Health Plan Weekly

In an effort to help ease cost concerns for those infected with COVID-19, the disease caused by the novel coronavirus, several health insurance companies have waived cost sharing requirements related to COVID-19 treatment.

Besides all the other ways it’s changing American life, the COVID-19 pandemic is sure to have a major impact on how the health care industry does business going forward, equities analysts said during a March 31 panel discussion hosted by the USC-Brookings Schaeffer Initiative for Health Policy.

The 24th Wall Street Comes to Washington Health Care Roundtable was held virtually this year in accordance with social distancing guidelines aimed at slowing the spread of COVID-19, the disease caused by the new coronavirus that emerged in China in late 2019 and then spread throughout the world. As of press time, complications from the virus had killed more than 6,000 people in the U.S. and more than 54,000 globally.

In a first-in-the-nation move, Blue Shield of California has agreed to cover rapid and ultra-rapid Whole Genome Sequencing for critically ill infants and children in intensive care who have unexplained medical conditions. The agreement — which will use testing at Rady Children’s Institute for Genomic Medicine, a center of excellence in genetic testing — likely will spur additional insurers to add coverage for this diagnostic technology, observers say.

“I think the way the health plans are going to go about implementing this is exactly what you’re seeing in this case — they’re going to pick a center of excellence,” Ashraf Shehata, KPMG national sector leader for health care and life sciences, tells AIS Health. “I think they’re going to put some bumper guards around how they could go forward with these approvals. And I think in addition to that, you’re going to see their medical policies probably begin to adapt a bit more to accept the outputs that are coming from these types of tests.”

Congress has now passed three separate bills to address the ever-worsening COVID-19 crisis in the U.S., spending trillions of dollars to lessen the economic impact and support the country’s overtaxed health care system. But for the most part, this legislation has not included measures requested by the health insurance industry aimed at boosting coverage affordability and access.

COVID-19, the disease caused by the new coronavirus that has swept the world, has claimed more than 4,000 lives in the U.S. and caused officials to shut down large portions of the economy as they try to slow the infection rate.

Many of the nation’s largest health insurers have now waived patient cost sharing and prior authorization requirements for treatment of COVID-19, the disease caused by the novel coronavirus. Experts praise payers for making the change, but say the moves could have negative financial impacts for some firms. The same experts believe consolidation is likely if payers and providers struggle with liquidity.

Payers waiving coinsurance include Anthem, Inc., UnitedHealth Group, Cigna Corp., Centene Corp., Humana Inc. and some Blue Cross Blue Shield plans. Companies that have relaxed prior authorization requirements include Anthem, Centene and Humana. (For a more complete list, see p. 5.)