Mississippi Administrative Code
Title 23 - Division of Medicaid
Part 219 - Laboratory Services
Chapter 1 - General
Rule 23-219-1.5 - Trofile Assay
Universal Citation: MS Code of Rules 23-219-1.5
Current through September 24, 2024
A. The "Trofile Assay" is covered for beneficiaries who are HIV-positive and diagnosed with Acquired Immune Deficiency Syndrome (AIDS) who have evidence of viral replication and HIV-1 strain resistance to multiple anti-retroviral agents.
B. Medicaid covers "Trofile Assay" for beneficiaries age sixteen (16) and over with the following restrictions/guidelines:
1. The assay is to be
obtained only in anticipation of treatment of HIV/AIDS patients with CCR5
antagonist agents who:
a) Are "treatment
experienced" defined as having been previously treated with anti-retroviral
regimen(s),
b) Have never received
Maraviroc/Selzentry or other CCR5-antagonist agents, and
c) Have been deemed to have "virologic
failure," or failed to obtain sufficiently low HIV viral loads despite prior
appropriate anti-retroviral therapy.
2. Medicaid covers one (1) assay per
beneficiary, per lifetime. Repeated testing or testing in follow-up of therapy
with CCR5 agents is not covered.
3.
The treating physician has expertise in Infectious Diseases and/or treating HIV
patients with anti-retroviral agents; or the treating physician has consulted
with an Infectious Disease physician prior to requesting the assay.
Miss. Code Ann. § 43-13-121
Disclaimer: These regulations may not be the most recent version. Mississippi may have more current or accurate information. We make no warranties or guarantees about the accuracy, completeness, or adequacy of the information contained on this site or the information linked to on the state site. Please check official sources.
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