Three Northeastern States Commit to Coordinating on COVID-19 Testing Guidance

By Roxanne Bangalan

Delaware, New Jersey, and Rhode Island announced last week a commitment to a common framework for COVID-19 testing for high-risk, asymptomatic residents and for financing this testing.

The absence of federal guidance on national testing protocols has put states at the helm of decisions about who and how to test their residents. With potential demand for testing exceeding supply, a shared and consistent evidence-informed approach to policymaking maximizes limited resources and improves the quality of the findings.

With support from the Milbank Memorial Fund and Center for Evidence-based Policy, the states identified priority populations for asymptomatic testing, including residents and staff in skilled nursing, assisted living, and other group settings, immunocompromised individuals, workers with high exposure risk, people experiencing homelessness, and asymptomatic people with known exposure. The states also outlined key strategies for testing in those populations and developed an approach to financing.

In a joint statement, governors emphasized using testing to mitigate the spread of the virus and ensure the “safe, sustainable re-opening of economies.” The governors underscored the following six principles in their science-based approach:

1. Prevent the transmission of SARS-CoV-2.
2. Inform infection control measures in high-risk settings.
3. Protect high-risk populations, especially those living and working in high-risk settings.
4. Provide predictability for all residents.
5. Allow flexibility to respond to urgent needs.
6. Ensure wise use of limited resources.

States devised a coordinated testing strategy involving baseline and intermittent follow-up testing adapted to local prevalence rates and encouraging standardized reporting of all test results. Other preventative safety measures such as hand hygiene, appropriate use of personal protective equipment (PPE), disinfecting, and physical distancing will continue.

To ensure coverage for asymptomatic testing and treatment, the states will consider issuing medical standards and guidance that specify the categories of individuals at high risk for COVID-19 and asymptomatic transmission, ensure evaluation of these individuals is not required prior to testing, and determine how test results will be reported to patients. In addition, the state agencies with oversight for private insurance will consider clarifying that the state’s standard for payment or medical necessity has been met and directing private insurance carriers to cover SARS-CoV-2 testing and treatment for these high-risk populations.

“We know that a strategic asymptomatic testing plan is one of our strongest lines of defense against the spread of COVID-19,” said Rhode Island Governor Gina M. Raimondo. “As case numbers spike across the country, it’s more important now than ever that we’re taking the most effective interventions possible. I’m grateful to my fellow governors for their collaboration as we follow this shared approach to keep our residents safe.”