BINGHAMTON, NY (WSKG) — Tompkins County will soon expand its partnership with Cayuga Health System (CHS)* and cover the cost of some COVID-19 testing.
Officials say that will take some strain off CHS. Pressure on the health system multiplied when federal changes were made to the rules governing which tests insurance providers must cover, and which expenses fall upon patients.
Since the end of March, the hospital system has run a drive-thru sampling site at The Shops at Ithaca Mall. That was back when federal provisions in the CARES Act and Families First Coronavirus Response Act required private health insurance providers to cover all COVID-19 testing and related services for the duration of the federally-declared public health emergency.
In June, however, new guidance jointly issued by the Departments of Health and Human Services (HHS), Treasury and Labor clarified testing requirements and what tests must be covered.
According to the guidance, health insurance providers need not cover tests for “general workplace safety” or “public health surveillance,” including back-to-work or general screening tests.
“So we’re now in a situation where insurers might pay us initially but then ask for the money back,” said Martin Stallone, CEO of Cayuga Medical Center in Ithaca.
Only tests for diagnostic and treatment purposes require coverage from insurers, the guidance explained. That limited the scope of covered testing to people who are symptomatic, have been exposed to a known positive case or who are tested before an operation.
According to Stallone, insurance providers are now asking for test fees dating back to the beginning of the pandemic. That puts major costs back on CHS, which already operates the COVID-19 screening site outside its budget.
CHS now offers $99 tests to people who don’t qualify for covered testing.
“It was unsustainable for Cayuga Health Systems to continue to provide it for free,” said Frank Kruppa, Public Health Director for Tompkins County.
According to Stallone, starting and operating the drive-thru sampling site cost the hospital system $5-10 million. He said most costly is administering the tests, which require labor as well as an array of supplies and equipment, like PPE.
To alleviate the strain, the Tompkins County legislature voted earlier this month to put $300,000 toward covering the cost of tests for county residents who would not otherwise be covered. They will do so while simultaneously seeking reimbursement from FEMA.
For now, the program will last 10 weeks. According to Kruppa, the county needs that time to assess the cost of testing before it can build a solid budget.
“Quite frankly, two weeks is a lifetime in this event, just because things have been changing so quickly,” Kruppa said. “We never know where we’re going to be in a couple of weeks.”
Kruppa added the county will announce its testing expansion in the coming days.
*Full disclosure: Cayuga Health System is a WSKG Underwriter.