Tuberculosis Medications Program Eligibility

MDH reserves the right to have Open Enrollment for no-cost latent TB infection medications (LTBI) or to enact Restricted Enrollment during which eligibility criteria will be required for accessing LTBI medications through MDH due to budget constraints.

The funding available to support LTBI treatment at no cost to the patient is based upon the current number of patients on treatment for active disease and the fluctuating costs of TB medications. When we have budget constraints, we will enact Restricted Enrollment and only provide LTBI treatment to those with the highest risk ratio of disease progression. When Restricted Enrollment is in place and your patient does not meet eligibility requirements, please continue the prescription process through your patient’s regular pharmacy of choice. MDH endorses CDC recommendations that all people living with latent TB infection receive treatment and that the shorter treatment regimens are used.

Current eligibility is OPEN ENROLLMENT

On this page:
Requirements for all patients
Requirements for LTBI treatment
Requirements for active TB disease treatment

Requirements for all patients (active disease and LTBI)

• Provider must submit patient insurance information with all prescriptions.
  • If patient is uninsured, patient must be referred to health insurance navigation assistance and insurance information submitted within the first month of treatment start.
  • If a patient is not legally eligible to receive insurance in Minnesota, document uninsurability on medications request form.
  • MDH reserves the right to decline program participation and refer the provider to use regular pharmacy channels.
• Vitamin B6 will only be provided if medically indicated.
• Treatment regimens using medications supplied by MDH must follow the Clinical Practice Guidelines: Treatment of Drug-Susceptible Tuberculosis, CID for treatment of LTBI or active TB disease.

Requirements for LTBI treatment during Open Enrollment

Have a verified diagnosis of LTBI (presence of active disease has been ruled out).

Requirement for LTBI treatment during Restricted Enrollment

Have a verified diagnosis of LTBI (presence of active disease has been ruled out) and meet at least one of the following eligibility criteria. Criteria must be documented in patient's medical record.

1. Local Public Health verified exposure to active disease within the last 2 years.
2. U.S. arrival date ≤ 5 years.
3. Child < 5 years of age.
4. Highly immunocompromised due to presence of at least one of the following:
   • HIV infection
   • Presently taking immunosuppressive therapy:
     • Beginning or currently in recipient process of stem cell or solid organ transplant
     • Current daily treatment with moderate or high dose corticosteroid [i.e., equivalent to prednisone ≥15 mg for 1 month or longer]
     • Beginning or currently receiving treatment with TNF-alpha antagonist
   • Silicosis
   • Abnormal chest x-ray consistent with stable, inactive TB disease.
5. TB test conversion (i.e., documented change in TB testing status within a 2 year period):
   • TST:  a change from negative to positive with an increase of ≥10 mm in induration within 2 years.
   • IGRA:  a change from negative to positive within 2 years.

Requirements for active TB disease treatment

N/A - all patients with active TB disease are eligible.