Across the country, every state is taking action to ensure accessible coronavirus (COVID-19) testing and treatment, engaging in cross-agency collaboration, employing unique approaches to testing, and preventing price-gouging on drugs and medical supplies. Here’s a sampling of what states are doing.
Testing and Quarantine Initiatives
Washington State: With the most coronavirus infections in the country, Washington is replicating drive-through testing practices used in South Korea and Great Britain. Employees of the University of Washington’s medical system can now get tested for coronavirus and influenza A and B without leaving their cars. The system’s medical center in Seattle turned a hospital garage lot into a drive-through clinic that can test a person every five minutes. People with symptoms register online and get an appointment for testing and typically get results within a day or so. Individuals don’t have to sit in a waiting room where they spread or contract the infection, and the ventilation of the open air reduces possible exposure for health care workers. The university also plans to work with the Bill and Melinda Gates Foundation to provide coronavirus testing kits that patients can use at home.
The state has also purchased a hotel and is converting a former youth detention center to house individuals and families placed in quarantine.
Rhode Island: Five experts from the US Centers for Disease Control and Prevention’s epidemic intelligence service are “embedded” with state health officials, according to Rhode Island’s Department of Health director to help the state build its response capacity. Specifically, the CDC officials are helping trace those who have come in contact with people who have tested positive for the virus since returning from a trip to Europe. The trip, by students and staff of a Catholic high school in Pawtucket, stopped in Italy. Gov. Gina Raimondo has also set up a 24/7 public hotline staffed with health care professionals for those with questions about the coronavirus or how to self-quarantine.
Nationwide, many states are ramping up their cross-agency state and local collaboration to spearhead efforts to control the infection by ramping up coordination among all state and local agencies. As one example, Maryland’s Institute for Emergency Medical Services Systems and its Department of Health, in partnership with the state’s hospital association, are coordinating around surge planning, including ambulance re-routing plans, suspension of voluntary admissions, and developing enhanced methods of medical monitoring for home-bound patients with mild to moderate symptoms.
Medicaid, Insurance Coverage, and Family Leave
Several states have issued some type of directive or emergency order for the insurance plans they regulate. Washington State specifically noted that short-term plans must abide by the order. States operating state-based insurance marketplaces also encouraged residents to check their insurance exchanges’ websites to see if they could be eligible for Medicaid or a special enrollment period.
Kentucky’s Medicaid enrollees will no longer be required to get prior authorizations to be tested or treated for coronavirus and, via an executive order, the state’s Department of Insurance would require private insurers to eliminate copays and other charges.
Michigan Gov. Gretchen Whitmer announced the state Medicaid program is waiving all copays and cost-sharing for testing and health care treatment related to the coronavirus.
Washington State Insurance Commissioner Mike Kreidler issued an emergency order to state health insurers requiring them to waive copays and deductibles for any consumer requiring testing. Insurers also must allow a one-time early refill for prescription drugs, and suspect prior authorization requirement for treatment or testing. In addition, if an insurer does not have enough medical providers in its network to provide testing and treatment, it must allow enrollees to be treated by another provider within a reasonable distance at no additional cost.
Nationwide, Blue Cross Blue Shield Association (BCBS) announced its 36 BCBS companies will waive prior authorizations and increase coverage for COVID-19 and increase access to prescription drugs, enhanced telehealth, and other clinical support systems. The actions will apply to fully-insured, individual, and Medicare members. It also expressed a commitment to working with state Medicaid and Children’s Health Insurance Program agencies to ensure that beneficiaries have access to needed testing and services.
California Gov. Gavin Newsom has directed commercial and Medi-Cal (Medicaid) health plans to waive cost-sharing for all medically necessary screening and testing related to the coronavirus. The California Employee Development Department announced that those unable to work due to exposure to COVID-19 may file a disability insurance claim and those caring for a family member exposed to the virus may apply for paid family leave.
Nevada Gov. Steve Sisolak adopted an emergency regulation to ensure residents with health insurance policies regulated by the state Division of Insurance can obtain medical services and prescriptions related to the coronavirus at normal costs. This emergency regulation prohibits insurers from imposing out-of-pocket costs for a provider, urgent care center, or emergency room visit testing. Insurers also cannot charge Nevadans for the test. Health insurers must provide information on patients’ available benefits, possible telehealth services and preventative measures related to the novel coronavirus.
New York Gov. Andrew Cuomo announced a directive requiring health insurers to waive cost-sharing associating with novel coronavirus testing, including emergency room, urgent care, and office visits. In addition, New Yorkers receiving Medicaid coverage will not have to pay a copay for any testing related to COVID-19. Health insurers must also keep people informed about their available benefits, offering telehealth services when possible.
California Attorney General Xavier Becerra issued a price gouging alert, reminding residents that the state’s anti-price-gouging law protects people impacted by an emergency from illegal price gouging on drugs, medical supplies, food, gas, and other essential supplies.