The California Department of Insurance (CDI) wishes to ensure that costs don’t create a barrier for consumers seeking medically necessary screening and testing for COVID-19.
These measures include:
- Waiver of Cost Sharing Amounts – insurers are directed to immediately reduce cost-sharing, such as co-pays, deductibles, or coinsurance, to ZERO for all necessary screening and testing for COVID-19; Notify Providers ASAP; Update any nurse line and CSRs on these reductions so they can clearly communicate with consumers; inform call center staff members on advising consumers about best access care for screening and treatment of COVID-19 prior to doctor visit of ER visit; update websites accordingly, with all haste.
- Ensuring Enrollees Have Timely Access to Care – The Department reminds insurers of existing California laws that require insurers to ensure their insureds are able to access medically necessary care in a timely fashion.
- Proactive Steps – the Department encourages insurers to act proactively to ensure consumers can access all medically necessary screening and testing of COVID-19. This includes working with their contracted providers to use telehealth services to deliver care when appropriate to eliminate exposure; in the event of shortages, insurers should waive prior authorization and/or step therapy requirements to help expedite necessary drug treatment.
- Bulletin in effect until further notice.