CMS Rejects California Proposal to Treat Partners of Medi-Cal Beneficiaries for Chlamydia Infection
CMS has rejected a California proposal to pay for antibiotics for the sexual partners of Medi-Cal beneficiaries who are infected with chlamydia, even if those partners are not themselves eligible for Medi-Cal, the Los Angeles Times reports. Because Medi-Cal is jointly funded by the state and federal government, California needed federal approval before moving ahead with the proposed plan, which sought in particular to reduce the chlamydia reinfection rate among female beneficiaries. Studies have shown that women who have been treated for chlamydia, which can lead to infertility if left untreated, have a 15% to 30% chance of becoming reinfected within six months if their sexual partners do not also receive treatment. However, CMS officials said that the plan, although well-intentioned, does not comply with Medicaid program rules. "We understand the public health value of doing something like this. ... But our bottom line was that we could not define the treatment of the partner as a service to the eligible (person), which is what we would have to do in order to pay for it," Linda Minamoto, CMS's associate regional Medicaid administrator, said. She added that federal officials were also concerned about appearing to endorse a California law enacted in 2000 that allows doctors to write antibiotic prescriptions for the sexual partners of patients diagnosed with chlamydia without first examining the partners. "I don't know that we, as an agency, wanted to encourage something like that. Typically, we wouldn't consider that to be good medicine," Minamoto stated.
Ken August, a spokesperson for the Department of Health Services, said that the agency was "disappointed." The state does not have legislative approval to use only state Medicaid funds to support the initiative. However, Gail Margolis, DHS' deputy director of medical care services, said that CMS' decision creates a "roadblock [for] payment, but not for treatment," adding that there are "other possible avenues" for providing medical treatment to the sexual partners of infected Medi-Cal beneficiaries, such as free clinics or other public programs. According to preliminary data for 2001, chlamydia infections in California topped 100,000 last year (Ornstein, Los Angeles Times, 3/12).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.