening in adults with a grade B rating since December 2009. The USPSTF recommends screening adults for depression when staff-assisted depression care supports are in place to assure accurate diagnosis, effective treatment, and follow-up.

CMS posted on its Medicare Coverage Database website a new report the first week of March announcing the NCA for depression screening. Recommendations for the appropriate frequency of this service based on documentation from medical literature, current practice guidelines or USPSTF recommendations are now being solicited.

The comment period for this NCA began March 2 and ends April 1. A final determination is expected by Dec. 1.

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