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Report Details COVID-19 Testing Within Federal Government

NEW YORK – The Pandemic Response Accountability Committee (PRAC) released on Thursday the Federal COVID-19 Testing Report, a multi-agency report looking at COVID-19 testing data compiled by six Offices of Inspector General across the federal government.

Among the report's key findings were that federal testing volume largely tracked with national testing trends; the majority of tests were molecular or antigen tests; test reimbursement varied across the different federal health programs; testing patterns were generally proportional to the demographics of the populations served; and turnaround time improved for the Veterans Administration and Department of Defense over time, while the Bureau of Prisons did not see improvements (the other three programs tracked by the report did not report turnaround time data).

During the period covered by the report — February 2000 through August 2000 — the six federal agencies — the US Department of Health and Human Services;  the US Department of Labor; the US Office of Personnel Management; the US Department of Veterans Affairs; the US Department of Defense; and the US Department of Justice, which oversees the Bureau of Prisons — paid for or administered 10.7 million COVID-19 tests, accounting for almost 13 percent of tests performed in the US in those months.

Those test were administered to some 6.5 million patients, with the bulk of those patients — 5.1 million — being Medicare Part B beneficiaries, with the rest being a mix of government and military employees or veterans, and federal inmates.

Medicare Part B covers, among other services, visits to doctors' offices and outpatient care.

PRAC is an independent oversight committee created by the Coronavirus Aid, Relief, and Economic Security, or CARES, Act of 2020 to oversee pandemic relief spending.

According to the report, testing by these federal agencies followed the pattern of testing in the US more generally, with little done in the first months of the pandemic, then volumes rising sharply through the spring and summer to peak in July and decline through August. The agencies performed or paid for 815 tests the week of February 24, 79,165 tests the week of March 30, 429,146 tests the week of May 25, 763,654 tests the week of July 6, and 506,406 tests the week of August 24.

Turnaround times improved over the course of the pandemic for two of the three agencies reporting this data. The VA and DoD saw turnaround times of more than four days and three days, respectively, in March 2020. That had dropped to around one day by July 2020. The Bureau of Prisons reported that at some sites, test turnaround took as long as two weeks in July and August as demand began to spike. The Bureau of Prisons also used rapid molecular testing, which returned results in as little as 15 minutes.

The report noted that the lack of data on turnaround time from HHS, DoL, and OPM "raises questions about how the timeliness of processing tests affects patient care, program integrity, and oversight activities," and that "payers may lack effective and ready access to data that would help them determine whether testing is of sufficient timeliness and quality to warrant payment."

At the beginning of 2021, the Centers for Medicare and Medicaid Services began incentivizing labs to return molecular COVID-19 test results within two days by requiring turnaround within this time frame to receive the full $100 reimbursement for these tests.

During the period covered by the report, the six agencies spent at least $659.5 million on COVID-19 tests for their beneficiaries, though this amount does not cover testing at the VA and may exclude some other portions of the agencies' test spending.

Test pricing varied considerably with average prices ranging from $69 to $130 among the four agencies that reported pricing data. This variation was due to factors including the use of different tests and different rules governing reimbursement within each agency, the report noted.

"Testing for COVID-19 is a critical component of the federal government's pandemic response," Michael Horowitz, chair of the PRAC, said in a statement accompanying release of the report. "Today's report examines the testing processed in multiple federal programs, providing a detailed look at testing trends, demographics, and spending."

He added that additional reports are to follow.