McDermottPlus Advocacy Coalition Pursues Medicare Coverage for At-Home COVID-19 Tests

THE CHALLENGE:

Deep into the COVID-19 pandemic, when at-home tests became available for over the counter (OTC) purchase, they helped reduce testing and quarantine delays that stemmed from the need to schedule an in-person appointment and, in many cases, wait for the results.

Several months after at-home tests entered local pharmacies, the Biden Administration announced that it would require private insurers and Medicaid programs to cover and reimburse plan participants for the cost of at-home COVID-19 tests. However, that cost still was not covered by Medicare—an omission that left many older Americans, who were among the most vulnerable to the life-threatening effects of COVID-19, unable to secure a no-cost OTC diagnostic test.

OUR OBJECTIVE:

Leveraging their industry relationships, a McDermott+Consulting (McDermottPlus) team led by Paul Radensky and Eric Zimmerman brought five market competitors, all of which furnish at-home COVID-19 testing tools, into an advocacy coalition. The companies united around the common goal of working with the Biden Administration and Congress to ensure all Medicare beneficiaries could access at-home COVID-19 tests at no cost, just like those who are privately insured.

THE OUTCOME:

With guidance and coordination from McDermottPlus, this collaborative approach strengthened the stakeholders’ combined message and put them in a powerful position to make their case to CMS and the White House.

Within two months, the Centers for Medicare and Medicaid Services (CMS) confirmed that people in both traditional Medicare and Medicare Advantage would also be able to get OTC COVID-19 tests at no cost.

The McDermottPlus team leveraged their deep knowledge of health policy, along with relationships in the industry, the Biden Administration and Congress, to focus attention and drive favorable change. To that end, the team instigated several potent and persuasive Congressional letters addressed to President Biden and CMS, reaching out directly to congressional offices to secure support. The coalition also attracted media attention from outlets such as the Washington Post, the New York Times and the Wall Street Journal, which published articles referencing those sign-on letters and validating the objectives.

In partnership with the coalition, McDermottPlus’s advocacy efforts drove a heightened sense of urgency around the issue and prompted involvement from high-level executives at CMS and leaders of the White House COVID-19 task force. As CMS searched for pathways to overcome legal challenges, McDermottPlus worked efficiently to bring in a legal team at partner law firm McDermott Will & Emery. The McDermott lawyers, including Mike Ryan and Moyo Koya, devised the legal analysis that proposed a roadmap and options for allowing Medicare coverage for the OTC tests.

GO FURTHER:

Building a coalition of competitors around a common objective helped the McDermottPlus team kick off a productive dialogue and achieve success on their behalf. Their coordinated efforts not only benefited the immediate objective of providing equal access to OTC at-home COVID-19 tests, they established a framework that will position the coalition to address future challenges.

Strong industry and political relationships, a deep understanding of the intricacies of health policy, and a close partnership with law firm McDermott Will & Emery allowed McDermottPlus to effectively and efficiently assemble the key players equipped to address the issue and find a solution.

Learn more about the McDermottPlus Health Advocacy, Policy & Lobbying Strategies.