Democratic Health Leaders Demand Trump Administration Immediately Revisit Guidance Limiting COVID-19 Testing Coverage
Bicameral Democratic Health Committee leaders wrote to Health and Human Services (HHS) Secretary Alex Azar, Labor Secretary Eugene Scalia and Treasury Secretary Steven Mnuchin today expressing serious concerns with guidance recently issued by the Trump Administration allowing insurance plans and group health plans to deny coverage claims for COVID-19 tests and other related services in violation of Congress’ clear legislative intent that these tests be provided without consumer cost-sharing and without limitation.
The letter was signed by House Energy and Commerce Chairman Frank Pallone, Jr. (D-NJ), House Education and Labor Chairman Robert C. “Bobby” Scott (D-VA), House Ways and Means Chairman Richard E. Neal (D-MA), Senate Health, Education, Labor, and Pensions (HELP) Ranking Member Patty Murray (D-WA) and Senate Finance Ranking Member Ron Wyden (D-OR).
“Your agencies recently issued guidance regarding insurers’ and group health plans’ obligation to cover the costs of testing and other related services will result in increased barriers to COVID-19 testing for individuals and pose a serious threat to the testing access needed to protect the nation’s public health,” the Democratic Committee leaders wrote. “With COVID-19 cases skyrocketing and our testing capacity nowhere near where it needs to be, it is unacceptable that this Administration’s priority seems to be giving insurance companies loopholes instead of getting people the free testing they need. We believe this guidance is contrary to statute, and urge you to take immediate action to clarify the obligations of group health plans and insurers to provide robust and comprehensive coverage of COVID-19 testing.”
Understanding that widespread access to testing is critical to the nation’s response to the coronavirus pandemic, Congress included provisions in both the Families First Coronavirus Response Act (the Families First Act) and the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) to ensure that health insurance and group health plans cover all COVID-19 tests and related services without any cost-sharing requirements, including deductibles, copayments, and coinsurance.
On June 23, 2020, the Departments of HHS, Labor, and the Treasury issued updated guidance providing that COVID-19 testing for surveillance or employment purposes such as to screen for general workplace health and safety is not required to be covered by insurance and group health plans. Additionally, the guidance stated that testing “for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-10” is beyond the scope of the law.
“We find the Administration’s revised guidance deeply concerning as it appears to be a change that is without basis in the plain language of the statute,” the Committee leaders wrote. “This interpretation of the Families First Act is not supported by the statute, which makes clear that health plans are required to cover, without any conditions or limitations, the specified items and services related to diagnostic tests for the detection of COVID-19.”
The Administration’s guidance coincided with a number of concerning reports on COVID-19 testing access including insurers declining to cover serology testing, insurers refusing to cover tests for asymptomatic individuals, nursing homes declining to pay for coverage of tests for their employees, and self-funded health plans refusing to pay for tests at all or requiring cost-sharing from consumers.
“We request that HHS, Labor, and the Treasury immediately reexamine their June 23, 2020, guidance and clarify the obligations of health plans to provide coverage of COVID-19 diagnostic and serologic tests without cost sharing in all circumstances,” the Democrats concluded. “The language of the Families First Act and the CARES Act should be interpreted broadly to ensure the widest possible availability of testing at no cost to patients.”
As part of their inquiry, the Democratic Committee leaders also requested documents and answers to a series of questions by July 14, 2020.
To read the full letter, click HERE.