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May 2014 VA Hep C Treatment Guidelines
UPDATE: Feb 26, 2016-
Funding and Prioritization Status Update

UPDATE: March 2016
VA Hep C Treatment Guidelines
VA to treat all vets in system
 

By Judith Graham
VA Extends New Hepatitis C Drugs to All Veterans in Its Health System

 
Orange Count Registry
Vietnam vets blame 'jet guns' for their hepatitis C
By Lily Leung Feb. 14, 2016 
 
CBS News Investigates
Congress outraged over hepatitis C treatment VA can't afford
Dr. Raymond Schinazi played a leading role developing a drug that cures hepatitis C while working seven-eighths of his time for the VA
 
ibtimes.com| By amynordrum
 


Hepatitis C drug costing VA, DoD millions
By Patricia Kime, Staff writer
We're looking at a company who is milking a cash cow for everything it's worth," Sanders said. 
 


VA to outsource care for 180,000 vets with hepatitis C
Dennis Wagner, The Arizona Republic 12:27 a.m. EDT June 21, 2015
 


VA to outsource care for 180,000 vets with hepatitis C
, The Republic | azcentral.com 11:51 a.m. MST June 19, 2015
Dr. David Ross, the VA's director public-health pathogens programs, resigned from the working group. "I cannot in good conscience continue to work on a plan for rationing care to veterans," he wrote.
 


VA Region Stops Referring Patients To Outside Hospitals Thanks To Budget Shortfall
Michael Volpe Contributor ...According to a memo — the entire region has been forced to stop all “non-VA care” referrals due to a budget shortfall.
 

DisabledVeterans.org
OIG INVESTIGATES VA CHOICE PROGRAM PROBLEMS
Sen. Mark Kirk admitted the VA Choice Program is a failed joke in a letter to Secretary Bob McDonald despite attempts to fix it.
 

 
Denied Hep C VA dental care?
Please click here

 
Dried Hepatitis C Blood Exposure 11/23/2013 Weeks later inconspicuous blood transmits virus and more likely to cause accidental exposures to Hep C
 

Lack of Standards for
Mass Vaccinations
1970 Jetgun Nursing Instructions
 

2014 AASLD Study Hepatitis C not an STD

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Blog for VA Claims
 


Help with VA Claims
 


 
Info: Plan Backfires-
VBA Fast Letter Boost Claims
 
Legal- Fed Regs state:
Judge decision may be relied upon
Cotant v. Principi, 17 Vet.App. 116, 134 (2003),
 
Service Connected Claims
# 1 Conclusion of Law 
# 2 Conclusion of Law 
 
More Claims
Jetgun Decisions
Hep C Decisions

BVA Granted Claims
Nexus Letters
Doctors Testimony

VA physicians
Private Physicians
 
Search Board of Appeals Website
BVA Jetgun Decisions
BVA Hepatitis C Decisions

Great Advice!  
After the jetgun win
What to do next

 

 


What has the VA's response been to the epidemic? 

The Federal Response
Search legislation and reports for Veterans submitted below at
http://Thomas.loc.gov
Bill number and summery provided below.

Late M. Action urged to stem hepatitis C. US Med 1998;34:3, 42, 43.

July 19, 1998
House Committee On Veterans' Affairs Subcommittee On Benefits
Statement Of LEONARD B. SEEFF, M.D.
National Institutes Of Diabetes, Digestive, And Kidney Diseases
National Institutes Of Health
And Former Chief, Gastroenterology & Hepatology
Veterans Affairs Medical Center, Washington, D.C.

