If ever you have to receive medical treatment like this, this is a Rule made by the MAC contractor you'll not like. Medicare does not allow it. My wife is immune-suppressed for ten years. The doctor changed her from cellcept to Rituxan. Testing for Virus and Infection is medically required prior to beginning Rituxan according to the FDA, Medicare, CMS and most peer-reviewed research. If you do not, Drug-Induced Hepatitis can result if you ever had hepatitis in your life. It will reactivate 30 years later receiving rituxan suppression. When one is suppressed, they no longer have B cells to fight off Hepatitis so the liver becomes toxic and many have died as result. Testing for hepatitis is a smarter choice before suppressing your immune system..

PalmettoGBA has ruled that based on the illness of Rheumatoid arthritis and Autoimmune encephalitis G04.81, for all persons who need to be tested,  for hepatitis panel, it is NOT NECESSARY under traditional medicare with these specific diseases. You can have had hepatitis 30 years ago and never knew it. So one can get Rituxan infusion without the Hepatitis screening which may result in drug-induced death and never knows why. 

Original medicare states that the beneficiary is not expected to learn to code as down coding might have caused this. 

 My wife now has had the rituxan approved twice by palmetto. But not the hepatitis screening allowed by medicare. Livanta is committed to improving your Medicare experience. says it is the responsibility of the person to know they may die should they turn down the Hepatitis test because medicare does not coveer it. This change in policy has to be made public. We do not want to lose this protection for those suppressed.  Gene and Patricia Desotell, Spotsylvania Va