Insurers Not On The Hook For Diagnostic COVID Tests Mandated By Employers, Administration Rules

Insurance companies have been anxious for guidance from the Trump administration on whether there would be patient cost-sharing responsibility for tests required by workplaces as employees return. Under the new guidance, such testing would not be covered under the Families First Coronavirus Response Act. Other medical and insurance marketplace developments are also in the news.

Modern Healthcare: Trump Administration Says Insurers Off The Hook For Back-To-Work COVID-19 Tests

Insurers are not required to cover COVID-19 tests that employers may mandate as they bring employees back to work, according to a guidance released Tuesday by the Trump administration. Insurers had been waiting for clarity from the administration on whether they would be on the hook for potentially repeated COVID-19 screening tests as states relax social distancing restrictions and employees return to work. The Families First Coronavirus Response Act required insurers to cover COVID-19 tests without patient cost-sharing, but Tuesday's guidance clarified that the law only applies to tests that are deemed "medically appropriate" by a healthcare provider. (Cohrs, 6/23)

Modern Healthcare: Survey: 1 In 4 Physicians Had Patient Seriously Affected By Prior Authorization

Nearly 1 in 4 physicians say prior authorization led to a serious adverse event for one of their patients, according to a survey released Tuesday by the American Medical Association. Another 16% of physicians reported prior authorization caused at least one of their patients to be hospitalized. And more than 9 in 10 physicians said prior authorization regularly delays access to necessary care for their patients. The AMA said the results are evidence that insurers have made little progress in reforming prior authorization since the healthcare industry issued a consensus statement about the need for reform more than two years ago. (Brady, 6/23)

Modern Healthcare: Cigna, Oscar To Offer Small Business Plans In Three States

Health insurers Oscar Health and Cigna Corp. said Tuesday they plan to offer co-branded, small business insurance coverage in Atlanta, San Francisco and four cities in Tennessee starting in the fourth quarter of this year. The plans will include certain benefits that are featured in other Oscar plans, such as a concierge team, including a nurse, to help members navigate their coverage and set up doctor's appointments. Members will also have access to telemedicine at no cost and some will benefit from $3 prescriptions drug co-payments. The plans primarily will be available to companies with 50 or fewer employees but will be offered to companies with up to 100 workers in some states. (Livingston, 6/23)

Modern Healthcare: Erlanger Ends COVID-19 Furloughs, Executive Pay Cuts

Erlanger Health System has brought back furloughed staff and restored work schedules that were pared back due to cut costs during the COVID-19 pandemic. The Chattanooga, Tenn.-based health system also plans to restore in August leadership salaries that had been lowered due to the pandemic. On July 28, Erlanger will restore paid time off accrual and it will bring back retirement plan contributions starting July 26. (Bannow, 6/23)

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