Tuesday, June 16, 2020

COVID Test Pricing Hits Headlines; Good-News Story about COVID Ramp-Up Appears

At the end of March, Congress passed the CARES Act, H.R. 748, which included sections that control COVID test coverage and pricing.  Section 3202 says that COVID tests are covered under commercial insurance, without a copay, and if the lab is out-of-network, the payer will pay the lab's cash price.  The lab is also required to publicize its cash price.

It's hitting the fan in a series of headlines this week.
  • Rep. Katherine Porter (D-Calif) got hit both with a copay and with a later bill, says Healthcare Dive here.
    • Her insurer, United, suspects a coding error of some kind.
    • Porter asks HHS and states to step up and really enforce Section 3202.
  • The "pay the lab's cash price" clause in Section 3203 is raising hackles, too.   See stories at Politico here and NYT here.  
    • Some small labs have submitted bills to insurers as high as $2300, even $7000, according to these sources.
    • We should have run a lottery for how many days after CARES Section 3202 this problem would take to appear as a major news story.
    • NYT summarizes CARES 3202 appropriately:  
    • "The recent CARES Act requires that insurers cover the full cost of coronavirus testing, with no co-pays or deductibles applied to the patient. The health plans must also pay an out-of-network doctor or lab its full charge so long as the provider posts that “cash price” online."  
    • However, it's not clear who enforces this, other than the patient calling up a customer service help line and complaining.
Update - Also a June 29 NYT article on the same topic here.

Good-News Article

Also this week, National Review published a "good news" article (by editor Rich Lowry) that are overall response to the ramp up to millions of COVID tests was done pretty well - that that glass should be viewed as half full, or better.  Shout-outs to White House committees to which helped get collection swabs ramped up at multiple suppliers, to Hologic (esp. its CEO, Stephen MacMillan) for ramping up high production of its Panther platform test, and some shout-outs to other diagnostics companies (e.g. Thermo Fisher, Roche, Abbott) as well.   Lowry argues that media coverage along the way was consistently over-negative.  It's a deep-dive story, at nearly 6000 words.