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CLIP — ACHP Requests CMS Set At-Home COVID-19 Testing Coverage Standards (HealthPayerIntelligence)

Manual claims submissions for at-home COVID-19 testing coverage could place a burden on the health care industry and upfront testing costs could pose social determinants of health barriers.

ACHP Asks CMS To Set At-Home COVID-19 Testing Coverage Standards

by Kelsey Waddill, HealthPayerIntelligence

In a letter to CMS, the Alliance of Community Health Plans (ACHP) has requested that the federal government establish certain requirements for at-home COVID-19 testing coverage.

“We support the Administration’s goal to improve access to FDA-approved COVID at-home tests while protecting the premium dollar of every patient, employer and taxpayer,” the organization began. “However, the responsibility for public health surveillance testing, including at-home tests, remains with the federal government.”

ACHP offered five recommendations to the Biden Administration regarding how to address coronavirus testing.

Overall, the operational challenges that at-home coronavirus testing poses were a key consideration that ACHP brought up to CMS. Consumers will have to submit reimbursement claims manually, which puts considerable strain on health insurers.

“To mitigate the extraordinary operational barriers and improve consumers’ ability to access at-home tests, ACHP encourages the Administration to consider alternative approaches that would build on the successful consumer, health plan and government partnership model utilized for COVID-19 vaccinations,” the ACHP letter shared.

The upfront cost of the test may still pose a social determinant of health barrier to low-income individuals, ACHP also noted.

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