Protecting Our Nation Through Robust Access to COVID-19 Testing

November 09, 2020 Categories: ACLA Blog, ACLA News, Reimbursement and Coverage, Featured News

Access to reliable and accurate COVID-19 testing remains critically important to all Americans. However, absent federal assurance that COVID-19 tests will be covered, patients continue to face a patchwork coverage system that drives uncertainty and undermines federal response efforts.

In June, new guidance from the U.S. Department of Health and Human Services, Labor and Treasury muddied the clear coverage mandates passed by Congress that require group health plans and health issuers to cover COVID-19 testing without cost sharing or prior authorization. 

As a result, federal protections that Congress promised to patients have significantly eroded over the past several months. 

As a group of 54 bipartisan lawmakers recently noted in a letter to Secretary Azar, there has been an increase of coverage denials from health plans for COVID-19 testing, particularly for asymptomatic individuals. Today, as the number of COVID-19 cases surge across the country, Americans still face barriers to accessing the COVID-19 testing they need for return-to-work, return-to-school or broader public health and surveillance purposes.   

A recent New York Times piece further underscores the barriers and blurred lines around the costs associated with COVID-19 testing. Out of the three patients profiled in the story, all assumed that their testing would be covered. Unfortunately, due to murky federal guidance, these patients found themselves victim of coverage denials and high costs.

Because the tri-agency guidance states that testing for the purpose of screening or employment isn’t required to be covered by a patient’s insurance plan, individuals who face increased risks as essential workers may face cost barriers accessing COVID-19 testing. For example, despite federal mandates to test all nursing home workers at a frequency based on local positivity rate, coverage barriers caused by the tri-agency guidance may continue to leave nursing home employees at risk and pose additional challenges to keeping nursing home residents safe. 

Patients need certainty that their COVID-19 tests will be covered. As clinical laboratories, we know that each and every highly-accurate COVID-19 test holds a vital purpose, both for the individual patient and for the broader community. Information gleaned from even a single test can help inform mitigation efforts and in turn, save lives. 

It’s with this value in mind that ACLA member laboratories have been working around the clock since March—many laboratories operating three shifts a day—to expand capacity and push forward innovations to meet the evolving needs of patients. 

Expanding coverage of and access to COVID-19 testing should be a top priority in the next presidential term. Patients are counting on elected leaders to strengthen coverage requirements to ensure testing is covered with no cost sharing for all Americans.  By closing persistent coverage gaps, we can better protect our nation and further promote our shared goal of safely reopening our local economies, workplaces and schools. 

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