Washington State
House of Representatives
Office of Program Research
BILL
ANALYSIS
Health Care & Wellness Committee
SB 5629
Brief Description: Concerning hepatitis B and hepatitis C screening and health care services.
Sponsors: Senators Conway, Dhingra, Hasegawa, Nobles and Wilson, C..
Brief Summary of Bill
  • Requires primary care providers to offer a hepatitis B and a hepatitis C screening test to any patient based on the latest federal screening recommendations to the extent the services are covered under the patient’s health insurance, unless the provider reasonably believes certain conditions are met.
Hearing Date: 3/24/23
Staff: Ingrid Lewis (786-7293).
Background:

United States Preventive Services Task Force.
The United States Preventive Services Task Force (USPSTF) is an independent, volunteer panel of national experts in disease prevention and evidence-based medicine.  The USPSTF makes evidence-based recommendations about preventive services such as screenings, behavioral counseling, and preventive medications. 

 

Under the Affordable Care Act, most private insurance plans are required to cover preventive services that receive a grade of A or B from the Task Force without a copay.

 

Hepatitis B
Hepatitis B is a vaccine-preventable liver infection caused by the hepatitis B virus (HBV).  Hepatitis B is spread when blood or other body fluids from a person infected with the virus enters the body of someone who is not infected.  

 

The USPSTF recommends screening for HBV in adolescents and adults at increased risk for infection.  Persons who are at increased risk include:  persons born in countries and regions with a high prevalence of HBV infection; persons born in the

United States who were not vaccinated as infants whose parents were born in regions with a very high prevalence of HBV infection; HIV positive persons; persons with injection drug use; men who have sex with men; and household contacts or sexual partners of persons with an HBV infection.  The USPSTF further recommends that persons with continued risk for HBV infection be screened periodically.  

 

The USPSTF has provided HBV a grade of B.  

 

Hepatitis C

Hepatitis C is a liver infection caused by the hepatitis C virus (HCV).  Hepatitis C is spread through contact with blood from an infected person.  The USPSTF recommends a one-time screening for HCV in all adults aged 18 to 79 years of age.  The

 

USPSTF also suggests clinicians consider screening persons younger than 18 years and older than 79 years who are at high risk for infection.  The USPSTF further recommends that persons with continued risk for HCV infection be screened periodically. 

 

The USPSTF has provided HCV a grade of B.

Summary of Bill:

A primary care provider must offer an HBV and an HCV screening test to any patient to the extent the services are covered under the patient’s health insurance.  The screening test should be offered according to the latest screening test recommendations from the USPSTF and the offer of testing must be culturally and linguistically appropriate.  

 

A primary care provider includes general practice physicians, family practitioners, internists, pediatricians, osteopathic physicians, naturopaths, physician assistants, and advanced registered nurse practitioners.  

 

A primary care provider is exempt from offering the screening tests if the primary care provider reasonably believes that:

  • the patient is experiencing an emergency;
  • the patient has previously been offered or has been the subject of an HBV or an HCV screening test, unless the primary care provider determines that one or both screenings should be offered again; or
  • the patient lacks capacity to consent. 

 

If the patient accepts the offer of a screening test and the result of the test is positive, the primary care provider must offer follow-up care or refer the patient to another primary care provider who can provide follow-up care.  For HCV, follow-up care must include an HCV diagnostic test.  

 

The requirement does not affect a primary care provider's scope of practice or diminish any authority, legal, or professional obligation.  Failure to comply with the requirement does not subject a primary care provider to any disciplinary actions related to licensure or certification or to any civil or criminal liability.  

 

The Department of Health may adopt rules involving the offering of screening tests, training requirements for HBV and HCV, and the training of primary care providers.

Appropriation: None.
Fiscal Note: Available.
Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.