N.J. coronavirus update: Legislation would ensure Medicaid and insurance coverage

Posted Mar 06, 2020

Insurance companies and Medicaid would be required to provide coverage for testing and treatment of coronavirus in New Jersey, under bills being introduced in the Legislature.

The proposed action comes as a number of states — including California, Washington and New York — have ordered insurance companies to waive out-of-pocket costs for testing, amid conflicting signals from the Trump administration earlier in the week over who will pick up those costs.

The New Jersey Department of Banking and Insurance, meanwhile, said it is closely monitoring the situation with other state agency partners in connection with the outbreak of COVID-19, the disease caused by the new coronavirus.

“The department is currently reviewing all available options to improve access for New Jersey residents to COVID-19 testing and treatment,” said Trish Graber, a spokeswoman for banking and insurance.

State Sen. Joseph Vitale, D-Middlesex, who chairs the Senate’s committee on Health, Human Services and Senior Citizens and one of the sponsors of the legislation, said the bills were aimed at ensuring that coverage exists for people as infection rates nationwide continue to grow.

“We’ve been hearing the more-than-anecdotal stories of people having had to incur the costs of tests and treatment,” he said. “You should be covered for it.”

The two bills would require health insurance carriers — including health, hospital and medical service corporations, health maintenance organizations and insurance companies, as well as the Medicaid program — to provide coverage for medical treatment incurred in the testing and treatment of coronavirus, provided that a health care provider has issued a medical order.

The bills, S2233 and S2234, also call for that coverage to be provided without cost-sharing and not be subject to a “medical necessity” review.

Sen. Joseph Lagana, D-Bergen, another sponsor, said the Murphy administration has been proactive with local government in organizing preventative measures. But he wants the state to ensure that cost is not a barrier to access either testing or treatment.

“While the federal government is moving to expand coverage for testing, which is important, this legislation would make sure that testing and treatment are covered for New Jersey residents with state-based plans or who are on Medicaid," he said. “That additional coverage could make a big difference for people impacted by COVID-19 and reduce the spread of the virus.”

Still to be addressed nationwide is how those without any health insurance will pay for testing or treatment.

Questions over Medicaid and Medicare coverage were raised earlier this week after Seema Verma, the administrator of the Centers for Medicare and Medicaid Services, said her agency was looking at what would be covered and “clarifying the types of products and services that our programs will be able to pay for in terms of Medicare and Medicaid.”

On Wednesday, the White House walked that back, and said there was no question that the federal programs would provide coverage to those affected.

“There will be coverage for this,” said Vice President Mike Pence, who is leading the administration’s response to the virus. “Medicare covers these. Medicaid covers these," he said, referring to testing. "We’re sending out that guidance immediately.”

Separately, at least one major insurance carrier, Cigna, has already announced that its customers will be granted access to coronavirus testing “as prescribed by health practitioners,” and that the company will waive all co-pays or cost-shares to help fight the rapid spread of the virus.

David M. Cordani, the company’s president and chief executive officer, said in a statement that Cigna’s role was clear. “We will do everything we can to help contain this virus, remove barriers to testing and treatment, especially for seniors and people who are chronically ill, and give peace of mind to those we serve,” he said.

So far, three people in New Jersey have tested “presumptive positive for coronavirus.

On Wednesday, officials announced the state’s first case, a 32-year-old Fort Lee man who was hospitalized at Hackensack University Medical Center with coronavirus symptoms. A day later, it was disclosed that a second person, a Bergen County woman in her 30s, also tested positive. She has since been released from a hospital and is now being self-quarantined. A third person, identified as a male resident of Camden County in his 60s, was reported hospitalized in stable condition at Jefferson Health in Cherry Hill on Friday.

The Frisch School in Paramus, has also temporarily closed after dozens of possible exposures among students.

According to New Jersey health officials, at least eight other cases are under investigation and have warned the virus is likely to spread in the state. More than a dozen people who have also been tested were found not to have coronavirus.

Federal health officials have announced they are providing the state with $1.75 million in what they called initial funding to respond to COVID-19, the disease caused by the new coronavirus. The U.S. House also passed an $8.3 billion bipartisan bill to combat the virus on Wednesday.

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