Medicaid coverage for Hepatitis A services

The Michigan Department of Health and Human Services (MDHHS), along with local health departments (LHDs), are currently investigating the hepatitis A outbreak in Southeast Michigan. In September, a letter from MDHHS was sent to providers in the affected areas, including those in the City of Detroit, and Macomb, Oakland, St. Clair and Wayne counties. The letter notified providers of covered services offered through Michigan Medicaid, and basic information about the infection:

Hepatitis A

Hepatitis A is a highly contagious, vaccine-preventable liver infection. Symptoms often include fever, fatigue, nausea, vomiting, abdominal pain, loss of appetite, jaundice, dark urine, pale stools and diarrhea. The infection is primarily spread from person-to-person through:

  • Ingestion of food, water, or oral contact with objects (including hands) contaminated by feces of a hepatitis A-infected individual.
  • Sexual and close household contact 
  • Persons sharing needles and non-injection drugs

Vaccinations

In addition to good hand hygiene after using the restroom and before handling food, hepatitis A vaccination is the best way to prevent hepatitis A infection. A routine hepatitis A vaccination is recommended as a two-dose series separated by six months. Due to the large number of cases seen in this outbreak, LHDs have expanded the use of the hepatitis A vaccine and are offering it to all individuals asking to be protected.The Advisory Committee on Immunization Practices (ACIP) recommends routine hepatitis A vaccination of the following populations:

  • Chronic liver disease patients (including hepatitis B/C and alcoholic cirrhosis)
  • Recipients of clotting factor concentrates
  • Men who have sex with men
  • Users of injection and non-injection drugs
  • Employees who work with hepatitis A-infected primates or in a hepatitis A virus research laboratory
  • Travelers to countries with intermediate or high levels of endemic hepatitis A infection

To end this outbreak, MDHHS is requesting your partnership to proactively increase vaccination among the highest risk individuals, including:

  • People who use injection and non-injection illicit drugs
  • Individuals who have been recently incarcerated
  • People who are homeless or have transient housing situations
  • People who participate in commercial exchange of sexual practices
  • Staff of healthcare and community service centers and law enforcement agents

Covered services

Michigan Medicaid, MIChild and the Healthy Michigan Plan cover the following services to help address the prevention, diagnosis, and treatment of hepatitis A and related health conditions, including Early and Periodic Screening, Diagnosis and Treatment (EPSDT) services for children under 21 years of age.

Preventive services

Hepatitis A vaccinations (pre-exposure and post-exposure) are a covered Medicaid benefit. Vaccination efforts should be supplemented by health education to improve sanitation, hygiene practices, clean needle practices, and food safety.

Diagnostic services

Medically necessary laboratory testing, including diagnostic testing for the hepatitis A virus, is covered.

Treatment

The following services are covered to treat individuals with active hepatitis A infection:

  • Practitioner visits and services
  • Prescribed drugs
  • Inpatient and outpatient hospital services