Friday, April 25, 2014

Congress Presses the VA for Increased Attention to Hepatitis C

Congress Presses the VA for Increased Attention to Hepatitis C

By Lyle Dennis, Cavarocchi – Ruscio – Dennis Associates, Consultants to AASLD

One of the more interesting aspects of the relationship between AASLD and the federal government is the broad range of interests that hepatologists have through many different departments and agencies.
Within the National Institutes of Health, there are about a dozen separate institutes and centers that play a role in liver-related research.

The Centers for Disease Control and Prevention, based in Atlanta, has the Division of Viral Hepatitis, with whom we work very closely.

The Food and Drug Administration deals with the approval of new drugs and such controversial issues as acetaminophen toxicity.

The Department of Defense and the Department of Veterans Affairs operate enormous health care systems and conduct relevant research, as well.

The Centers for Medicare and Medicaid Services set payment rates for liver-related services, physician reimbursements, and medication.

The Health Resources and Services Administration, through its Division on Transplantation, governs organ donation programs.

The list goes on and on. Each year as Congress moves its appropriations bills to fund all of these agencies, they issue a report (known as a Committee Report) explaining their intent in setting the funding levels they do. Thus far, the only such report issued for the FY2015 budget year is the House Military Construction/Veterans Affairs report, which addresses Congress’s interest in the Veterans Health Administration, among many other things.

The Committee Report contains an unusually-lengthy section related to hepatitis C in the veteran population:

Hepatitis C virus — The Committee has previously encouraged the VA to increase hepatitis C (HCV) testing and work to implement the Center for Disease Control and Prevention’s (CDC) HCV testing recommendations within the VA system. In light of the growing burden of hepatitis C-related liver complications and mortality among Veterans and the recent introduction of more effective treatments for HCV, the Committee directs the VA to establish a plan for testing and treating veterans enrolled in the VHA system and considered to be at risk for hepatitis C, including Vietnam-era veterans in the baby boomer birth cohort. Additionally, the VA shall submit a report to the Committee, no later than six months after enactment of this Act, updating its 2010 report, The State of Care for Veterans with Chronic Hepatitis C, on the prevalence of hepatitis C among veterans and detailing the estimated impact its HCV treatment plan will have on preventing hepatitis C-related cirrhosis, hepatocellular carcinoma, and mortality among veterans.

This language states clearly Congress’s interest in ramping up the VA’s attention to hepatitis C. While it is true that Congress does not always put "its money where its mouth is," language like this and the reports it requests go a long way toward building the case for more research, more services, and more attention to liver disease throughout the federal government.

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