Lankford eyes insurance coverage of COVID-19 tests
U.S. Sen. James Lankford joined an effort Monday to make sure health insurance companies cover the costs of C OVID -19 tests, whether or not a person had symptoms when getting tested.
The Oklahoma Republican and some of his GOP colleagues sent a letter to the Health and Human Services Department saying two different pieces of pandemic legislation “made sure that individuals can receive COVID-19 tests without out- of- pocket costs.”
The letter says the administration c reated some confusion in a document published in June and that, in recent weeks ,“we have been made aware of increasing coverage denials from health plans for COVID-19 testing, particularly for asymptomatic individuals.”
“For Americans who wish to safely return to school and work, access to testing is critical, and they should not have to question whether or not COVID-19 diagnostic or antibody testing is covered by their insurance,” the letter states.
“No one should have to pay for a test. If someone want sat est, they should be able to get a test, and that test should be covered by insurance without any out-ofpocket costs.”
A spokesperson for t he Health and Human Services Department said the department would respond to the senators' letter.
“Insurance com panies are required to cover diagnostic testing for their members without imposing any cost sharing,” the spokesperson said.
“When it comes to surveillance, that is performed as a public health activity and should be paid for differently. States have received funding specifically for conducting public health activities like surveillance testing.
“States have received $10.25 billion ... to conduct whatever type of COVID testing they like. The $10.25 billion in funding is completely separate from the testing supplies, media and reagents HHS/ FEMA sends states each month. What type of COVID tests states want to implement( diagnostic, antibody, contact tracing) and how they execute on those are outlined by each state in their state plan.”
Surveillance testing generally refers to public health agency efforts to determine the spread of the disease in certain populations or areas.
The Health and Human Services Department spokesperson said the agency that over sees Medicare and Medicaid has made changes that: allow pharmacists to order and administer COVID- 1 9 tests; allow providers to bill for a Level One visit, which costs $23, for a test; and allow labs to bill Medicare for COVID-19 lab tests when ordered by a healthcare professional, including a pharmacist, authorized to do so under state law.
“C VS has already implemented this model and reimbursement mechanisms in over 1,400 of their stores, and we are hoping all retail and grocery pharmacy chains take advantage of these regulatory flexibilities,” the spokesperson said.
Blue Cross and Blue Shield of Oklahoma, the largest health insurance provider in the state, covers testing-related visit sat no cost to its members when they see a primary care provider in their plan's network; the visit can be in person or using telemedicine.
That policy suggests that members who go to a clinic or other site for testing without first consulting an in-network primary care doctor might not have their testing costs covered. Costs for tests vary, but can top $200 for a molecular (PCR) test.
The company earlier this year announced it would waive all cost-sharing costs for COVID- 1 9 treatments, including de ductib les, co payments and co insurance. That benefit is in effect through the end of the year, while its testing cost benefit is in effect through the end of the public health emergency.
Joseph R. Cunningham, M.D., BCBSOK president, said, “As the state's largest private health insurer, it is paramount that we provide the highest quality of care to our members and community.
“We continue to focus on our members' health and well-being to ensure they have the security and peace of mind to access the coverage they need, to help ease the burden of those impacted by COVID-19."