Direct Observation Therapy for Tuberculosis

Direct observation therapy (DOT) services are offered by local health departments (LHDs) to monitor members with clinically active tuberculosis (TB) who have been identified by their primary care physician (PCP) as at risk for potential noncompliance with the treatment regimen. DOT is a measure to ensure adherence to tuberculosis treatment for members at risk for noncompliance in taking medications or who are unable to follow the treatment regimen and to protect the public health. DOT is a process by which a health care worker observes the patient swallowing anti-TB medications. The purpose of DOT is to assure that the entire course of medication is taken in the correct dose, at the correct time and for the complete period of therapy. 

DOT services are carved-out under the Health Net Medi-Cal managed care program, but the member remains enrolled with Health Net for the purpose of receiving primary care and services unrelated to DOT.

The responsibility for paying for DOT services for a member enrolled in managed care rests with the LHD rather than the health plan.