White House releases statement on at-home COVID-19 testing, potential cost implications - Bim Group

White House releases statement on at-home COVID-19 testing, potential cost implications

SOURCE: UnitedHealthcare

READ TIME: 2 MINUTES

On Dec. 2, 2021, the White House released a statement announcing several actions to fight COVID-19, including requiring commercial health plans to cover COVID-19 at-home tests – approved or authorized by the Food and Drug Administration (FDA) – without cost-sharing. The White House has directed the Tri-Agencies (Departments of Health and Human Services, Labor and the Treasury) to issue guidance implementing this policy by Jan. 15, 2022.

The following information has been conveyed through the statement and press announcement:

  • The requirements will likely apply to fully insured, level-funded and self-funded group plans, including grandfathered and transitional relief business and business through the Exchanges.
  • The Administration preliminarily indicated the coverage requirements would not apply retroactively and would only provide coverage for diagnostic tests, as the current requirement stipulates.
  • Any requirements would likely extend through the Public Health Emergency.

UnitedHealthcare regulatory, clinical, actuarial, operations and COVID-19 testing teams are working to address and respond to the guidance when it is released.

The guidance is expected to impact 2022 health care spending. For example, at an average cost of $25 for 2 tests, and 6 tests submitted per member in 2022, the additional cost per member would be $75.

UnitedHealthcare will provide input to the Administration on how to best implement this new policy in a manner that balances access with affordability and patient safety.

Please contact your broker or UnitedHealthcare representative if you have questions or would like to learn more about advocacy efforts.

Recent Insights

November 29, 2023
News

Important Reminder: Gag Clause Attestation Due 12/31/23

The Consolidated Appropriations Act of 2021 (the CAA) requires group health plans to attest compliance with the CAA’s gag clause prohibition on an annual basis. While the prohibition of gag clauses was effective December 27, 2020, the first annual attestation is due December 31, 2023. Group health plan sponsors should begin taking steps now to […]
Read more
November 20, 2023
News

New PCORI Fee Announced by IRS

READ TIME:  7 MINUTES The Internal Revenue Service (IRS) recently released the adjusted Patient-Centered Outcomes Research Institute (PCORI) fee rate for policy and plan years ending on or after October 1, 2023, and before October 1, 2024. Background The Affordable Care Act (ACA) imposed a fee on issuers of fully insured plans and plan sponsors […]
Read more
November 20, 2023
HHS

HHS Announces Civil Penalties for HIPAA, ACA, and MSP Violations

READ TIME: 5 MINUTES On October 6, 2023, the Department of Health and Human Services (HHS) released inflation-related penalty adjustments for violations of the Health Insurance Portability and Accountability Act (HIPAA), Affordable Care Act (ACA), and the Medicare Secondary Payer (MSP) rules. These adjusted amounts apply to penalties assessed on or after October 6, 2023, […]
Read more
November 20, 2023
Webinar

Webinar: Year-End Compliance and What to Expect in 2024

Tuesday, December 12, 2023 1 – 2PM CST Register Now Registration Code:UBA410EW   Attend this month’s webinar to review 2023 employee benefits compliance requirements and learn about compliance challenges employers will face in 2024. Gain insights into: Reproductive healthcare and contraceptive coverage requirements Prescription drug and healthcare reporting Consolidated Appropriations Act components that may impact […]
Read more