California: Gov. Newsom orders insurance carriers to waive all coronavirus-related testing fees

This is likely to turn into a repetitive headline over the next couple of weeks as more states follow New York's lead in issuing similar blanket Executive Orders or State of Emergency declarations:

California orders insurers to waive out-of-pocket costs for coronavirus testing

California on Thursday became the latest state to order insurance companies to waive out-of-pocket costs for coronavirus testing.

The California Department of Insurance and Department of Managed Health Care ordered all full-service commercial and Medi-Cal plans to “immediately reduce cost-sharing — including, but not limited to, co-pays, deductibles or coinsurance — to zero for all medically necessary screening and testing for COVID-19, including hospital, emergency department, urgent care and provider office visits where the purpose of the visit is to be screened and/or tested for COVID-19.”

Larry Levitt of the Kaiser Family Foundation notes:

California is requiring insurers to cover coronavirus testing with no patient cost-sharing. As in other states, this doesn’t apply to self-insured employer plans. But, just 33% of California workers are in self-insured plans, compared to 61% nationally. https://t.co/OhbUMtvoip

— Larry Levitt (@larry_levitt) March 6, 2020

That's not terribly reassuring for Californians and far less so for other states...

Anyway, here's the official order:

Governor Newsom, State Health Officials Announce More than 22 Million Californians Now Eligible for Free Medically Necessary COVID-19 Testing

Date: March 5, 2020

• ​​All Commercial & Medi-Cal Health Plans Regulated By Department of Managed Health Care Will Eliminate Cost-Sharing For Medically Necessary Testing 
• Support Is Now Available Through the Employee Development Department For Businesses and Workers Impacted By COVID 19 
• Governor Newsom Declared State Of Emergency to Help State Prepare For Broader Spread Of COVID-19

SACRAMENTO – Today, under the direction of Governor Gavin Newsom, the Department of Managed Health Care directed all commercial and Medi-Cal health plans regulated by the Department to immediately reduce cost-sharing to zero for all medically necessary screening and testing for the COVID-19 in the All Plan Letter (PDF). This includes waiving cost-sharing for emergency room, urgent care or provider office visits when the purpose of the visit is to be screened and tested for COVID-19. The need for COVID-19 testing is based on medical necessity, a clinical determination made on a case by case basis by medical professionals.

"Californians shouldn't have to fear a big medical bill just because they took a test for COVID-19," said Governor Newsom. "This action means that Californians who fit the testing requirements can receive the test at no cost. We're all in this together, and I'm grateful to those health providers who have already stepped up and heeded our call." 

"This action will ensure that Californians who need a test will receive one at no cost," said Dr. Mark Ghaly, secretary of the California Health and Human Services Agency. "This doesn't mean every Californians should be seeking a test. If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care."

Today the California Department of Insurance issued similar direction providing cost free medically necessary testing for an additional 2 million Californians. Combined these announcements ensure that 24 million more Californians are eligible to receive testing, should their health care provider deem it medically necessary. Insurance Bulletin COVID-19 Screening and Testing (PDF).

The Department of Managed Health Care also directed health plans to increase capacity to screen and treat COVID-19 as needed to minimize further transmission by encouraging health plans to expand telehealth services and to take steps to ensure patients receive medically necessary medication if there is a shortage of a particular drug.

These orders from the Department of Managed Health Care and the Department of Insurance do not apply to individuals in self-insured health coverage products.

Support Now Available for Employers and Workers Impacted by COVID-19

Also today, the California Employee Development Department announced support services to individuals affected by COVID-19 in California. For faster and more convenient access to those services, the use of online options is encouraged.

Individuals who are unable to work due to having or being exposed to COVID-19 (certified by a medical professional) can file a Disability Insurance (DI) claim.

Disability Insurance provides short-term benefit payments to eligible workers who have full or partial loss of wages due to a non-work-related illness, injury, or pregnancy. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 - $1,300 a week.

