Health Plan Weekly

The ongoing pandemic has forced the health care system to quickly reorganize care delivery, as payers and providers have worked together to keep low-acuity patients away from hospitals overwhelmed by severe COVID-19 cases. Experts say such changes in health care delivery might become permanent as more consumers are introduced to nontraditional care sites.

Growth in telehealth delivery is well-documented, and during the current public health crisis, most private insurers have expanded access to telehealth, with some waiving related cost sharing. There are signs beneficiaries are taking advantage: Blue Cross Blue Shield of Massachusetts said it processed 180,000 telehealth visits in March, a 5,100% increase in utilization compared with 2019’s monthly average.

With the Trump administration anxious to “reopen” the U.S. economy and ease the social-distancing measures meant to slow the spread of COVID-19, officials have pointed to antibody testing as a critical tool to accomplish those goals. To that end, the administration on April 11 issued a document clarifying that most private health plans must cover such tests, which detect antibodies against the new coronavirus found in the blood of people who have been infected and now may be immune.

Experts tell AIS Health that the requirement to cover antibody (also known as serological) testing wasn’t entirely unexpected, but it does raise a host of still- unanswered questions, such as how much these tests will cost, how widely available they’ll be, and whether they can be relied upon.

✦ Insurance companies that sustain heavy losses during the COVID-19 pandemic can access tax relief through the recently passed Coronavirus Aid, Relief and Economic Security (CARES) Act, building on policies established in the 2017 Tax Cut and Jobs Act. That’s according to a new report from credit rating firm A.M. Best, which writes in a news release that “the $2 trillion CARES Act provides a special rule applicable for all companies’ net operating losses in 2018 to year-end 2020, allowing these to be carried back to each of the five tax years prior to the year of loss, which could help all insurance segments.” Read the full analysis at https://bit.ly/2VjoK9d.

✦ New York state will require insurers to pay claims on behalf of beneficiaries who can’t pay their premiums due to the COVID-19 pandemic and related economic contraction. The state also mandated that payers defer premiums due for individual and small group commercial plans to June 1 if plan members lose the ability to pay due to the pandemic, and it banned payers from reporting such missed premiums to credit agencies. Payers in New York cannot impose late fees on premiums. New York’s Dept. of Financial Services “will consider any liquidity or solvency concerns of the health plans in giving effect to this directive,” said a state press release. Go to https://on.ny.gov/2Rquywr.

More than 6.6 million Americans filed initial unemployment claims for the week that ended April 4, as many businesses were asked to shutter or adjust their operations to slow the spread of the novel coronavirus. Under a medium unemployment scenario in which 21 million people lose their jobs, Medicaid and individual marketplace enrollment could increase by 16.5 million and 1.5 million, respectively, across all states over the next few months, while the number of uninsured could grow by 5.2 million, according to an analysis by Health Management Associates.

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