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Critical to TB elimination efforts is the scale-up of screening and treatment for the estimated 13\u00a0million Americans with TB infection. For the Medicare population, the implementation of TB preventive services is hampered by the lack of clear coverage of TB infection screening. Despite a consistent US Preventive Services Task Force (USPSTF) recommendation since 1996, TB infection screening does not have a Medicare national coverage determination, which would ensure consistent coverage across the US. All other USPSTF recommended preventive services for Medicare recipients have a national coverage determination, a broadly applicable clinical quality measure or are medications generally covered through Medicare Part D. The lack of a national coverage determination for TB infection screening is crucially a health equity issue with TB disproportionally affecting non-US-born and minoritized US-born persons. 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For all other authors, no specific grant or funding from any agency supported the work for this manuscript.For all authors, grants or contracts from any source in the past 36 months are reported according to the ICMJE Disclosure Form and summarized below. Matthew Murrill has also received salary support from the following grants: AHRQ ASPIRE grant number R01HS028024 (PI: Yazdany), Tuberculosis (TB) Epidemiologic Studies Consortium-3 grant number US Centers for Disease Control and Prevention (CDC) U01 75D30121C12879 (PI: Shete).Katya Salcedo is employed by the California Department of Public Health, TB Control Branch and received salary support through TB Epidemiologic Studies Consortium-3 grant number CDC U01 75D30121C12879 (PI: Shete).Cynthia (A) Tschampl holds an unpaid leadership position as chair of Stop TB USA.Nisha Ahamed is employed by Rutgers Global TB Institute, which receives funding as a CDC TB Center of Excellence (COE). She has also previously had short-term contracts with Mayo clinic Center for TB (2023) and Heartland National TB Center (2019-2022) which are or were CDC-funded TB COEs. She has had contract work with the National TB Coalition of America (NTCA), a non-profit comprised of TB control program staff. She has a position on the Stop TB USA Coordinating Board. Elinor S. Coates: has previously received travel cost reimbursement from NTCA and Stop TB USA to attend conferences and meetings, including: CDC TB Education and Training Network in Atlanta (September 2024), annual outreach & advocacy visits to members of US Congress on World TB Day, and the NTCA Conference in June 2023. She has an unpaid leadership position in We Are TB, a TB survivors advocacy group advocating for emotional support for TB patients, survivors and families.Jennifer Flood has a position with the California Department of Public Health, TB Control Branch. She has received grant support from the CDC for tuberculosis research and activities.Donna H. Wegener is the Executive Director of the National TB Coalition of America and has no financial disclosures.Priya (B) Shete is the principal investigator of the TB Epidemiologic Studies Consortium-3 grant number CDC U01 75D30121C12879 (with funds made to University of California San Francisco).","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}]}}