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California to health insurance companies: Pay for coronavirus testing

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California to health insurance companies: Pay for coronavirus testing

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With coronavirus cases surging and the need for testing at an all-time high, California officials are putting pressure on major health insurance companies to help finance the fight against the pandemic.

The state Department of Managed Health Care will soon issue new regulations requiring health insurers to pay for coronavirus testing for most patients, state officials said Tuesday. They hope the move will lead to large hospitals, clinics and other health care providers conducting more testing at a time the public needs it the most.

“It will reinforce and support our delivery system, clinics, hospital systems, to be able to test more and test more confidently so it’s widely available,” said California Health and Human Services Agency Secretary Dr. Mark Ghaly.

The number of people hospitalized with COVID-19 in the Bay Area reached an all-time high of 633 patients, surpassing 600 for the first time, as hospitalizations jumped in eight counties, according to state data released Tuesday. Contra Costa, Solano and San Mateo counties each reported five new hospitalized patients, while San Francisco admitted nine more people and Santa Clara reported 10 new patients. Tuesday marked the ninth straight day that regional hospitalizations have climbed upward.

New coronavirus cases in the Bay Area similarly surged during the month of June, peaking in early July before tapering off slightly the last couple of days. Health officials attribute the rise to the overall relaxing of shelter-in-place restrictions, family gatherings and new infections among essential workers who are not able to work from home — particularly those who live with several other people in the same household to whom they are spreading the virus.

As of Tuesday evening, California had reported 344,905 cases with 7,235 deaths. The state reached its third highest caseload today with 9,430 reported cases and its 142 deaths were the second highest total.

In the Bay Area, there were 37,494 cases with 667 deaths total. Today’s tally of 16 Bay Area deaths was the highest since May 5.

U.S. cases have reached nearly 3.4 million, including 136,117 deaths.

Los Angeles County, which has been driving much of the surge in the state, on Tuesday reported its highest single-day increase with 4,244 new cases.

“Today’s numbers are alarming and unfortunately are the result of many businesses and individuals not adhering to the basic public health requirements of distancing and wearing face coverings, Dr. Barbara Ferrer, Los Angeles County’s director of public health. “We are just not able to continue on a recovery journey without everyone doing their part.”

The recent surge in infections prompted Gov. Gavin Newsom on Monday to drastically scale back reopening plans — shutting down indoor dining, bars, movie theaters, gyms and other businesses in counties that account for 80% of the state’s population.

And the surge has led to a spike in demand for testing that has left many health care providers and laboratories struggling to test people quickly and process tests promptly. As a result, many Californians are waiting several days to get tested, and some are waiting up to two weeks to get test results back.

Ghaly did not specify when the new regulations for insurance companies will be posted, or when they would take effect. The regulation will be filed Tuesday or Wednesday with the Office of Administrative Law, a Department of Managed Health Care spokeswoman said.

The state also issued new guidance to laboratories on which tests should be processed first. Hospitalized patients and people in riskier settings — like residents and employees at nursing homes and prisons — will be considered the highest priority groups and will get test results faster than lower-risk, asymptomatic people who can self-isolate in their homes.

“We know patients awaiting care in the hospital, who may be COVID-19 positive, need that test result so we can appropriately cohort those patients and provide the necessary treatment,” he said.

Testing delays have worsened the last few weeks and are hampering public health officials’ ability to track and trace transmission quickly. The delays also have left many patients frustrated as they wait for an answer on whether they need to self-quarantine or if they can safely resume interacting with friends, family and co-workers.

The large number of new cases is complicating contact tracing — identifying an infected person and speaking to all their close contacts — Ghaly said.

“Contact tracing with this level of transmission is much, much more difficult,” he said.

The state is conducting about 105,000 tests each day — significantly better than the few thousand a day it was doing in March, but well short of the roughly 223,000 tests a day that Harvard researchers estimate need to be done to control the spread of the virus.

Some Bay Area public health officials have criticized large hospital systems, including Kaiser and Sutter, for not conducting more coronavirus tests — which has shifted the burden and cost of testing onto the counties.

Santa Clara County last month issued a health order demanding large health care systems do more testing. But most of the testing in the county is still being done by the county health system, according to county testing data. During the final week of June, for instance, the county was performing an average of 721 tests each day on county residents, compared to Kaiser’s 126 and Stanford’s 121, according to Santa Clara County testing data that was last updated July 7.

In other coronavirus news Tuesday:

• The White House ordered hospitals to start sending coronavirus patient information to a database in Washington, D.C. and bypass the Centers for Disease Control and Prevention, alarming health officials who fear the data may be altered for political purposes, The New York Times reports. The instructions, expected to take effect Wednesday, were revealed in a document posted this week on the Department of Health and Human Services’ website, according to the report.

• Moderna’s experimental COVID-19 vaccine provoked immune responses in all 45 health volunteers in an ongoing early-stage study, U.S. researchers reported Tuesday. No serious side effects were seen but more than half of participants reported mild or moderate reactions such as fatigue, headache, chills, aches or pain at the injection site. These were more likely to occur after the second dose and in people who got the highest dose, the team reported in the New England Journal of Medicine.

Chronicle staff writers Anna Bauman and Alejandro Serrano contributed to this report.

Catherine Ho is a San Francisco Chronicle staff writer. Email: cho@sfchronicle.com Twitter: @Cat_Ho



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