WASHINGTON – U.S. Senators Maggie Hassan (D-NH) and Jeanne Shaheen (D-NH) joined their colleagues in urging the Biden administration to ensure that insurance companies are following the law and providing Granite Staters and Americans COVID-19 diagnostic tests at no cost.
In their letter to the Department of Health and Human Services, the Senators praised the new guidance that the administration has released to help ensure that Americans can receive COVID-19 testing free of charge, which was included in the Families First Coronavirus Response Act that the Senators worked to pass into law last year. The Senators are pushing for additional action that would protect more Americans, though, after recent reports of significant COVID-19 test fees.
“The recently issued guidance also acknowledges additional testing challenges that need to be addressed,” the Senators wrote. “We hope you will consider provisions …to clarify the process for submitting claims for COVID-19 tests and related office visits so that individuals do not receive unnecessary charges.”
The Senators also called on the Department of Health and Human Services to address price gouging of COVID-19 tests by analyzing which providers are charging for COVID-19 tests “that substantially exceed the average cash price.”
The letter builds on Senators Hassan and Shaheen’s efforts to bring down health costs for individuals. Senator Hassan successfully led and Shaheen supported bipartisan efforts to help end the practice of surprise medical billing in the year-end government funding package. The approximately $18 billion in savings from this legislation extends funding for vital public health priorities including community health centers for three years.
Read the Senators’ letter here or below.
Dear Secretary Becerra:
Congratulations on your confirmation to become the Secretary of the Department of Health and Human Services (HHS). We are confident that you are equipped with the health policy and management experience to lead HHS at this critical time, to implement a national COVID-19 testing and vaccination strategy, and to finally defeat the COVID-19 pandemic. We write to draw your attention to positive steps that HHS has already taken to address persistent testing challenges that face our nation and to offer additional solutions to address these problems.
On Friday, February 26, 2021, the Departments of Labor, Health and Human Services, and Treasury issued updated sub regulatory guidance to clarify questions on provisions in the Families First Coronavirus Response Act (FFCRA) that are intended to provide COVID-19 testing without out-of-pocket charges. We were pleased the guidance explains that COVID-19 diagnostic tests must be covered for individuals without symptoms and without known exposure to COVID-19. The guidance also clarifies that individuals who receive COVID-19 diagnostic tests by any licensed or authorized health care professionals at community-based testing sites administered by states or localities or “drive-through” sites should receive these tests without out-of-pocket expenses. Finally, the guidance states that individuals should have access to point-of-care COVID-19 tests without cost sharing.
These clarifications are closely aligned with provisions in our bill, the Stop COVID-19 Test Surprise Medical Bills Act. Our legislation would clarify that health insurers cannot refuse to cover the full cost of or delay access to a COVID-19 test on the basis of whether the test was ordered by a physician, whether the individual seeking a test had symptoms, or whether an individual seeks a test multiple times. We are pleased to see that the Biden Administration has already taken action to promptly make the changes that our legislation seeks to provide and protect patients from surprise medical bills for COVID-19 tests.
The recently issued guidance also acknowledges additional testing challenges that need to be addressed. First, the guidance reiterates that health plans must cover items and services associated with receiving a COVID-19 test, including services furnished during in-person and telehealth provider office visits, urgent care visits, and emergency room visits. The guidance directs health plans to maintain claims processing to protect patients from cost sharing for these associated services and invites feedback on specific steps that health insurers should take. We hope you will consider provisions from our Stop COVID-19 Test Surprise Medical Bills Act that direct the Departments of Health, Labor, and Treasury to issue guidance to clarify the process for submitting claims for COVID-19 tests and related office visits so that individuals do not receive unnecessary charges.
Second, the guidance highlights the problem of providers of COVID-19 diagnostic tests failing to comply with requirements to post their cash price for COVID-19 tests, leading to price-gouging. The agencies direct health plans to report providers who are violating these requirements and invite feedback on how to best monitor abusive pricing practices. We hope you will consider another provision from our Stop COVID-19 Test Surprise Medical Bills Act in order to address price gouging of COVID-19 tests. Our bill requires HHS to survey providers of COVID-19 tests and issue a public report, highlighting which providers are charging prices that substantially exceed the average cash price.
The guidance takes positive steps to address persistent challenges that are leading to out-of-pocket testing charges for the American people. We stand ready to work with you as the guidance is implemented and if there are additional solutions that require legislative action, and we look forward to working with you to protect all Americans from out-of-pocket costs for their COVID-19 tests.
 (2021, February 26). FAQs About Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act Implementation Part 44. Retrieved from https://www.cms.gov/files/document/faqs-part-44.pdf