[Code of Federal Regulations] [Title 42, Volume 2] [Revised as of October 1, 2004] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR410.63] [Page 287] TITLE 42--PUBLIC HEALTH CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PART 410_SUPPLEMENTARY MEDICAL INSURANCE (SMI) BENEFITS--Table of Contents Subpart B_Medical and Other Health Services Sec. 410.63 Hepatitis B vaccine and blood clotting factors: Conditions. Notwithstanding the exclusion from coverage of vaccines (see Sec. 405.310 of this chapter) and self-administered drugs (see Sec. 410.29), the following services are included as medical and other health services covered under Sec. 410.10, subject to the specified conditions: (a) Hepatitis B vaccine: Conditions. Effective September 1, 1984, hepatitis B vaccinations that are reasonable and necessary for the prevention of illness for those individuals who are at high or intermediate risk of contracting hepatitis B as listed below: (1) High risk groups. (i) End-Stage Renal Disease (ESRD) patients; (ii) Hemophiliacs who receive Factor VIII or IX concentrates; (iii) Clients of institutions for the mentally retarded; (iv) Persons who live in the same household as a hepatitis B carrier; (v) Homosexual men; (vi) Illicit injectable drug abusers; and (vii) Pacific Islanders (that is, those Medicare beneficiaries who reside on Pacific islands under U.S. jurisdiction, other than residents of Hawaii). (2) Intermediate risk groups. (i) Staff in institutions for the mentally retarded and classroom employees who work with mentally retarded persons; (ii) Workers in health care professions who have frequent contact with blood or blood-derived body fluids during routine work (including workers who work outside of a hospital and have frequent contact with blood or other infectious secretions); and (iii) Heterosexually active persons with multiple sexual partners (that is, those Medicare beneficiaries who have had at least two documented episodes of sexually transmitted diseases within the preceding 5 years). (3) Exception. Individuals described in paragraphs (a) (1) and (2) of this section are not considered at high or intermediate risk of contracting hepatitis B if they have undergone a prevaccination screening and have been found to be currently positive for antibodies to hepatitis B. (b) Blood clotting factors. Effective July 18, 1984, blood clotting factors to control bleeding for hemophilia patients competent to use these factors without medical or other supervision, and items related to the administration of those factors. The amount of clotting factors covered under this provision is determined by the carrier based on the historical utilization pattern or profile developed by the carrier for each patient, and based on consideration of the need for a reasonable reserve supply to be kept in the home in the event of emergency or unforeseen circumstance. [55 FR 22790, June 4, 1990; 55 FR 31186, Aug. 1, 1990]