Health Plan Weekly

Medicare Part B will now cover eight over-the-counter, at-home COVID-19 tests per month with no cost sharing for beneficiaries starting April 4, according to a new Biden administration policy. Medicare Part B and Medicare Advantage beneficiaries will be able to order the tests from a government website or acquire them from participating retailers through the end of the public health emergency.

The new benefit will not require much participation from Medicare Advantage plans, although their members are eligible to receive it. Members can submit purchases for reimbursement or obtain the tests for free from retailers.

The Biden administration’s proposed budget includes an ambitious mental health care agenda that would step up enforcement of mental health parity, change medical necessity standards and require expanded mental health benefits. Though the budget is only a proposal and must pass Congress, where it will be heavily modified, the document arrives at a moment when legislators in both parties have made expanding access for behavioral health care a central element of their responses to the COVID-19 pandemic and opioid misuse epidemic.

The administration’s proposed 2023 HHS budget in brief includes several notable behavioral health proposals that would impact commercial insurers. That list of proposed policies includes stepped-up behavioral health parity enforcement, more funding for Medicare and Medicaid behavioral health benefits and a requirement that all health plans — including commercial group plans backed by employers — provide three behavioral health visits per member every year without charging any cost sharing.

Fueled by the COVID-19 pandemic’s deepening of disparities and the Biden administration’s own focus on the issue, health equity is undeniably top of mind for health insurers these days. But how can firms move beyond just appointing new C-suite officers or setting lofty mission statements — and instead weave equity initiatives into the fabric of their businesses?

To answer that question, payer executives during AHIP’s recent National Conference on Health Policy and Government Health Programs explained the business case for furthering health equity and how they’re marshaling processes like data analytics and vendor selections to achieve their goals.

UnitedHealth Group said on March 29 that it will spend approximately $6 billion in cash to purchase LHC Group, Inc., a home health care company. Experts tell AIS Health, a division of MMIT, that the move will bolster UnitedHealth’s current strengths and help the integrated benefits and care delivery giant hold on to the top spot in Medicare Advantage (MA) enrollment.

According to Moody’s Investor Service, UnitedHealth will spend $5.4 billion to purchase stock in LHC and use another $600 million to amortize LHC debt. Dean Ungar, Moody’s senior vice president and senior credit officer, wrote in a March 30 note to investors that the deal “is a classic [UnitedHealth] acquisition in that it modestly increases consolidated [UnitedHealth] leverage, but does not pose significant integration risk and should incrementally strengthen the business over time,” adding that the deal should close in the second half of the year.