California Insurers Must Now Cover HPV Testing
[Posted 10/19/06]

Governor Schwarzenegger recently signed a CMA-sponsored bill that requires California insurers to immediately begin covering human papillomavirus (HPV) testing as part of cervical cancer screening. The law, which makes California the fifth state in the nation to require coverage of HPV testing, underscores the test’s role as an emerging standard of care in cancer screening.

Digene Corporation manufactures the only FDA-approved test for high-risk strains of HPV. The test is approved for use along with a Pap smear to screen women age 30 and older, the group most at risk for cervical cancer.

Earlier this year the Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices (ACIP) recommended that 11- and 12-year-old girls be routinely vaccinated against HPV. With ACIP approval, it is likely that federal officials will also vote to add the HPV vaccine to the federal Vaccines for Children program, which pays for immunizations for the poor.

A CMA-sponsored law requires California health plans to pay for vaccines covered by the federal vaccine program. Unfortunately, although the vaccine is approved for females age 9 to 26, is it likely that most payors will only cover the vaccine for 11 and 12 year olds, as would be required by law. The vaccine costs $360 (three shots at $120 each).

Contact: Sandra Bressler, 415/882-5171 or sbressler@cmanet.org.