AHIP members say they'll ease any barriers to testing and
treatment, including cost-sharing.
A map showing where
laboratory-confirmed SARS-CoV-2 infections have shown up, as of Wednesday.
(Credit: CDC)
The board of America’s Health Insurance Plans
says member insurers will take decisive action — including waiving plan
cost-sharing requirements — to fight Covid-19 pneumonia
“Our priority is the health and well-being of
the people we serve,” the AHIP board said in a statement issued today.
·
The AHIP board said
member insurers are moving to:
·
Keep out-of-pocket
costs from being a barrier to SARS-CoV-2 testing and treatment.
·
Make sure that
effective treatment is available for people who have SARS-CoV-2 infections.
·
Educate people
about ways to stay healthy.
“We will cover needed diagnostic testing when
ordered by a physician,” the AHIP board said. “We will take action to ease
network, referral, and prior authorization requirements and/or waive patient
cost sharing. We will also take action so that patients will have continuous
access to their regular prescription medications, while at the same time
avoiding potential problems, such as drug shortages.”
AHIP will also be working with state and
federal policymakers to make changes in “preventive services, benefit design,
and treatment options,” to help people immediately, the AHIP board said.
AHIP said one way government policymakers can
help is to ease any barriers to coverage for telehealth services.
AHIP member insurers will be encouraging use
of telehealth services to expand access to care and to reduce infection risk,
the AHIP board said.
The Backdrop
Public health authorities around the world
have reported 97,873 confirmed cases of people infected with the severe
acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes
the Covid-19 pneumonia, according to the Johns Hopkins Center for Systems Science and Engineering.
At least 3,347 of the people known to be infected, or 3.4% of the total,
have died from Covid-19 pneumonia.
Testing problems slowed efforts to confirm
diagnoses in the United States. Now that the testing problems have started to
ease, the number of confirmed U.S. cases has increased to 149 today, up from 12
cases a month ago.
The New York State Department of Financial
Services issued a circular letter setting Covid-19 emergency response standards
Tuesday. The New York department asked insurers to eliminate any coverage
barriers to SARS-CoV-2 testing, and to take steps to keep a major Covid-19
pneumonia epidemic from disrupting enrollees’ access to prescription drugs.
Missouri insurance regulators then issued a
Covid-19 emergency response bulletin that was similar to New York’s circular
letter.
The Federal Response
Today, public health agencies are providing SARS-CoV-2
testing for free, but at least one patient who went in for testing has reported receiving a $3,275 bill.
Some policymakers, including Sen. Patty Murray,
D-Wash., have suggested that fear of huge bills could keep some infected people
from getting tested.
Vice President Mike Pence, the head of the
federal Covid-19 pneumonia response effort, said Wednesday, at a briefing at
the White House, that the U.S. Department of Health and Human Services has
designated the SARS-CoV-2 test as an “essential health benefit” (EHB) under the
Affordable Care Act.
Under the ACA, individual major medical
insurance policies and small-group medical insurance policies issued since
Jan. 1, 2014, must cover at least about 58% of the actuarial value of the
essential health benefits package for most insureds, and at least 50% of the
actuarial value of the EHB package for insureds who are eligible to buy
bare-bones catastrophic plans.
Under the ACA, all major medical plans,
including fully insured large-group plans and self-insured group plans, most
provide full coverage for designated “preventive services,” such as checkups,
and vaccinations against measles, without imposing deductibles, co-payments or
other coinsurance requirements on the insureds.
That means that even health savings account
(HSA) owners, who are required by law to use their HSAs together with
high-deductible health plan coverage, can get measles and tetanus shots “for
free.”
The HHS secretary adds products and services
to the preventive services category with advice from the U.S. Preventive
Services Task Force.
The task force has been working on
recommendations related to matters such as hepatitis C and cognitive impairment but does not
appear to have a SARS-CoV-2 testing recommendation in progress at this time.
Allison Bell, ThinkAdvisor's insurance editor, previously was
LifeHealthPro's health insurance editor. She has a bachelor's degree in
economics from Washington University in St. Louis and a master's degree in
journalism from the Medill School of Journalism at Northwestern University. She
can be reached at abell@alm.com or on Twitter at @Think_Allison.
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