The only large, population-based screening study in the VA of which I am aware is one that was conducted at my VA Medical 2355l Center here in Washington, DC over a 6-week period at the beginning of 1994. The intent of our study was to screen 1,000 consecutive patients ...for the presence of hepatitis B and hepatitis C markers. We accomplished our aim in 839 patients and were astonished to find that, whereas 3% were infected with hepatitis B, 21% had markers of hepatitis C virus infection....
Viral Hepatitis the US Military- A Study of Hospitalization

October 15, 1998
House Report 105 HR 820

DAN BURTON, Indiana, Chairman-
Seventh Report By The Committee On Government Reform And Oversight
51 351 CC Union Calendar No. 461 105th Congress, 2d Session

HEPATITIS C: SILENT EPIDEMIC, MUTE PUBLIC HEALTH RESPONSE

Between 1995 and 1997 the annual number of newly identified persons rose from 20,203 to 21,424 to 24,850. In 1998 an additional 29,799 unique cases were recorded within the VA. Of all veterans in the VA system testing positive for hepatitis C, 64% were Vietnam Era veterans. The mean age of HCV infected veterans is 49 years.

VA researcher Dr. Gary Roselle reports HCV infection in VA has increased 285% during the 4 year period Roselle states; “Since most veterans are not treated in VA medical facilities, the actual incidence of HCV infected veterans is undoubtedly much greater.”
 

Former Surgeon General C. Everett Koop – ¡HCV screening program for all U.S. military personnel… ¡all possible transmission routes for hepatitis C - including ¡more research is needed on immune globulin inoculations...begin screening troops for hepatitis C.

"You've got a demon on your hands," he said. "You'd better find out where that's coming from if you can."

Search legislation for Veterans submitted to Congress below at
http://Thomas.loc.gov

106 Congress-
Two House Bills

H. R. 1020 SNYDER
Veterans' Hepatitis C Benefits Act of 1999
establish a presumption of service connection for the occurrence of hepatitis C in certain veterans .
(1) Transfusion of blood or blood products before December 31, 1992.
(2) Blood exposure on or through skin or mucous membrane.
(3) Hemodialysis.
(4) Tattoo or body piercing or acupuncture.
(5) Unexplained liver disease.
(6) Unexplained abnormal liver function tests.
(7) Working in a health care occupation.

Referred to the Committee on Veterans' Affairs HR 4751 IH > H. R. 1020> HCON 130 IH

nH. R. 5132 FRELINGHUYSEN
Veterans Comprehensive Hepatitis C Health Care Act
establish a comprehensive program for testing and treatment of veterans for the Hepatitis C virus.
(A) each veteran who served in the active military, naval, or air service during the Vietnam era and is enrolled to receive care under section 1710 of this title who requests the test or is otherwise receiving a physical examination or any care or treatment from the Secretary; and

(B) to any other veteran who requests the test.
(2) After the end of the one-year period referred to in paragraph (1), the Secretary shall provide a blood test for the Hepatitis C virus to any veteran who presents one or more risk factors for that virus and who requests the test.

Referred to the Committee on Veterans' Affairs H. R. 5132 >H. R. 639

Alter MJ, et al. The prevalence of hepatitis C virus infection in the United States, 1988 through 1994. N Engl J Med 1999;341:556-562

The GAO, CDC, NIH and VA met and moved HCV classification was downgraded from level 3 to level 2 and research moved from

Search legislation for Veterans submitted to Congress below at
http://Thomas.loc.gov

2001
107 Congress

Veteran's own willful misconduct -
It must be taken into consideration that the Hepatitis C virus penetrates the blood-brain barrier causing an array of mental problems that impacts veterans lives. Greater than 60% of HCV patients suffer from conditions such as "brain fog," depression, to more sever disorders that include bipolar and schizophrenic behaviors. Higher numbers suffer from chronic fatigue and joint pain long before the diagnoses of Hepatitis C is obtained. Self medication though alcohol and other substances is common place. This form of self-help is a death warrant for the vet.

Senate version:
S 457 IS SNOWE
PRESUMPTION OF SERVICE-CONNECTION FOR CERTAIN VETERANS WITH HEPATITIS C ...establish a presumption of service-connection for certain veterans with Hepatitis C

(A) Period of service before December 31, 1992, a transfusion of blood or blood products.

(B) Exposed to blood on or through the skin or a mucous membrane during a period of service.

