Buy kits first, get paid later
Paper receipts? US to unveil details on how self-test plan to work against coronavirus
WASHINGTON — The Biden administration’s plan for health insurers to reimburse consumers for over-the-counter COVID-19 tests echoes a bygone era when companies processed large volumes of claims from individuals — with paper receipts.
It’s unclear if the buy-first, get-paid-later approach will spur people to go out and get the tests, even with new urgency around the omicron variant.
“It’s not likely to yield the same level of accessibility that people in other countries have,” said Cynthia Cox of the nonpartisan Kaiser Family Foundation. Cox, who tracks the U.S. health system in comparison to other advanced countries, points out that consumers in the United Kingdom can pick up free rapid tests at the pharmacy or have them delivered to their homes.
“I think we are still going to have testing problems next year,” Cox said.
Omicron is not the only reason testing is taking on renewed importance. Anticipated approval of antiviral pills that COVID-19 patients can take at home is also expected to increase demand for fast tests that can provide reliable results.
Officials have yet to provide operational details of the Biden plan, with formal guidance due Jan. 15. But the administration is confident it can overcome problems that have bedeviled U.S. testing from the start of the pandemic.
According to a White House fact sheet, health insurance companies will become the cornerstone of testing for more than 150 million people with private coverage. Insurers would reimburse for rapid tests that deliver results in as little as 15 minutes.
Coronavirus response coordinator Jeff Zients says the administration has quadrupled the supply of at-home tests, while creating a streamlined process to get new options to market. The government is scaling up free testing at pharmacies and community venues as well.
“Our goal is to give free tests to everyone who wants one in the most efficient and effective way possible,” Zients said recently. “There is enough testing capacity in this country, and we’re confident that as more tests come to market ... innovation will continue and prices will come down.”
Estimated prices for at-homes tests in the U.S. range from about $15 to $30, compared with about $1 in Germany.
Health insurance companies have been cool to the idea.
The largest trade group, America’s Health Insurance Plans, has expressed concerns about price gouging for overthe-counter tests and higher premiums for consumers. The Blue Cross Blue Shield Association has called for “common-sense implementation.”
There’s a sense that the industry is being handed a new kind of mission.
Health insurance normally covers medically necessary services and procedures, but would COVID-19 testing for a longdesired family reunion meet that threshold? And with the automation of insurance billing, companies say they’ll have to bring on new staff to handle the volume of claims for over-the-counter COVID-19 tests even if consumers upload their paper receipts.
Some public health experts are concerned the administration may be off course.
“If what we get is that everybody has to buy tests and submit paperwork for reimbursement and then get a refund, that is going to result in many people not getting tested because there are too many barriers in the way,” said Dr. Leana Wen, a former Baltimore health commissioner and commentator on the pandemic.