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

The Trump administration recently issued guidance to health insurers, determining that they are not required to cover workplace or public health surveillance testing for COVID-19. In a recent post for the State Health & Value Strategies project, Sabrina Corlette assesses what this latest federal interpretation means for states’ efforts to combat the pandemic. Continue reading

On the Whole, Health Insurers Aren’t – Yet – Fearing COVID-19 Costs: A Review of 2021 Rate Filings

Several states ask for – and publicly post – health insurers’ proposed 2021 premium rates in May and June. These early rate filings can provide hints about how insurers are responding to market trends, policy changes, and emerging drivers of health care costs. CHIR’s Sabrina Corlette took a deep dive into insurers’ actuarial memos to find out how they’re thinking about COVID-19, repeal of the ACA’s individual mandate penalty, and more. Continue reading

Instead of Encouraging Enrollment in Comprehensive Health Coverage, New Federal Guidance Requires Taxpayers to Subsidize Health Care Sharing Ministries

In the midst of the COVID-19 pandemic, the IRS has published a proposed rule that would grant tax advantages reserved for insurance to individuals’ spending on health care sharing ministries, raising real questions about using federal funds to promote a coverage option that fails to provide consumers with financial protection for health care expenses. JoAnn Volk walks through the proposed rule and its potential implications for consumers.
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I’ve been calling for greater private insurance coverage of COVID-19 testing. I’ve been wrong

As the nation combats the biggest threat to its public health and economy that any of us have seen in our lifetimes, the key to recovery will lie in widespread, universally accessible testing for COVID-19. In a recent blog post for Health Affairs, CHIR’s Sabrina Corlette argues that our traditional, insurance-based model of financing health care services won’t work if we want to use testing to help us get back to work, schools, and community life. Continue reading

The Provider Relief Fund: How Well Does it Protect Patients from Surprise Medical Bills for COVID-19 Related Services?

The $175 billion Provider Relief Fund prohibits participating providers from balance billing COVID-19 patients, regardless of their source of coverage. While this could help many patients avoid surprise medical bills, there remain several questions about the scope of protection this will provide. In an update to his April 30, 2020 post, Georgetown expert Jack Hoadley takes a look at the fine print of the program as well as new guidance from HHS. Continue reading

When Things Fall Apart: A Roadmap for State Regulators Managing Fallout from Provider-Payer Contract Disputes

High profile contract disputes between insurers and providers appear to be on the rise, raising the risks of disruptions for patients and unexpected out-of-network billing. In a new report for the Robert Wood Johnson Foundation, CHIR experts examine best practices among state regulators and insurers to protect consumers and provide recommended policies and procedures to mitigate risks when a provider leaves a health plan network. Continue reading