Health Plan Weekly

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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Facing mounting criticism for deciding not to allow a special enrollment period (SEP) on the federal health insurance exchange amid the COVID-19 crisis, the Trump administration offered up a different strategy to help the uninsured get the care they need if stricken by the disease caused by the new coronavirus. In short, the administration will funnel a portion of the $100 billion in funding earmarked for U.S. hospitals in the latest emergency stimulus bill “to cover providers’ costs of delivering COVID-19 care for the uninsured,” HHS Secretary Alex Azar explained during an April 3 White House press briefing.

Ten years after the launch of a mobile outpatient cardiac telemetry device from medtech company BioTelemetry, Inc., insurer Health Care Service Corp. (HCSC) has included it in its medical coverage policy. Pennsylvania-based manufacturer BioTelemetry revealed the coverage decision in a February earnings call, saying that the move was the result of a non-stop effort to flip a small holdout of insurers. BioTelemetry says about 95% of payers cover the diagnostic device, and many without step therapy requirements that mandate patients try other devices first.

The mobile outpatient cardiac telemetry (MOCT) device is perhaps one of the most recent medical developments used for diagnosing heart rhythm and rate abnormalities. These problems — the heart pumping too slow or too fast — can cause sudden cardiac arrest, stroke and/or death.

An earlier version of this story incorrectly stated that a Wakely study of COVID-19-related risk to insurers only examined the risk to commercial carriers. While the study did not estimate risk to traditional Medicare or Medicaid, it did include risk to Medicaid managed care and Medicare Advantage plans. This version of the story has been corrected.

In a series of open letters dated April 1, the American Hospital Association (AHA) asked payers to consider moving temporarily to an advance or scheduled payments model because hospitals’ cash flow is strained by the COVID-19 pandemic. Experts say the need for liquidity is very real, but what hospitals are requesting may not be feasible.