Dear Secretary Becerra:
Thank you for your continued leadership to combat the spread of the Omicron variant and a new winter strategy to combat the COVID-19 pandemic. We appreciate your continued work to improve the federal response to COVID-19 and your plan's prioritization of expanded access to free at-home COVID-19 testing. As you work to draft guidance to allow Americans with private health insurance to be reimbursed for rapid, at-home COVID-19 tests, we urge you to take steps to make this process as seamless as possible for individual patients.
Rapid tests are a critical tool in slowing the spread of the virus that causes COVID-19. These tests can help people learn if they have COVID-19, and are critical to informing when they should stay home to protect themselves and others. Furthermore, rapid tests can identify 98 percent of cases in which a person is still infectious with COVID-19. As the nation continues to battle the spread of the Delta variant and confronts the spread of the more infectious Omicron variant, easy access to free rapid COVID-19 tests will be even more important.
We appreciate that the Administration recognizes the importance of making tests more accessible, including the recent announcement that the federal government will purchase 500 million rapid COVID-19 tests and distribute them for free to Americans who order them online. We look forward to receiving additional information about this initiative in a forthcoming briefing with the White House COVID-19 Response Team.
In addition, we appreciate that the Departments of Health and Human Services, Labor, and the Treasury will issue sub-regulatory guidance to allow individuals who purchase over-the-counter (OTC) rapid COVID-19 tests to seek reimbursement from their private health insurance plans. Finally, we applaud the Administration's announcement that the federal government will provide 50 million rapid COVID-19 tests to people without health insurance through community health centers, rural health clinics, and other community sites. These points of access will be critical for individuals who do not have access to reliable, high-speed internet.
As you move to draft new regulations and implement policies to expand access to rapid COVID-19 tests, we seek answers to the following questions. We ask for your responses by January 13, 2022.
Which specific policy options did the Administration consider to expand access to rapid COVID-19 tests for people with private health insurance?
For example, did the Administration consider an option that would require private health insurers to reimburse enrollees and their dependents for a set number of rapid COVID-19 tests per month, or did you consider coverage of rapid COVID-19 tests through a health plan's pharmacy benefit with no co-pay?
If you considered additional policy options for people with private health insurance, how did you conclude that retroactive reimbursement for rapid COVID-19 tests would be the best policy to minimize the administrative burden and upfront costs paid by individual patients?
As you develop sub-regulatory guidance to require private health insurance plans to reimburse for rapid COVID-19 tests, what guardrails are you considering to prevent manufacturers of tests from raising the price of COVID-19 tests?
How is your administration working to ensure an adequate supply of rapid tests?
Will you clarify whether an order from a health care provider will be required in order for a private health insurance plan to fully reimburse for the price of a rapid COVID-19 test?
While your announcement proposes policies to increase access to rapid COVID-19 tests for people with private health insurance and without any health insurance, your announcement did not address the policy for beneficiaries of Medicaid, the Children's Health Insurance Program (CHIP), Medicare, TRICARE, the VA, and the Indian Health Service (IHS).
Will individuals covered through Medicaid, CHIP, Medicare, TRICARE, the VA, and IHS have access to free rapid COVID-19 tests under provisions from the Free COVID-19 Testing Act, which was enacted as part of the Families First Coronavirus Response Act?
If not, what steps are you taking to make sure that these individuals have access to free rapid COVID-19 tests?
What will be the reimbursement rate by these public payers for rapid COVID-19 tests?
Regarding your announcement that you will distribute 50 million rapid COVID-19 tests to people without health insurance through community health centers, rural health clinics, and other community-based organizations, what criteria will you use to select these sites for rapid COVID-19 tests?
What are your plans to support these community-based organizations with the additional resources they need to get tests to people at the right time, let them know that tests are available, educate them on how to use these tests, and support them when they test positive?
Generally, what is your administration doing to provide additional resources and information to make individuals and families aware of the availability of tests, educate them on how to use these tests, and support them when they test positive?
More broadly on public health surveillance and the role of rapid COVID-19 tests, how are we working to integrate rapid COVID-19 testing data results into the positivity rate, breakthrough infection rate, and other data that inform our understanding of how COVID-19 is spreading in local communities? Does the Administration have a plan to set up a process for individuals to report their rapid COVID-19 test results?
Thank you again for your work to expand access to rapid COVID-19 tests and to lead us out of the COVID-19 pandemic. We look forward to reviewing your responses to our questions.