Washington Insurance Commissioner Orders Insurers to Cover COVID-19 Testing

Washington Insurance Commissioner Mike Kreidler issued an emergency order Thursday requiring all health insurance carriers in the state to waive copays and deductibles for consumers requiring COVID-19 testing.

The order, which is effective through May 4, follows the February 29 proclamation by Gov. Jay Inslee of a state of emergency due to the COVID-19 outbreak in the state, which saw the first reported US case of the virus reported on January 20. The number of cases of COVID-19 in Washington has continued to rise, with 70 reported cases and 10 deaths in the state as of Thursday morning, according to the Washington Department of Health.

“Consumers are rightly concerned about prevention, testing and possible treatment,” Kreidler said in a statement. “My emergency order provides guidance to health insurers and should help reassure the public that we will take all necessary steps to protect them.”

The order also requires insurers to allow a 1-time early refill for prescription drugs, suspend any prior authorization requirements for treatment or testing of COVID-19, and allow enrollees to be treated at no additional cost by out-of-network providers within a reasonable distance if it doesn’t have enough providers in its network to meet the needs.

State law allows for an emergency order such as that issued Thursday when the governor declares a state of emergency. After its initial 60-day period, the order could be extended by an additional 30 days.

The order applies to insurers that cover about 1.2 million people through individual market plans and employer plans, according to reports. Self-funded employer plans, Medicaid and Medicare, which are regulated by the federal government, do not fall under the order.

For those who lack health insurance, Inslee said the state has “the authority and intention to cover those costs by the state of Washington.”

The Public Health Laboratory in Shoreline, Washington, has the capacity to test up to 100 people per day and the state Department of Health is working with the University of Washington Virology Lab to increase testing capacity, according to a Department of Health statement.

On Wednesday, the US Centers for Disease Control and Prevention (CDC) expanded the criteria for Persons Under Investigation (PUI) to include a wider group of symptomatic patients. The CDC recommends that clinicians use their judgment to determine whether a patient should be tested for COVID-19 based on local epidemiology and clinical course of the illness. Factors include those who have had close contact with a confirmed COVID-19 patient or have traveled to affected areas. Testing criteria now includes people who are hospitalized with otherwise unexplained symptoms.

As the outbreak continues to evolve, testing may become more widely available.

To mitigate the spread of the disease, health officials have put an emphasis on closely monitoring people who have had close contacted with confirmed COVID-19 patients, starting with the first case confirmed in Washington on January 20.

The outbreak is evolving rapidly, making it important for clinicians to stay up to date on the latest information from trusted sources such as the CDC, New Jersey epidemiologist Christina Tan, MD, MPH, recently told Contagion^®. The first presumptive positive case of COVID-19 in New Jersey was reported Wednesday.

For the most recent case counts in the COVID-19 outbreak, check out the Contagion® Outbreak Monitor.