HealthPayerIntelligence: ACHP Responds to CMS’ COVID Testing Guidance

Following a CMS announcement on over-the-counter tests, ACHP responds in HealthPayerIntelligence to this important improvement in testing guidance.

CMS Issues Over-the-Counter Coronavirus Testing Guidance

by Kelsey Waddill, HealthPayerIntelligence

CMS released guidance around the over-the-counter coronavirus testing requirement, providing greater clarity regarding what kinds of direct-to-consumer access mechanisms fall under compliance and answering questions related to testing shortages and fraud.

The guidance explained that the requirement to provide adequate access to over-the-counter coronavirus tests entails establishing an in-person method of receiving the tests and a direct-to-consumer shipping option.

One of the primary problems that payers and consumers faced with this rule was that coronavirus tests are limited in supply. An eHealth survey found that almost three out of ten consumers experienced challenges accessing a coronavirus test in the past six months.

CMS explained that payers would not be penalized for not providing access to over-the-counter coronavirus tests if their supply is limited due to the shortage. Payers who face this scenario can continue restricting their coronavirus testing coverage to $12 per test.

Major payer organizations have responded positively to the agency’s decision to require Medicare to cover at-home coronavirus tests.

“Medicare coverage of over-the-counter COVID tests is a critical step in ensuring timely, equitable and affordable access — no matter where you live, how old you are or whether you have private health insurance. Our seniors and the most vulnerable deserve this important and potentially life-saving benefit” — Ceci Connolly, Alliance of Community Health Plans

Read the Full Article on HealthPayerIntelligence


Learn More About ACHP’s Recommendations to Expand Access to COVID-19 Testing

Learn How ACHP Member Plans Turbocharge Vaccine Efforts

Press Contact

All media inquiries should be directed to:

Mat Gulick
Director, Communications
Making Health Care Better

ACHP is the voice of a unique approach in health care today, one that puts the patient at the center with plans and clinical teams collaborating to improve health outcomes and reduce costs. Our advocacy focuses on providing policymakers with tested solutions, rooted in a model that is proven to deliver better value for patients, employers and taxpayers.

icon-arrow
client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo client-logo
icon-arrow

Stay Connected