Bipartisan Letter to HHS Secretary Expresses Concerns About Recent Coverage Denials for COVID-19 Testing

WASHINGTON, DC– U.S. Reps. David B. McKinley, P.E., (R-WV-01) and Bill Pascrell Jr. (D-NJ-09) have led a letter with 54 Members of Congress to U.S. Department of Health and Human Services (HHS) Secretary Alex Azar expressing concerns over recent coverage denials from health plans for COVID-19 testing.

The Families First Coronavirus Response Act passed by Congress in March and the CARES Act both included provisions ensuring that individuals can receive COVID-19 tests without out-of-pocket costs. However, recent changes have created confusion regarding coverage requirements for COVID-19 testing.

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“One of the tools needed for safely reopening our society and getting people back to work and school is for COVID-19 testing to be widely available,” Rep. McKinley said. “Cost should not be a barrier for anyone who needs a test. Penalizing people with out-of-pocket costs will only discourage people from getting tested and may prolong this pandemic.”

“Access to covered testing is a critical tool for Americans to move forward during the COVID-19 pandemic,” said Rep. Pascrell. “The House took action to ensure coverage for any type of diagnostic test. The Trump administration now must listen to the people’s representatives and implement guidance immediately. To delay any further would risk countless American lives.”

“Changes made in a tri-agency guidance on June 23, 2020 have created confusion regarding coverage requirements for COVID-19 testing,” write the Members. “Individuals should not have any question whether they will face out-of-pocket costs for COVID-19 diagnostic or antibody testing.  We urge HHS to clarify the June 23 tri-agency guidance to be consistent with congressional intent and, ultimately, so that individuals who need a test can receive one without cost-sharing, medical management, or prior authorization, and regardless of whether the individual is symptomatic.”

The letter is signed by Reps. McKinley, Pascrell, Tony Cárdenas (D-CA-29), Terri A. Sewell (D-AL-07), Jeff Van Drew (R-NJ-02), Brian Fitzpatrick (R-PA-01), David Schweikert (R-AZ-06), Lisa Blunt Rochester (D-DE-AL), David Trone (D-MD-06), Max Rose (D-NY-11), Steven Horsford (D-NV-04), Jimmy Panetta (D-CA-20), Susan Wild (D-PA-07), John Larson (D-CT-01), Ed Perlmutter (D-CO-07), Lloyd Smucker (R-PA-11), David Price (D-NC-04), Bill Foster (D-IL-11), Lauren Underwood (D-IL-14), Barbara Lee (D-CA-13), John Rutherford (R-FL-04), Bruce Westerman (R-AR-04), Albio Sires (D-NJ-08), Betty McCollum (D-MN-04), Katie Porter (D-CA-45), James McGovern (D-MA-02), Steve Cohen (D-TN-09), Van Taylor (R-TX-03), Mark DeSaulnier (D-CA-11), Mikie Sherrill (D-NJ-11), Mike Levin (D-CA-49), Jodey Arrington (R-TX-19), Brian Higgins (D-NY-26), Kim Schrier, M.D. (D-WA-08), Ann Wagner (R-MO-02), Josh Harder (D-CA-10), Juan Vargas (D-CA-51), Harley Rouda (D-CA-48), Tim Ryan (D-OH-13), Ted Deutch (D-FL-22), Gilbert Cisneros, Jr. (D-CA-39), Al Lawson (D-FL-05), Donna E. Shalala (D-FL-27), Jamie Raskin (D-MD-08), Abigail Spanberger (D-VA-07), Jason Crow (D-CO-06), Jahana Hayes (D-CT-05), Marcy Kaptur (D-OH-09), Ron Kind (D-WI-03), Mary Gay Scanlon (D-PA-05), Angie Craig (D-MN-02), and Eddie Bernice Johnson (D-TX-30).

The full text of members’ letter is provided below.

October 23, 2020

 

The Honorable Alex M. Azar II

Secretary

U.S. Department of Health & Human Services

200 Independence Avenue, S.W.

Washington, D.C. 20201

 

Dear Secretary Azar:

 

The Department of Health and Human Services (HHS) has taken extraordinary actions to fight the COVID-19 pandemic. Throughout the public health emergency, the federal government and our states have taken critical steps to increase COVID-19 testing capacity because Congress provided additional resources to harness the strength and innovation of the private sector. While greater access to testing is needed, the United States has conducted over 100 million PCR tests that has helped contain the virus, reopen the economy, and Americans return to work and school.

 

The Families First Coronavirus Response Act and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which  were passed overwhelmingly by Congress and signed into law by President Trump earlier this year, contained provisions ensuring that individuals can receive COVID-19 tests without out-of-pocket costs. President Trump’s recent “Executive Order on An America-First Healthcare Plan” signaled the Administration’s commitment to ensuring that individuals are held harmless from surprise medical bills, including for testing.

 

Unfortunately, changes made in a tri-agency guidance on June 23, 2020 have created confusion regarding coverage requirements for COVID-19 testing. In recent weeks, there has been an increase of coverage denials from health plans for COVID-19 testing, particularly for asymptomatic individuals.

 

For all Americans desiring to safely return to school and work, access to testing is critical. Individuals should not have any question whether they will face out-of-pocket costs for COVID-19 diagnostic or antibody testing.  We urge HHS to clarify the June 23 tri-agency guidance to be consistent with congressional intent and, ultimately, so that individuals who need a test can receive one without cost-sharing, medical management, or prior authorization, and regardless of whether the individual is symptomatic.

 

Thank you again for your leadership during these unprecedented times. We look forward to continuing to work with the Trump Administration to overcome the health and economic challenges posed by this pandemic.

 

Sincerely,