Expert Perspectives

Jun 25, 2020 

Update on Federal Mandates to Cover COVID-19 Testing Services: New Guidance for States, Plans, and Insurers

The Departments of Health & Human Services, Labor, and Treasury (collectively, the “tri-agencies”) published guidance on April 11 in attempt to clarify some of the testing coverage requirements under FFCRA and the CARES Act. However, as calls have increased for more widespread and frequent testing, particularly of at-risk populations such as health care workers, residents and staff of long-term care facilities, and people potentially exposed at protests or rallies, insurers have questioned their responsibility to cover all testing in all circumstances.On June 23, the tri-agencies published new guidance that attempts to answer implementation questions from states, plans, and insurers, including the definition of “medically necessary”, surveillance or workplace related testing, coverage of hospital “facility fees”, and protections against provider balance billing.

Jun 23, 2020 

Addressing Equity through COVID-19 Response: Communications Approaches in States

This expert perspective highlights examples employed by DC Health Link, the Oregon Health Authority, and beWellnm and the community-centered outreach they are using to actively enroll and connect consumers to care.  The expert perspective also includes best practices surfaced for marketplaces and agencies to adapt their COVID-19 communications and outreach—and beyond—to ensure those with inequitable access to health coverage are prioritized and supported.

May 29, 2020 

Is COVID-19 the End of Fee-for-Service Payment?

The coronavirus pandemic of 2020 has created a seemingly paradoxical scenario for the finances of health care providers. While states were rushing to build field hospitals to prepare for a surge of COVID-19 patients, traditional revenue streams for providers completely dried up: elective procedures were suspended and social distancing protocols limited the number of patients in office settings. A public health crisis became a health care crisis, as COVID-19 revealed the faults in the way necessary and critical health care services are paid for in America.

May 28, 2020 

States’ Reporting of COVID-19 Health Equity Data

This expert perspective looks in more depth at which states are regularly reporting data that helps shed light on the health equity issues of this crisis. Specifically, the post includes interactive maps that explore the extent to which all 50 states and the District of Columbia are reporting (as of May 28) data breakdowns by age, gender, race, ethnicity, and health care workers for both cases of and deaths from COVID-19.