News Briefs

✦ HHS Secretary Xavier Becerra on June 9 sent a letter to health insurers and providers warning them that COVID-19 vaccines and tests must be provided free of charge to patients. “In light of recent reports of consumer cost concerns,” he wrote — citing a recent New York Times article that indicated concern over unexpected medical bills was a reason cited by people who indicated they are hesitant to get the coronavirus vaccine — “I am reminding health care providers of their signed agreements to cover the administration of COVID-19 vaccines free-of-charge to patients, and group health plans and health insurers of their legal requirement to provide coverage of COVID-19 vaccinations and diagnostic testing without patients shouldering any cost.” Health plans that fail to comply with those legal requirements may be reported to appropriate state insurance departments or CMS “for possible enforcement action,” Becerra said.

✦ Clover Health Investments, Corp. on June 9 unveiled plans to expand its in-home primary care program, Clover Home Care, through CMS’s Direct Contracting model. The Medicare Advantage-focused startup insurer has bet big on that new model, which aims to lower costs and improve care quality for fee-for-service Medicare beneficiaries, but it also revealed during its first-quarter 2021 earnings report that it will likely have far fewer people covered by that program than it originally anticipated. In its most recent announcement, Clover said that “the goal of Direct Contracting is to make the Medicare program more financially sustainable for taxpayers while improving health outcomes for beneficiaries, which aligns with the work of Clover Home Care.” The company said its first two partners in the new effort, Spiras Health and Upward Health, “were chosen because of their record of exceptional care delivery in the home via a multidisciplinary model, which is core to Clover’s strategy for complex care management.”

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