HEALTH CARE BRIEFING: insurers ask for limits on “free” Covid tests

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The Biden administration’s plan to make rapid at-home Covid-19 tests effectively free for millions of Americans could skyrocket the cost of such tests, insurers and employers are warning the government.

Federal health officials are expected to release guidelines this month outlining how private health plans should reimburse beneficiaries for the cost of home Covid testing. Politics are key to the administration’s efforts to curb the spread of the virus, which is now occurring at historic levels.

Health insurers and employer groups ask Department of Health and Human Services to place limits on what private health plans must pay for home Covid tests or limit where Americans can buy them .

The concern of consumer advocates is that some retailers or even diagnostic companies will increase the cost of testing once they know insurers are footing the bill. “If insurers are to reimburse home tests from anywhere and at any cost, they will be at the mercy of price increases by unscrupulous sellers,” said Larry Levitt, executive vice president of the health policy at the Kaiser Family Foundation. “If insurers remain in charge, consumers will be partly protected against price increases, but they still face risks. “

The White House said in December that it wanted the more than 150 million Americans with private health insurance reimbursed for home tests as part of the public health emergency. The departments of Health and Human Services, Labor and the Treasury are due to issue guidance on the requirement by January 15. Public insurance programs like Medicare were not included in the plans, although diagnostic companies are now lobbying to include them.

Kristine Grow, spokesperson for U.S. health insurance plans, said her group had warned HHS officials of concerns about the potential prices of rapid tests.

Two large retailers – Walmart and Kroger – recently increased the price of a popular Covid-19 home test after a deal with the White House expired to sell the kits at cost. The price of Abbott Laboratories’ BinaxNOW tests at Walmart dropped from $ 14 to $ 19.88 this week. CVS Health and Walgreens charged $ 24 for Binax testing. Read more about Alex Ruoff.

Illinois Governor JB Pritzker (D) asked the Biden administration for Covid-19 tests to help resolve the latest dispute between Chicago’s public schools and its teachers’ union, a disagreement that has led to the cancellation of classes for three consecutive days. “I have spoken for the past two days with the White House asking them for help with Chicago public schools,” Pritzker said in an interview yesterday. “There is a challenge across the country that needs testing, but I think there is an urgent need in Chicago because we want to get these kids back to school.”

The Chicago Teachers Union voted on Tuesday to return to distance learning from the next day amid calls for schools in the city to step up measures to mitigate a Covid-19 surge caused by the omicron variant. His demands include an extension of testing amid a city-wide positivity rate that has soared to 23%. The union is calling on Chicago public schools to expand testing due to low vaccination rates and the number of students enrolled in weekly surveillance tests. Read more about Shruti Date Singh.

The coronavirus pandemic

Biden entrepreneur’s vaccine mandate remains stuck: Cincinnati federal appeals court rejected Biden’s request to lift a judge’s order blocking the application of a Covid-19 vaccine warrant for federal contractors in three states as it assesses a challenge judicial decision of the executive decree. The U.S. Sixth Circuit denied the administration’s request for an emergency stay, staying the preliminary injunction issued by a Kentucky federal judge as he pursued an appeal. This lower court verdict only applies to companies with federal contracts in Kentucky, Ohio, and Tennessee. Read more about Erin Mulvaney.

WHO highlights the risk of Omicron: The omicron variant of the Covid-19 virus appears to be less severe than previous strains, but it should not be considered mild, the director-general of the World Health Organization has said. Early studies suggested that the new variant causes less severe illness and fewer hospitalizations, but it’s so highly transmissible that infections around the world are skyrocketing to record levels, straining many healthcare systems. The WHO said global cases rose a record 71% in the week to January 2, compared to the previous week, while the number of new deaths rose 10%. Andy Hoffman has more.

One-third of small businesses in New York City have vaccination requirements: The share of small U.S. businesses requiring their employees to get vaccinated has jumped in most major cities in recent weeks as the omicron variant spread across the country. In New York City, which implemented one of the country’s toughest private sector mandates late last month, a third of small businesses are asking their employees for their shots in the latest weekly US Census Bureau Small Business Pulse Survey. That’s up from 28% in Christmas week and less than a quarter three months ago. Read more about Alex Tanzi.

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What else to know today

Lawsuits, injunctions await LGBTQ health protections: A Biden administration proposal Preventing qualified health insurance plans from discriminating against gay and transgender people is the latest regulatory step in an ongoing battle for broader healthcare protections for LGBTQ people. A slew of legal challenges are already in play, including two court rulings that could prevent the Department of Health and Human Services from enforcing a more drastic rule against some medical providers even before it is released. officially proposed. Read more about Lydia Wheeler.

Medicare drug plans must pass savings on to consumers: Medicare beneficiaries would pay lower out-of-pocket costs for prescription drugs under a rule proposed by the Biden administration that would require Medicare prescription drug plans to pass savings on to consumers. More and more Medicare “Part D” drug plans are entering into “price concession” agreements in which they pay reduced costs to certain pharmacies for certain dispensed drugs. But these arrangements are not publicly disclosed, and drug plans do not pass savings on to Medicare beneficiaries who purchase the drugs.

In late 2018, the Centers for Medicare & Medicaid Services solicited comments on a policy requiring Part D plans to “enforce any price concessions they receive from network pharmacies at point of sale, which would reduce sharing. costs by beneficiaries, ”according to a press release yesterday from the agency. After considering the comments, CMS is now proposing this policy, which would take effect on January 1, 2023, to reduce out-of-pocket expenses for Medicare Part D beneficiaries and improve price transparency and market competition in the program. Part D. ” Read more about Tony Pugh.

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To contact the reporter on this story: Brandon lee in Washington at [email protected]

To contact the editors responsible for this story: Zachary Sherwood at [email protected]; Giuseppe Macri at [email protected]; Michaela ross at [email protected]


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