The Centers for Medicare and Medicaid Services (CMS) has announced increased latitude in COVID-19 testing, treatment and prevention for patients of Medicare Advantage and Part D and health drug plans.
In wake of the 2019 Novel Coronavirus (COVID-19) outbreak, several leading insurance companies and their industry associations announced they will be treating COVID-19 diagnostic tests as covered benefits and will waive cost sharing that would otherwise apply to the test. In conjunction, CMS published a memorandum to Medicare Advantage (MA) and Part D health and prescription drug plans informing them of the flexibilities they have to provide healthcare coverage to Medicare beneficiaries for COVID-19 testing, treatments, and prevention.
In the memorandum issued, CMS outlines the flexibilities MA and Part D plans have to waive certain requirements to help prevent the spread of COVID-19. These flexibilities include:
- Waiving cost-sharing for COVID-19 tests
- Waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
- Removing prior authorizations requirements
- Waiving prescription refill limits
- Relaxing restrictions on home or mail delivery of prescription drugs
- Expanding access to certain telehealth services
These waivers break down barriers to beneficiaries accessing care and allow plans to work with pharmacies and providers to treat patients without burdensome requirements limiting their options during this outbreak.
To view, CMS’s memorandum for MA and Part D plans, visit: https://www.cms.gov/files/document/hpms-memo-covid-information-plans.pdf
To view up-to-date CMS news on COVID-19, visit the Current Emergencies Website