The $1.9 trillion American Rescue Plan signed into law by President Biden on March 11 sets aside $47.8 billion for the Department of Health and Human Services (HHS) to spend on SARS-CoV-2 testing. While HHS has yet to release a full plan for exactly how all the funds will be spent and when, the bill outlines a number of key areas.
A chief problem for clinical laboratories has been a shortage of nearly every kind of supply needed for testing. The bill directs HHS to support the development, manufacturing, procurement, distribution, and administration of SARS-CoV-2 tests and supplies; it also directs HHS to acquire, construct, or renovate facilities to produce diagnostic supplies as necessary to bolster the supply chain.
Congress also tasks HHS with implementing a national, evidence-based strategy for testing, contact tracing, and surveillance. Part of that work must include providing technical assistance or grants to state and local health departments. The law also outlines investment in laboratory capacity for SARS-CoV-2 testing and enhancement of information technology to support data sharing related to public health. HHS also can use the funds to award grants that sustain the public health workforce.
In addition to the $47.8 billion for diagnostic testing for SARS-CoV-2, the bill appropriates $1.75 billion specifically for genomic sequencing and surveillance. HHS must use the funds to build capacity through the Centers for Disease Control and Prevention (CDC) and state or local public health departments, with the aim of increasing their capacity to sequence genomes of circulating strains of “viruses and other organisms,” including SARS-CoV-2. This section of the bill also specifically calls out the need to enhance and expand the informatics capabilities of public health departments.
To further advance informatics capabilities, the bill includes an additional $500 million for CDC to modernize public health surveillance and analytics so that the agency can track hotspots for SARS-CoV-2 and other biological threats.
Advisers Question Keeping Medicare Telehealth Expansion Post-Pandemic
A significant and potentially enduring shift during the COVID-19 pandemic has been a rapid expansion of telehealth services. Medicare expanded telehealth benefits in 2020 to encourage greater use of these services. In a new report to policymakers, the Medicare Payment Advisory Commission (MedPAC), an independent advisory panel to Congress, recommends that policymakers “temporarily continue” to pay for certain telehealth services for one to two years after the COVID-19 public health emergency to study clinical benefit.
However, MedPAC recommends that Medicare return after this period to paying the physician fee schedule’s facility rate for telehealth services, which is less than rates for in-person services. The American Hospital Association has called for Medicare to ensure appropriate payment for telehealth services because they require additional technological resources to deliver.
CMS Strengthens Requirements for Issuers to Cover SARS-CoV-2 Tests
Following an executive order from President Biden, the Centers for Medicare and Medicaid Services (CMS) issued new guidance that aims to remove barriers to SARS-CoV-2 testing and ensure that health plans cover diagnostic testing without cost sharing.
According to the guidance, issuers generally cannot use medical screening criteria to deny coverage or require cost sharing for SARS-CoV-2 tests for asymptomatic people, whether performed in a laboratory or at the point of care.
The guidance specifically cites as an example a person wanting to ensure they are SARS-CoV-2 negative prior to visiting a family member. The guidance also includes information for providers on how to get reimbursed for SARS-CoV-2 diagnostic testing or for administering the COVID-19 vaccine to those who are uninsured.