COVID-19 Insurance Updates

On March 17, 2020, Insurance Commissioner Mulready issued LH Bulletin No. 2020-02 in response to the COVID-19 outbreak. The bulletin asks health carriers regulated by the state to review their internal processes and continuity of operations, including ability to telecommute, to ensure that they are prepared to address COVID-19 cases in the state and serve their members, including by providing insureds with information and timely access to all medically necessary covered health care services. Carriers are asked to inform insureds of available benefits specifically related to telemedicine, quickly respond to insured inquiries, and consider revisions needed to streamline responses and benefits for insureds. The bulletin also asks that carriers waive any cost sharing for COVID-19 laboratory tests so that cost sharing does not serve as a barrier to access to this important testing and waive the cost sharing for an in-network provider office visit and an in-network urgent care center visit when testing for COVID-19. Carriers are also asked to make sure that their network providers and telehealth programs are capable of handling increased demand and, particularly with telehealth, that insureds can access them easily.

The bulletin prohibits carriers from cancelling the coverage of any person who has been diagnosed with COVID-19 and is unable to return to work or maintain coverage under their current health carrier because of COVID -19 for the next ninety (90) days. Health carriers are asked to extend the traditional thirty (30) day grace period to a sixty (60) day grace period for nonpayment of premiums. The bulletin points out that federal rules governing marketplace policies (ACA) will remain in effect with respect to grace periods.

Finally, the bulletin indicates that pharmacists writing “COVID-19” or substantially similar language on a prescription shall be equivalent to receiving a signature. Pharmacy benefit managers are asked to immediately cease all audits while the Declaration of Emergency is in place. Additionally, a sixty (60) day supply may be provided for a thirty (30) day prescription for maintenance drugs with appropriate copays (not applicable to controlled substances). Further, all restrictions on pharmacies doing mail order should be waived.

Employers with policies regulated by Oklahoma should be aware of these developments.

LH Bulletin No. 2020-02 »