§ 31-2803 — Emergency department HIV screening.

(a) For the purposes of this section, the term.

(1) “Health benefit plan,” “health insurer,” and “insured” shall have the same meanings as provided in § 31-3001 .

(2) “HIV screening test” shall mean the testing for the human immunodeficiency virus or any other identified causative agent of the acquired immune deficiency syndrome by:

(A) Conducting a rapid-result test by means of the swabbing of a patient’s gums, finger-prick blood test, or other suitable rapid-result test; and

(B) If the result is positive, conducting an additional blood test for submission to a laboratory to confirm the results of the rapid-result test.

(b) A health benefit plan shall reimburse the cost of a voluntary HIV screening test performed on its insured while the insured is receiving emergency medical services, other than HIV screening, at a hospital emergency department, whether or not the HIV screening test is necessary for the treatment of the medical emergency which caused the insured to seek emergency services.

(c) The benefits mandated by subsection (b) of this section shall:

(1) Include at least one annual emergency department HIV screening test;

(2) Reimburse the costs of administering such a test, all laboratory expenses to analyze the test, and the costs of communicating to the patient the results of the test and any applicable follow-up instructions for obtaining health care and supportive services; and

(3) Not be subject to any annual or coinsurance deductible or any co-payment other than the co-payment that the insured would have to pay for the applicable hospital emergency department visit.

(d) A representative of the emergency department of a hospital that provides emergency department HIV screening shall advise any patient between 13 and 64 years of age:

(1) That unless a patient, or in the case of a minor, the patient’s parent, legal guardian, or other person authorized to make health care decisions for the minor, chooses to withhold consent, an HIV screening test will be performed at the time he or she receives emergency medical treatment;

(2) That, if the patient is covered by a health benefit plan issued by a health insurer, the cost of at least one annual emergency department HIV screening test is a covered benefit;

(3) That the test results are confidential, except that a positive test result will be reported to the Department of Health for statistical and public health purposes; and

(4) In the case of a positive test result, where the patient may obtain appropriate health care and supportive services.

(e) A health insurer shall not:

(1) Require an insured or applicant for insurance to pay a higher deductible, copayment, or coinsurance, require a longer waiting period, or impose any other condition for coverage of benefits solely because an insured or applicant for insurance used the benefits covered by this section;

(2) Refuse to issue a health benefit plan solely because an applicant may use the benefits covered by this section; or

(3) Cancel or refuse to renew a health benefit plan solely because an insured has used the benefits covered by this section.

(f) The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 , may issue rules to implement the provisions of this section.

Legislative History

Sept. 11, 1998, D.C. Law 12-145, § 3a; as added Mar. 21, 2009, D.C. Law 17-316, § 2, 56 DCR 206