Skip to main content
Sister Publication Links
  • ESG: THE IMPLEMENTATION IMPERATIVE
Subscribe
  • Sign Up Free
  • Login
  • Subscribe
  • News
    • Current News
    • Providers
    • Insurance
    • Digital Health
    • Government
    • Finance
    • Technology
    • Safety & Quality
    • Transformation
    • People
    • Regional News
    • Digital Edition (Web Version)
    • Patients
    • Operations
    • Care Delivery
    • Payment
    • Midwest
    • Northeast
    • South
    • West
  • Unwell in America
  • Opinion
    • Bold Moves
    • Breaking Bias
    • Commentaries
    • Letters
    • Vital Signs Blog
    • From the Editor
  • Events & Awards
    • Awards
    • Conferences
    • Galas
    • Virtual Briefings
    • Webinars
    • Nominate/Eligibility
    • 100 Most Influential People
    • 50 Most Influential Clinical Executives
    • Best Places to Work in Healthcare
    • Excellence in Governance
    • Health Care Hall of Fame
    • Healthcare Marketing Impact Awards
    • Top 25 Emerging Leaders
    • Top 25 Innovators
    • Diversity in Healthcare
      • - Luminaries
      • - Top 25 Diversity Leaders
      • - Leaders to Watch
    • Women in Healthcare
      • - Luminaries
      • - Top 25 Women Leaders
      • - Women to Watch
    • Digital Health Transformation Summit
    • ESG: The Implementation Imperative Summit
    • Leadership Symposium
    • Social Determinants of Health Symposium
    • Women Leaders in Healthcare Conference
    • Best Places to Work Awards Gala
    • Health Care Hall of Fame Gala
    • Top 25 Diversity Leaders Gala
    • Top 25 Women Leaders Gala
    • - Hospital of the Future
    • - Value Based Care
    • - Hospital at Home
    • - Workplace of the Future
    • - Digital Health
    • - Future of Staffing
    • - Hospital of the Future (Fall)
  • Multimedia
    • Podcast - Beyond the Byline
    • Sponsored Podcast - Healthcare Insider
    • Video Series - The Check Up
    • Sponsored Video Series - One on One
  • Data Center
    • Data Center Home
    • Hospital Financials
    • Staffing & Compensation
    • Quality & Safety
    • Mergers & Acquisitions
    • Data Archive
    • Resource Guide: By the Numbers
    • Surveys
    • Data Points
  • MORE+
    • Contact Us
    • Advertise
    • Media Kit
    • Newsletters
    • Jobs
    • People on the Move
    • Reprints & Licensing
MENU
Breadcrumb
  1. Home
  2. Payment
June 23, 2020 09:05 PM

Trump administration says insurers off the hook for back-to-work COVID-19 tests

Rachel Cohrs
  • Tweet
  • Share
  • Share
  • Email
  • More
    Reprints Print
    Modern Healthcare Illustration / Getty Images

    Insurers are not required to cover COVID-19 tests that employers may mandate as they bring employees back to work, according to guidance released Tuesday by the Trump administration.

    Insurers had been waiting for clarity from the administration on whether they would be on the hook for potentially repeated COVID-19 screening tests as states relax social distancing restrictions and employees return to work. The Families First Coronavirus Response Act required insurers to cover COVID-19 tests without patient cost-sharing, but Tuesday's guidance clarified that the law only applies to tests that are deemed "medically appropriate" by a healthcare provider.

    "Testing conducted to screen for general workplace health and safety (such as employee "return to work" programs), for public health surveillance for SARS-CoV-2, or for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-19 or another health condition is beyond the scope of section 6001 of the [Families First Coronavirus Response Act]," the guidance from HHS, the Department of Labor, and Department of the Treasury states.

    America's Health Insurance Plans said testing for public and occupational health services should be supported by more government funds.

    "As the country reopens and returns to work, these strategies must include more federal guidance as well as funding for testing," AHIP spokesperson David Allen said.

    House Energy & Commerce Chair Frank Pallone (D-N.J.) said in a written statement that he is concerned that the guidance will disproportionately impact frontline workers struggling to make ends meet while giving a handout to the insurance industry.

    "HHS's new guidance appears to violate Congress' clear legislative intent that coronavirus testing be free of cost for all consumers," Pallone said.

    Consumer advocacy group Families USA also voiced concern that the guidance adds a layer of complexity for consumers trying to figure out how to get tested, and said states don't have resources to fill the gap.

    "We need clear guidance about when back-to-work testing is helpful, and insurers should cover that," said Cheryl Fish-Parcham, Director of Access Initiatives at Families USA.

    As healthcare utilization plummeted, the nation's largest health insurers came out of the first quarter virtually unscathed financially from the coronavirus pandemic. But AHIP commissioned a study that found diagnostic testing could cost the U.S. between $6 billion and $25 billion annually, and antibody testing could cost $5 billion to $19 billion.

    Nursing homes will be among the employers most impacted by the new testing coverage guidance. Some states require the facilities to test employees regularly and CMS recommends weekly testing.

    The American Health Care Association/National Center for Assisted Living said they hope insurers will voluntarily decide to foot the bill for the tests anyway.

    "Repeated, ongoing testing is the only way we are going to beat this virus. We hope that insurers will understand this and cover the costs," AHCA/NCAL said in a statement.

    AHCA/NCAL estimated that testing all employees of nursing homes and assisted living facilities once would cost $672 million.

