Senate Majority Leader Mitch McConnell (R-KY) released the “phase 3” coronavirus stimulus package on March 19, 2020. The Senate is expected to vote on the package early next week. In response, WHG has issued a summary of the health-related provisions that address medical supply shortages, coverage of COVID-19 diagnostic testing, support for health care providers, and Medicare flexibilities, among other issues. Our full summary is available here. A few items we want to highlight in particular follow.
- The bill would allow diagnostic tests for COVID-19 to be marketed in the U.S. during a public health emergency if the test:
- Is developed in a State lab in which the State intends to authorize the test;
- Is developed in laborities that are certified to conduct high-complexity testing and are pursuing Emergency Use Authorization; and,
- Is an in vitro diagnostic test made by a manufacturer that meets the requirements imposed on labs certified to conduct high-complexity testing.
- It would also require commercial insurers to provide coverage for diagnostic testing, and items and services furnished during provider visits that result in a diagnostic test. Moreover, plans would have to cover such services without imposing and cost-sharing requirements on enrollees.
- In an arrangement analogous to the surprise medical billing debate, the bill would require health plans to reimburse providers for diagnostic tests per the negotiated rate, if a rate exists. If not, the plan would have to reimburse the provider based on the publicly listed cash price of the test.
- Commercial plans would also have to cover any qualifying preventive service for COVID-19.
- HHS would have to pay for telehealth services furnished by a Federally Qualified Health Center (FQHC) or a Rural Health Clinic (RHC) to Medicare beneficiaries during the emergency period (payment will be based on comparable telehealth services under the physician fee schedule).
Again, you can find our full summary of the bill text here.
Alyssa Llamas is a Policy Director at Wynne Health Group, focusing primarily on legislative activity to reform health care. She brings her public health background and expertise to understanding how federal decisions impact state and local partners. She is also a proud dog mom to her Shihtzu, Lemon. You can reach her via email at alyssa@wynnehealth.com, and can find her on LinkedIn and Twitter here.
Josh LaRosa is a Policy Director at Wynne Health Group, focusing primarily on regulatory affairs with an emphasis on the FDA and CMS. His interests lie in delivery reform and innovations in payment and care delivery models. You can reach Josh via email at josh@wynnehealth.com, and can find him on LinkedIn and Twitter as well.