(C )Underwent hemodyalisis during a period of service.

(D) Experienced a needle-stick accident or medical event involving a needle, not due to the veteran's own willful misconduct, during a period of service.

(E) Diagnosed with unexplained liver disease during a period of service.

(F) Experienced an unexplained liver dysfunction value or test during a period of service.

(G) Served in a health-care position or specialty during a period of service under such circumstances as the Secretary shall prescribe for purposes of this subsection.

Referred to the Committee on Veterans' Affairs S.2599.IS > S 457 IS > S 1846 IS

Congress version:nH. R. 639 FRELINGHUYSEN

Veterans Comprehensive Hepatitis C Health Care Act 2001...testing and treatment of veterans for the Hepatitis C virus.¡(2) shall provide appropriate treatment for that veteran in accordance with the national protocol for the treatment of Hepatitis C .

n (A) each veteran who served in the active military, naval, or air service during the Vietnam era or who is considered to be `at risk,' and is enrolled to receive care under section 1710 of this title who requests the test or is otherwise receiving a physical examination or any care or treatment from the Secretary; and

n(B) to any other veteran who requests the test.

Referred to the Committee on Veterans' Affairs- H. R. 5132 >H. R. 639 > H. R. 73

Search legislation for Veterans submitted to Congress below at
http://Thomas.loc.gov

n

2004
108 Congress
H. RES. 633
UDALL
Expressing the sense of the House of Representatives 2004
Expressing the sense of the House of Representatives that there is a critical need to increase awareness and education about hepatitis C .

Mr. UDALL of New Mexico submitted the following resolution; which was "Whereas the majority of veterans infected are Vietnam era veterans , and the prevalence of infection is highest in this group"
Referred to the Committee on Energy and Commerce

nLast attempt by congress for a veteran's Presumed Service Connection bill

2005
109 Congress
H. R. 3434 ANDREWS
PRESUMPTION OF SERVICE-CONNECTION FOR CERTAIN VETERANS WITH HEPATITIS C ...establish a presumption of service-connection for certain veterans with Hepatitis C

(A) during a period of service before December 31, 1992, a transfusion of blood or blood products.
(B) exposed to blood on or through the skin or a mucous membrane during a period of service.
(C ) underwent hemodyalisis during a period of service.
(D) experienced a needle-stick accident or medical event involving a needle, not due to the veteran's own willful misconduct, during a period of service.
(E) diagnosed with unexplained liver disease during a period of service.
(F) experienced an unexplained liver dysfunction value or test during a period of service.
(G) served in a health-care position or specialty during a period of service under such circumstances as the Secretary shall prescribe for purposes of this subsection.

Referred to the Committee on Veterans' Affairs
HR 3455 IH > H. R. 3434

Search legislation for Veterans submitted to Congress below at
http://Thomas.loc.gov

These little pieces mean something when your writing legislation.
110 Congress
H. R. 2552 TOWNS - WILSON
Hepatitis C Epidemic Control and Prevention Act
Referred to the Committee on Energy and Commerce
HR 3539 > HR 1290 > H. R. 2552 >

Senate
S 1445 IS KENNEDY-HUTCHISON
Hepatitis C Epidemic Control and Prevention Act 2007
Referred to the Committee on Health, Education, Labor, and Pensions
S. 1143 > S 521 IS > S 1445 IS

Congress makes the following findings:
(8) Conservative estimates place the costs of direct medical expenses for Hepatitis C at more than $1,000,000,000 in the United States annually, and such costs will undoubtedly increase in the absence of expanded prevention and treatment efforts.

This bill does not mention what type of expanded prevention and treatment effort, i.e., national level, high risk population or a well defined general population, etc. Veterans that do not attend VA health care centers will not be notified of the risk for the Hepatitis C virus infection. This act and others that have followed are not a "federal response" to the hepatitis C epidemic:(

More history here http://hcvets.com/data/military/PrevalenceVets.htm