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Miserly coverage for COVID-19 testing for children puts pediatricians in a no-win situation

On February 3, 2021, the New York Times blew the whistle on health insurers under-reimbursing COVID-19 tests for children. Here’s who’s profiteering at the expense of pediatricians and their patients.

In October, we shared a story about insurers actively blocking access to care and refusing to fully cover COVID-19 tests. Now, there are reports of insurers denying coverage for kids while passing the buck to providers.

Testing for kids is hard to come by, and pediatricians offer much-needed access with in-office rapid tests. But certain insurers are being miserly when it comes to reimbursement, with—surprise!—UnitedHealthcare being named as a top offender. Also—and this is a surprise—certain Medicaid plans, which are meant to protect the country’s most vulnerable children, are underpaying to the point where even the cost of the test supplies isn’t covered.

Because insurers won’t pay their fair share, providers are being forced to choose whether to sacrifice their patients’ health or their own financial health. Some have stopped testing kids altogether or are only testing those with certain insurance—a move that, when it comes to Medicaid populations in particular, could widen the health disparity gap. Limited testing for children could also have cascading effects, as new virus strains, schools re-opening, and kids being last in line for vaccines create a perfect storm for outbreaks.

Apparently, this isn’t troubling United, which, true to form, is focused on its bottom line. The company reported a $15.4 billion profit in 2020. Shortchanging pediatricians during the pandemic could be one way to hit its projection of even greater profits in 2021.

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