Nursing home operators and insurers are butting heads over who should cover COVID-19 testing costs for workers.
The conflict comes after the federal government directed states to require universal testing in nursing homes. Some states have gone even further, like New York, which now requires twice-a- week testing for nursing home employees.
State health and financial officials have deemed the tests medically necessary, according to Stephen Hanse, president and CEO of the New York State Health Facilities Association/NYS Center for Assisted Living. The designation means that the tests should be covered by insurers under the CARES Act.
“What we’re seeing in New York is that most commercial insurers are refusing to cover those costs. We’re also seeing situations where union health plans are not covering the costs,” Hanse told McKnight’s. “For those providers who are self-insured, the CARES Act doesn’t provide any coverage for them. So, really it’s a significant cost issue.”
Several insurers, however, have said they will not cover the screening tests for employees, The New York Times reported. Several trade groups have also called on the federal government to release “clear guidance” on who should cover the tests.
It costs about $100 for laboratories to process each coronavirus test. The state has nearly 122,000 nursing home employees and about 20,600 assisted living employees.
“So on a weekly basis you’re looking at over $40 million,” he said.
Hanse said the associations working in partnership with the state of New York in order to ensure reimbursement for the costs of these tests, and it’s “not clear” who the testing cost burden will ultimately fall on.
“After the expenses associated with staff, with PPE, with significantly diminished census and the state suspension of elective surgeries and its impact on sub-acute care in nursing homes, many nursing homes throughout the state are struggling financially,” Hanse said.
“It’s imperative that we work with the state in partnership to have these costs reimbursed — whether through federal funding [or] commercial plans — but it’s essential that these costs get covered,” he added.