[Federal Register Volume 89, Number 90 (Wednesday, May 8, 2024)]
[Notices]
[Pages 38905-38906]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-10006]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES


Notice for Public Comments on Potential Viral Hepatitis Quality 
Measures in Medicaid

AGENCY: Office of Infectious Disease and HIV/AIDS Policy, Office of the 
Assistant Secretary for Health, Office of the Secretary, Department of 
Health and Human Services.

ACTION: Notice for public comment.

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SUMMARY: The Department of Health and Human Services' (HHS) Office of 
Infectious Disease and HIV/AIDS Policy (OIDP) in the Office of the 
Assistant Secretary for Health (OASH) invites public comment on 
potential viral hepatitis quality measures for implementation at the 
state and territory level. In March 2024, OIDP hosted a technical 
consultation meeting (https://youtu.be/YCVC8GwFE7E) to initiate the 
process of understanding the needs and developing national consensus on 
clinically meaningful and feasible viral hepatitis quality measures for 
proposal to the Medicaid Adult Core Set.

DATES: All comments must be received by 5 p.m. ET on June 7, 2024 to be 
considered.

ADDRESSES: All comments must be submitted electronically to 
[email protected] to be considered.

FOR FURTHER INFORMATION CONTACT: Jessica Deerin, Ph.D., MPH, OIDP, 
Viral Hepatitis Policy Advisor at [email protected] or 202-795-
7625.

SUPPLEMENTARY INFORMATION: CDC released updated hepatitis C and 
hepatitis B screening recommendations to screen all adults aged 18 
years and older at least once in a lifetime and all pregnant women 
during each pregnancy in April 2020 and March 2023, respectively. 
Screening is an important first step in the viral hepatitis continuum 
of care and a necessary tool to reach viral hepatitis elimination by 
2030.
    Additionally, hepatitis C has a life-saving treatment resulting in 
a cure in >95% of patients. Yet, many patients are not linked to care 
and complete treatment. Less than 1 in 3 people with health insurance 
initiated DAA treatment within a year of hepatitis C diagnosis and 
people with Medicaid were less likely to initiate treatment than those 
with private insurance. Hepatitis B treatment can reduce hepatitis B 
viral load, lowering the risk of liver cancer and mortality.
    Quality measures are tools to monitor and improve the quality of 
health care. Scaling up viral hepatitis screening, linkage to care, and 
access to treatment will ultimately reduce transmission, incidence of 
new infections, prevent liver cancer and mortality, and allow the U.S. 
to make strides in reaching viral hepatitis elimination by 2030.
    There are currently no viral hepatitis quality measures in the 
Medicaid Adult Core Set. The Medicaid Adult Core Set is a core set of 
health care quality measures related to physical and behavioral health 
for adult Medicaid enrollees. The Adult Core Set encourages 
standardized reporting by States on a uniform set of measures to drive 
quality improvement. Since Medicaid provides coverage for a 
disproportionate number of people with hepatitis B and hepatitis C, 
OIDP is leading an initiative to develop consensus around clinically 
meaningful and feasible state level viral hepatitis quality measures to 
propose to the Medicaid Adult Core Set.
    OIDP hosted a Viral Hepatitis Quality Measures Technical 
Consultation Meeting on March 7, 2024. State panelists from Medicaid 
and public health departments shared their experience in selection, 
testing, and implementation of current state viral hepatitis quality 
measures, as well as recommendations for measures to propose to the 
Medicaid Adult Core Set. State panelists reached consensus to 
prioritize the development, use, and adoption of a hepatitis C 
screening and treatment initiation measure based on the following 
rationale:
     Clinical and public health insights are high, leading to 
an understanding of the cascade of care for infected people who access 
treatment and cure;
     The measure drives screening and linkage to care by 
translating recently updated CDC recommendations into routine practice 
in the health care delivery system;
     Data for a screening and treatment initiation measure is 
available to state Medicaid programs through administrative claims and 
encounter data, and is consistent and comparable across states; and
     The method of using administrative data sources to 
represent hepatitis C treatment through pharmacy claims was explained 
as an acceptable proxy for receipt of treatment.
    HHS hereby requests public comment on the clinical significance, 
usability, feasibility, and likely uptake of hepatitis C screening and 
hepatitis C treatment initiation quality measures, as well as 
recommendations with adequate justifications on other feasible viral 
hepatitis measures to consider.

Information Needs

    HHS is seeking responses with adequate justification to the 
questions listed below.
    1. Are you in support of adopting a hepatitis C screening and 
treatment initiation measure within state Medicaid programs?
    a. If you represent a state Medicaid program, what is the likely 
uptake of this measure?
    2. What other measures should HHS consider for testing and proposal 
to the Medicaid Adult Core Set (i.e., hepatitis B screening, hepatitis 
B linkage to care, hepatitis C sustained virological response (SVR))? 
Please provide support for how that measure is clinically meaningful, 
feasible, and actionable for state Medicaid programs. What data source 
or data element can be utilized to calculate the measure?
    3. Would it be feasible and clinically meaningful to implement a 
hepatitis B screening, hepatitis C screening and hepatitis C treatment 
initiation quality measure within state Medicaid programs? If you 
represent a state Medicaid program, what is the likely uptake of this 
measure?


[[Page 38906]]


    Dated: May 2, 2024.
B. Kaye Hayes,
Deputy Assistant Secretary for Infectious Disease, Department of Health 
and Human Services.
[FR Doc. 2024-10006 Filed 5-7-24; 8:45 am]
BILLING CODE 4150-44-P