Texas Responds to Coronavirus (COVID-19) Healthcare Costs

March 11, 2020

By: Rachael K. Padgett

Category: Coronavirus (COVID-19), Insurance Regulatory

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Yesterday, Texas Governor Greg Abbott and the Texas Department of Insurance (TDI) asked Texas-regulated health plans to waive all costs associated with testing and telemedicine visits for the diagnosis of COVID-19. TDI specifically asked the health plans to take the following actions as they relate to COVID-19:

  • Waive co-payments, co-insurance, and deductibles for testing that is consistent with guidance issued by the Centers for Disease Control and Prevention (CDC).
  • Waive consumer cost-sharing and facilitate expanded use of telemedicine.
  • Cover necessary medical equipment, supplies, and services.
  • Waive penalties, restrictions, and claims denials for necessary out-of-network services.
  • Waive requirements for pre-authorization, referrals, notification of hospital admission, or medical necessity reviews for care consistent with CDC guidance.
  • Allow extra time for health providers and facilities to file claims.
  • Authorize payment to pharmacies for up to a 90-day supply of any prescription medication for individuals, regardless of when the prescription was filled.

So far, 95% of Texas-regulated health plans have agreed.

Other states are taking similar actions including Massachusetts, Oregon, and Wisconsin. In Washington State, New York, and California health plans have been ordered to take similar action.

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