Health Plan Weekly

To some policy experts, the COVID-19 pandemic offers a chance to rethink the national debate over universal health coverage — potentially bolstering the case for a Medicare for All system or a public option that provides government-sponsored, less expensive health plans alongside private offerings.

“I submit that COVID is an opportunity for us to reframe our understanding of health care’s role, for us to connect back with an older vision of health as something that if not dealt with for some amongst us has devastating effects on the rest of us,” Daniel Wikler, a professor of ethics and population health at the Harvard TH Chan School of Public Health, said during a May 28 virtual panel discussion hosted by the Georgetown University Law Center and its O’Neill Institute for National & Global Health Law. “We certainly see that dramatically with infectious disease.”

As part of their response to the COVID-19 pandemic, many insurers waived member cost sharing for health care services and treatment related to the disease caused by the new coronavirus. Those waivers were generally set to expire in early summer, but some of the nation’s largest insurers have now extended the benefit. Experts say the resulting financial risk to those payers seems minimal, and other firms are likely to make similar moves.

Payers that have extended cost-sharing waivers include:

The recent protests over how police treat communities of color has led an array of different corporations to weigh in on the matter — including not only household names such as Nike, Inc., Twitter, Inc. and The Walt Disney Co., but also health insurers.

One reaction that stood out was from UnitedHealth Group, which is headquartered in Minnetonka, Minn., less than a half hour’s drive away from Minneapolis where George Floyd’s May 25 death in police custody sparked outrage throughout the country.

✦ Some health insurers received and then returned unsolicited payments from the $30 billion grant fund that HHS distributed to offer COVID-19 financial relief to health care providers, Modern Healthcare reported. UnitedHealth Group received and returned $49 million, Cigna Corp. returned $41 million, and CVS Health Corp., which owns Aetna, received and returned $43 million. Humana Inc. and Centene Corp. also told Modern Healthcare that they returned some relief funding, though they did not disclose how much. Read the article at https://bit.ly/2Xa9FZv.

✦ CVS Health Corp. is being sued by six Blue Cross Blue Shield plans that claim CVS “intentionally engaged in a fraudulent scheme” to overcharge them for prescription drugs by “submitting claims for payment at artificially inflated prices.” The lawsuit claims CVS “intentionally told third-party payors, including Plaintiffs, that the prices charged to cash customers for …generic drugs were higher — often much higher,” than they actually were. “Third-party payors then reimbursed CVS based on those higher, inflated prices — instead of the actual, lower, prices CVS offered to the general public, including through its Cash Discount Programs.” CVS is disputing the claims. View the lawsuit at https://go.aws/36FfpO5.