Biden: Health Insurers Should Pay for Home COVID Tests

by Peter Johnson

In remarks to staffers at the National Institutes of Health (NIH) on the federal response to the omicron variant of COVID-19, President Joe Biden said his administration intends to make home testing more accessible — and require insurance companies to cover the cost of those tests from retailers. 

Biden Promises Home Testing Coverage 

• The administration has set the goal of “making free, at-home tests more available than ever before, and having them covered by private insurance plans,” Biden said. He added that tests will be “available in thousands of locations and available at community health sites for the uninsured.” 
• “If you’re one of the 150 million Americans with private health insurance, next month, your plan will cover at-home tests,” the president continued. “Private insurance already covered the expensive PCR test that you get at a doctor’s office. And now they will cover at-home tests as well.” 

ACHP Outlines Concerns 

• The news may stir some concern among health insurers, despite rulemaking from the Biden administration limiting the types of tests they’re obligated to pay for.  
• In February, the Biden administration issued guidance reaffirming that health plans are not responsible for covering tests done for “public health surveillance or employment purposes” — only tests that are for “individualized diagnosis or treatment of COVID-19.” (The Trump administration took the same stance.) 
• In an Oct. 5 letter to CMS Administrator Chiquita Brooks-LaSure, the Alliance of Community Health Plans (ACHP) asked the Biden administration to take additional steps to ensure that carriers would not have to pay for extraneous tests. 
• Notably, the payer trade group asked for the administration to take steps “to identify the purpose for a COVID-19 test on a claim. We encourage the Administration to establish a national standard as changes to claims submission requirements would be best undertaken as a national strategy as opposed to individual entity initiatives.” ACHP suggested using the medical claims coding system to address the issue. 
• “We point to existing ICD-10 codes, such as return-to-work (Z02.79), return-to-school (Z02.0) and participation in sports (Z02.5) as potential avenues to clearly indicate the reason for COVID-19 testing on a claim,” wrote ACHP President and CEO Ceci Connolly. 

From Health Plan Weekly