W.Va. Advances Bill to Charge for HIV Tests

CHARLESTON (AP) – Facing pressure from shrinking federal funds, the West Virginia Senate advanced a bill last week that would allow local health departments to charge patients for testing for sexually transmitted diseases.

The bill is part of an effort to shift costs away from states and toward patients and private insurers. Loretta Haddy, the director of epidemiology at the state Department of Health and Human Resources, said the bill is necessary to allow local clinics to continue operating.

“The only way we can deliver basic public health services is to amend our legislation to allow local health departments to charge for delivery services,” Haddy said.

Haddy said because of the budget cuts and the coming provisions of the Affordable Care Act – which will increase the number of patients with insurance – states are being encouraged to transfer costs to insurers.

“The reason we’re being encouraged to do it is because the federal funding is being cut year after year,” Haddy said. “And there’s no end in sight.”

Currently, anyone in West Virginia can get free STD tests and treatment from local health departments.

The funding for those services comes primarily from the federal Centers for Disease Control and Prevention, which has had recent budget cuts.

Over the last two years, West Virginia has lost about $617,000 in federal money for its HIV-AIDS program. Much of that money was shifted from West Virginia to states with higher HIV rates.

Despite the funding cuts, local health departments have continued to provide basic testing and treatment free of charge.

Under the proposed bill, local health departments would charge patients for STD testing, but would continue to provide free or reduced testing and treatment for the uninsured.

Howard Gamble, Wheeling-Ohio County Health Department administrator, said he is waiting to see the final version of the bill.

”Yes we know funds are shrinking and that we may need to find ways to re coup costs associated with clinical testing. Depending on how the final version of the bill is defined and if it passes this session, local health departments may be able to bill or charge for STD (including HIV) testing,” he said. ”The billing and charging may be … based on either a sliding fee or fee for service schedule of a health department. The legislation may also allow for the billing of a client’s insurance carrier, which could be a problem for both the department, which may not have a billing system, and the client who may not want it known that specific test was conducted.”

He noted if the bill doesn’t pass, the health department will continue to provide the service free of charge.

Ronda Francis, Marshall County Health Department administrator, said whether to charge for such testing services will be up to her board of health.

”Based on our declination of funding, it is certainly something I will bring to their attention as a means to help offset some of the cost of providing such services. Naturally, the willingness of insurance companies to reimburse us for testing and treatment will play a part in the board’s decision,” Francis said.

Sen. Ron Stollings, the bill’s sponsor and former president of the West Virginia Medical Association, said the bill was necessary to try to continue to provide the same services while accounting for reduced federal funding.

“This is a mechanism whereby we can continue to do the sexually transmitted disease testing, the HIV testing,” Stollings said. “There would be a charge to the patient.”

The vast majority of private insurance plans cover HIV and STD testing. The automatic federal budget cuts that went into effect March 1 are expected to cut an additional $62,000 from West Virginia’s HIV-AIDS program. West Virginia’s HIV rate is the 16th lowest in the country and is well below the national average, according to CDC data. Its rates of chlamydia and gonorrhea are also significantly below the national average.

The bill unanimously passed the Senate Health and Human Resources Committee on Thursday. The committee also advanced a bill that would allow doctors to prescribe medication, without an examination, to the partners of people with an STD.