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  • Access to Care and Delivery System > Routine Voluntary HIV Testing

    In New York State, voluntary HIV testing is part of routine medical care. Additionally, New York State public health law requires most medical facilities to offer voluntary HIV testing to patients of all ages. With limited exceptions, the law applies to anyone receiving treatment for a condition that is not life-threatening, whether in a hospital, emergency room or primary care setting such as a doctor's office or outpatient clinic.

    For a summary of changes to simplify HIV testing consent and improve linkage to care, please see New York State HIV Testing Law Update: May 2014.

    Consent Still Required

    The amended law allows patients to give verbal consent for a rapid HIV test, which produces results within an hour. Consent must be documented in the patient's medical record, and the practitioner must counsel the patient on the following seven points about HIV:

    1. HIV is the virus that causes AIDS. HIV can be passed through:
      • Unprotected sex (vaginal, anal or oral sex without a condom) with a person who has HIV.
      • Shooting drugs with needles, or "works," of a person who has HIV.
      • Pregnancy, birth or breastfeeding.
    2. Treatments are available to help people living with HIV stay healthy. Getting tested early can help patients get the most from their health care benefits.
    3. HIV testing is important for women before or during pregnancy. Treatment can reduce the chance that a woman with HIV will pass the virus to her infant.
    4. Many resources are available in New York to help people living with HIV meet their medical, social and legal needs.
    5. HIV testing is confidential. A doctor can share HIV test results with other practitioners only when the information is needed for the patient's health care. The names of people who have HIV or other STDs, such as syphilis and gonorrhea, are confidentially sent to the State Health Department. This helps the State Health Department plan services for people with HIV.
    6. If test results show that a patient has HIV, the doctor will talk with the patient about urging sex and needle-sharing partners to get tested for HIV. Counselors from the Health Department's Partner Assistance Program (PNAP) or Contact Notification Assistance Program (CNAP in New York City) can help notify partners without revealing the patient's name.
    7. HIV testing is voluntary. The practitioner must ask the patient to sign a consent form for HIV testing, and the patient should read this form carefully. The practitioner will answer any questions the patient has about HIV testing.

    Patients must still provide written consent for HIV tests that require more time, but the process has been simplified. Consent for HIV testing can now be included in a patient's general consent for routine medical care as long as the consent form permits patients to opt out of HIV testing.

    Treating HIV/AIDS

    We post clinical practice guidelines for the treatment of HIV/AIDS on our Web site. To review these guidelines, visit Clinical Corner at www.emblemhealth.com . In addition, New York State Quality Assurance Reporting Requirements (QARR) include four quality measures for HIV/AIDS Comprehensive Care. Recommended treatment and preventive criteria for people living with HIV/AIDS are:

    • Two outpatient visits occurring at least 182 days apart (every six months) for each patient age 2 and older.
    • Two annual viral load tests conducted at least 182 days apart for each patient age 2 and older.
    • One annual screening for syphilis for each patient age 19 and older.
    • One annual screening for cervical cancer for each female patient age 19 to 64.

    Documentation of these measures must be included in the patient's medical records and will be reviewed as necessary.

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    Glossary terms found on this page:

    Services available to a member as defined in his or her contract. Benefit design includes the types of benefits offered, limits (e.g., number of visits, percentage paid or dollar maximums applied) and subscriber responsibility (cost sharing components).

    Means a medical or behavioral condition, the onset of which is sudden, that manifests itself by symptoms of sufficient severity, including severe pain, that a prudent layperson, possessing an average knowledge of medicine and health, could reasonably expect the absence of immediate medical attention to result in (a) placing the health of the person afflicted with such condition in serious jeopardy, or in the case of a behavioral condition, placing the health of such person or others in serious jeopardy; (b) serious impairment to such person’s bodily functions; (c) serious dysfunction of any bodily organ or part of such person; or (d) serious disfigurement of such person.

    A health care benefit arrangement that is similar to a preferred provider organization in administration, structure and operation but does not cover out-of-network care. Also called an Exclusive Provider Organization.

    An institution which provides inpatient services under the supervision of a physician, and meets the following requirements:

    • Provides diagnostic and therapeutic services for medical diagnosis, treatment and care of injured and sick persons and has, as a minimum, laboratory and radiology services and organized departments of medicine and surgery
    • Has an organized medical staff which may include, in addition to doctors of medicine, doctors of osteopathy and dentistry
    • Has bylaws, rules and regulations pertaining to standards of medical care and service rendered by its medical staff
    • Maintains medical records for all patients
    • Has a requirement that every patient be under the care of a member of the medical staff
    • Provides 24-hour patient services
    • Has in effect agreements with a home health agency for referral and transfer of patients to home health agency care when such service is appropriate to meet the patient's requirements

    Acronym for Medicare Advantage. An alternative to the traditional Medicare program in which private plans run by health insurance companies provide health care benefits that eligible beneficiaries would otherwise receive directly from the Medicare program.

    Professional services rendered by a physician for the treatment or diagnosis of an illness or injury.

    A type of health benefit plan that allows enrollees to go outside the health plan's provider network for care, but requires enrollees to pay higher out-of-pocket fees when they do. Also called Point of Service.

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