Californians who are unable to work because they are caring for an ill or quarantined family member with COVID-19 (certified by a medical professional) can file a Paid Family Leave (PFL) claim.

Paid Family Leave provides up to six weeks of benefit payments to eligible workers who have a full or partial loss of wages because they need time off work to care for a seriously ill family member or to bond with a new child. Benefit amounts are approximately 60-70 percent of wages (depending on income) and range from $50 - $1,300 a week.

Employers experiencing a slowdown in their businesses or services as a result of the Coronavirus impact on the economy may apply for the UI Work Sharing Program. This program allows employers to seek an alternative to layoffs - retaining their trained employees by reducing their hours and wages that can be partially offset with UI benefits. Workers of employers who are approved to participate in the Work Sharing Program receive the percentage of their weekly Unemployment Insurance benefit amount based on the percentage of hours and wages reduced, not to exceed 60 percent.

Visit the Work Sharing Program to learn more about its benefits for employers and employees, and how to apply.

Governor Proclaimed State of Emergency

Governor Gavin Newsom yesterday declared a State of Emergency to make additional resources available, formalize emergency actions already underway across multiple state agencies and departments, and help the state prepare for broader spread of COVID-19. The proclamation comes as the number of positive California cases rises and following one official COVID-19 death.

The emergency proclamation includes provisions that protect consumers against price gouging, allow for health care workers to come from out of state to assist at health care facilities, and give health care facilities the flexibility to plan and adapt to accommodate incoming patients.

View a copy of the emergency proclamation (PDF).

COVID-19 in California by the Numbers (as of 10 a.m. Pacific Time):

• 60– Positive cases
• 1 – Death
• 24 – Cases of positive tests related to federal repatriation flights
• 36 – Cases not related to repatriation flights
• 18 - Travel-related
• 10 - Person to person
• 4 - Community transmission
• 4 – Currently under investigation

• 9,400+ – number of people self-monitoring who returned to the U.S. through SFO or LAX
• 49 – Number of local health jurisdictions involved in self-monitoring
• 15 – Labs with test kits

How Can People Protect Themselves:

Every person has a role to play. So much of protecting yourself and your family comes down to common sense:

• Washing hands with soap and water.
• Avoiding touching eyes, nose or mouth with unwashed hands.
• Avoiding close contact with people who are sick.
• Staying away from work, school or other people if you become sick with respiratory symptoms like fever and cough.
• Following guidance from public health officials.

What to Do if You Think You're Sick:

Call ahead: If you are experiencing symptoms of COVID-19 and may have had contact with a person with COVID-19 or recently traveled to countries with apparent community spread, call your health care provider or local public health department first before seeking medical care so that appropriate precautions can be taken.

California's Response to COVID-19:

We have been actively and extensively planning with our local public health and health care delivery systems. Here are some of the things we are already doing: 

• As in any public health event, the California Department of Public Health's Medical and Health Coordination Center has been activated and is coordinating public health response efforts across the state.
• California continues to prepare and respond in coordination with federal and local partners, hospitals and physicians.
• California activated the State Operations Center to coordinate response efforts across the state.
• Governor Gavin Newsom requested the Legislature make up to $20 million available for state government to respond to the spread of COVID-19.
• California made available some of its emergency planning reserves of 21 million N95 filtering facepiece masks for use in certain health care settings to ease shortages of personal protective equipment.
• The Public Health Department is providing information, guidance documents, and technical support to local health departments, health care facilities, providers, schools, universities, colleges, and childcare facilities across California.
• It is coordinating with federal authorities and local health departments that have implemented screening, monitoring and, in some cases quarantine of returning travelers.
• In coordination with the CDC, state and local health departments, we are actively responding to cases of COVID-19. 
• The Public Health Department is supporting hospitals and local public health laboratories in the collection of specimens and testing for COVID-19.
• The California Department of Public Health's state laboratory in Richmond and 14 other public health department laboratories now have tests for the virus that causes COVID-19.