OPM has told FEHB carriers that they must provide coverage and waive deductibles, copayments, and coinsurance, and waive prior authorization requirements for certain testing related to diagnosis of covid-19 or to detect the presence of antibodies against the virus, and the office visit related to such testing.
That applies to tests approved by the FDA, tests under an emergency use authorization pending approval, certain state-approved tests and other tests as allowed by HHS, OPM told carriers.
It added: “Currently, there are no evidence-based preventive services or vaccines for the novel coronavirus that causes COVID-19. But when such preventive services or vaccines do become available, Carriers must cover them, without any cost-sharing, as soon as possible after approval, clearance, or authorization.”
Further, it said that all carriers who have not already done so “should strongly consider waiving cost-sharing (including deductibles, copayments, and coinsurance) for telehealth or other remote care services associated with treatment of COVID-19.” Carriers that offer a health savings account-qualified high deductible health plan may offer telehealth and other remote care services in their HDHP before the deductible, it said.
OPM earlier had told carriers to “minimize barriers to testing and treatment” related to the Coronavirus, for example by considering relaxing referral or pre-authorization requirements for testing, care and medication, authorizing access to out-of-network services with in-network cost sharing, and waiving cost sharing for testing and telemedicine/ telehealth visits.