Medicaid dollars can be used on Zika prevention like mosquito repellent

States can use Medicaid funding for items such as condoms and mosquito repellent to prevent the spread of the Zika virus, according to a new letter from CMS.

Allowing states to use existing fund to cover repellent may offer a short-term solution to funding problems for Zika prevention efforts, as Congress is on a break until June 7 after failing to settle a dispute over extra funding for federal agencies.

CMS Director Vikki Wachino wrote that while more common over-the-counter repellents wouldn’t be covered by this guidance, state Medicaid programs could be reimbursed with federal funds when repellents are prescribed by a healthcare professional.

“CDC recommends people use Environmental Protection Agency (EPA)-registered insect repellents with one of the following active ingredients: DEET, picaridin, IR3535, oil of lemon eucalyptus or para-menthane-diol,” Wachino wrote.  

The letter restates existing policy on family planning and contraceptives. Federal Medicaid funding covers up to 90 percent of the costs of those services, like counseling and contraceptives including condoms and intrauterine devices, which Wachino said are all “critical” due to evidence Zika can be spread by sexual contact and cause birth defects like Guillain-Barré syndrome and microcephaly.

According to the Associated Press, two babies with defects linked to the virus have been born in the U.S., one in Hawaii and one in New Jersey. As with all Zika cases in the country so far, the virus had been acquired while traveling. Because of those risks, the Centers for Disease Control and Prevention has recommended pregnant women avoid traveling to Zika-affected countries.

Wachino’s letter also listed other Medicaid-covered services could be used to diagnose Zika.

“For example, if a pregnant women has recently traveled to an area with active mosquito-borne transmission of the Zika virus, her primary care doctor may recommend a blood test,” Wachino wrote. “If positive, her doctor may order an ultrasound to assess the health and development of the fetus. If abnormalities are detected, further testing may be required, including CAT scans and MRIs to ensure the health of the mother and fetus.”

If children are born with Zika-related disabilities, the guidance said they may need physical therapy and long-term rehabilitative care services covered by Medicaid.