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Meningitis Outbreak

The Center for Medicaid and CHIP Services (CMCS) is issuing this guidance in response to the Centers for Disease Control and Prevention’s (CDC) interim treatment guidance for central nervous system (CNS) and/or parameningeal infections and septic arthritis associated with contaminated steroid products produced by the New England Compounding Center (NECC): http://www.cdc.gov/hai/outbreaks/clinicians/index.html.

While CDC has identified specific states with clinics that have received contaminated product, patients in other states may be affected. Additional information on the outbreak can be found at: http://www.cdc.gov/hai/outbreaks/clinicians/faq_meningitis_outbreak.html

We urge states to review the information available from CDC, monitor the CDC Web site for updates, and take the steps necessary to ensure timely access to CDC-recommended drug therapies for CNS and/or parameningeal infections and septic arthritis associated with contaminated steroid products produced by NECC.

At this time, CMS expects states to be prepared for new Medicaid prescription requests for voriconazole as part of the regimen specified in the CDC interim treatment guidance referenced above. Given the severity of this situation, we also expect states to expedite all coverage determination requests for this medication, and other appropriate antifungal medications, due to the potentially life-threatening consequences of a delay in therapy for those patients with CNS and/or parameningeal infections and septic arthritis.

If you have any questions regarding this memorandum, please contact Dr. Steve Cha at 410-786-1876 or Stephen.Cha@cms.hhs.gov

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