    The American Clinical Lab Association said the guidance creates "widespread gaps in coverage" for COVID-19 testing and undermines Congress' testing coverage mandate. The group is also worried labs will get stuck with some of the cost.

    "While there is widespread agreement that this testing is necessary, the issue of how these tests will be paid for remains unclear. Laboratories cannot — and should not be expected to — absorb the costs for return to work and surveillance testing," ACLA President Julie Khani said in a written statement.

    James Gelfand, the senior vice president of health policy at The ERISA Industry Committee, said the new guidance is consistent in finding that the testing coverage mandate for insurers does not apply to tests administered solely for public health applications.

    "We know testing is important for reopening the economy, and hope Congress and the administration can help ensure adequate resources are available to support the testing needed," Gelfand said in a statement.

    Employers can require employees to be tested before returning to work, but the Pacific Business Group on Health said it would be highly unusual for a large employer to require testing for employees without paying for the tests in full.

    "We would not anticipate employees to be on the hook for the cost of a COVID test if taking one is a requirement of them going back to work," PBGH senior director Lauren Vela said.

    The National Association of Insurance Commissioners in May asked HHS to clarify guidance on coverage requirements for tests used for surveillance purposes, and a spokesperson said the new guidance will be helpful to states.

    Letter
    to the
    Editor

    Send us a letter

    Have an opinion about this story? Click here to submit a Letter to the Editor, and we may publish it in print.

    Recommended for You
    A stethoscope resting on a stack of 100-dollar bills
    Quality over quantity? Changing how doctors get paid presents new complications
    Most Popular
    1
    More healthcare organizations at risk of credit default, Moody's says
    2
    Centene fills out senior executive team with new president, COO
    3
    SCAN, CareOregon plan to merge into the HealthRight Group
    4
    Blue Cross Blue Shield of Michigan unveils big push that lets physicians take on risk, reap rewards
    5
    Bright Health weighs reverse stock split as delisting looms
    Sponsored Content
    Daily Finance Newsletter: Sign up to receive daily news and data that has a direct impact on the business and financing of healthcare.
    Get Newsletters

    Sign up for enewsletters and alerts to receive breaking news and in-depth coverage of healthcare events and trends, as they happen, right to your inbox.

    Subscribe Today
    MH Magazine Cover

    MH magazine offers content that sheds light on healthcare leaders’ complex choices and touch points—from strategy, governance, leadership development and finance to operations, clinical care, and marketing.

    Subscribe
    Connect with Us
    • LinkedIn
    • Twitter
    • Facebook
    • RSS

    Our Mission

    Modern Healthcare empowers industry leaders to succeed by providing unbiased reporting of the news, insights, analysis and data.

    Contact Us

    (877) 812-1581

    Email us

     

    Resources
    • Contact Us
    • Advertise with Us
    • Ad Choices Ad Choices
    • Sitemap
    Editorial Dept
    • Submission Guidelines
    • Code of Ethics
    • Awards
    • About Us
    Legal
    • Terms and Conditions
    • Privacy Policy
    • Privacy Request
    Modern Healthcare
    Copyright © 1996-2023. Crain Communications, Inc. All Rights Reserved.
    • News
      • Current News
      • Providers
      • Insurance
      • Digital Health
      • Government
      • Finance
      • Technology
      • Safety & Quality
      • Transformation
        • Patients
        • Operations
        • Care Delivery
        • Payment
      • People
      • Regional News
        • Midwest
        • Northeast
        • South
        • West
      • Digital Edition (Web Version)
    • Unwell in America
    • Opinion
      • Bold Moves
      • Breaking Bias
      • Commentaries
      • Letters
      • Vital Signs Blog
      • From the Editor
    • Events & Awards
      • Awards
        • Nominate/Eligibility
        • 100 Most Influential People
        • 50 Most Influential Clinical Executives
        • Best Places to Work in Healthcare
        • Excellence in Governance
        • Health Care Hall of Fame
        • Healthcare Marketing Impact Awards
        • Top 25 Emerging Leaders
        • Top 25 Innovators
        • Diversity in Healthcare
          • - Luminaries
          • - Top 25 Diversity Leaders
          • - Leaders to Watch
        • Women in Healthcare
          • - Luminaries
          • - Top 25 Women Leaders
          • - Women to Watch
      • Conferences
        • Digital Health Transformation Summit
        • ESG: The Implementation Imperative Summit
        • Leadership Symposium
        • Social Determinants of Health Symposium
        • Women Leaders in Healthcare Conference
      • Galas
        • Best Places to Work Awards Gala
        • Health Care Hall of Fame Gala
        • Top 25 Diversity Leaders Gala
        • Top 25 Women Leaders Gala
      • Virtual Briefings
        • - Hospital of the Future
        • - Value Based Care
        • - Hospital at Home
        • - Workplace of the Future
        • - Digital Health
        • - Future of Staffing
        • - Hospital of the Future (Fall)
      • Webinars
    • Multimedia
      • Podcast - Beyond the Byline
      • Sponsored Podcast - Healthcare Insider
      • Video Series - The Check Up
      • Sponsored Video Series - One on One
    • Data Center
      • Data Center Home
      • Hospital Financials
      • Staffing & Compensation
      • Quality & Safety
      • Mergers & Acquisitions
      • Data Archive
      • Resource Guide: By the Numbers
      • Surveys
      • Data Points
    • MORE+
      • Contact Us
      • Advertise
      • Media Kit
      • Newsletters
      • Jobs
      • People on the Move
      • Reprints & Licensing