FEHB carriers must continue to cover laboratory and over-the-counter COVID-19 diagnostic tests. Image: Kenishirotie/Shutterstock.com
By: FEDweek StaffOPM has told FEHB carriers that they must continue many policies that were put in place in response to the Coronavirus pandemic, even after the national health emergency declaration ends May 15.
Carriers must continue to cover laboratory and over-the-counter COVID-19 diagnostic tests including associated items and services for furnishing those tests, OPM said in a notice to them. They further “must continue to cover, without cost-sharing, COVID-19 vaccines (including their administration), and any other qualifying coronavirus preventive services intended to prevent or mitigate COVID-19 on an in-network basis.”
They will no longer be required to provide out-of-network coverage for COVID-19 vaccines, their administration or related services, however. OPM said it expects that “carriers that continue to offer out-of-network coverage will do so with out-of-network cost sharing.”
Carriers were further encouraged, although not required, to “waive cost-sharing (including deductibles, copayments, and coinsurance) and medical management (including prior authorization) for COVID-19 diagnostic tests and associated items and services furnished.” If they choose not to waive such costs, they must pay for any services that started before the health emergency designation ends, it says.
OPM similarly encouraged carriers to “provide notice to covered individuals about changes to key information about their COVID-19 benefits” such as the date when the carrier would begin to impose cost-sharing, prior authorization or other requirements on COVID-19 tests.
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