When a Medicare recipient has to sign an advance beneficiary notice, it is notice that medicare says this test is not medically necessary. So in our case, both the hospital and Palmetto, through the advance beneficiary notice, said that a hepatitis test is not medically necessary before having your immune system suppressed. After being suppressed, if you ever had hepatitis and didn't know it, good chance you will die. By supporting that hepatitis testing prior to suppression is asking people to gamble with their life and likely will lose because hepatitis cannot be controlled after being suppressed