CMS Issues Guidance for Medicare Advantage and Part D Plans Response to COVID-19

CMS released guidance this week to try to ensure that patients have access to critical healthcare services they need as the Coronavirus continues to spread throughout the U.S. In the memorandum issued on Tuesday, CMS outlined the flexibilities MA and Part D plans have to waive certain requirements to help prevent the spread of COVID-19. These flexibilities include:

  • waiving cost-sharing for COVID-19 tests
  • waiving cost-sharing for COVID-19 treatments in doctor’s offices or emergency rooms and services delivered via telehealth
  • removing prior authorizations requirements
  • waiving prescription refill limits
  • relaxing restrictions on home or mail delivery of prescription drugs
  • expanding access to certain telehealth services
  • “The president directed CMS to make sure Medicare Advantage beneficiaries have access to the healthcare services they need during this time,” said CMS Administrator Seema Verma. “Today we announced guidance to Medicare Advantage and Part D plans to remove barriers that could prevent or delay beneficiaries from receiving care. Medicare beneficiaries are at the greatest risk of serious illness due to COVID-19 and CMS will continue doing everything in our power to protect them.”

These waivers break down barriers to beneficiaries accessing care and allow plans to work with pharmacies and providers to treat patients without burdensome requirements limiting their options during this outbreak. This action is part of the broader effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high risk of complications from the COVID-19 virus – have access to the benefits that can help keep them healthy while helping to contain the spread of this disease. To keep up to date with the important work CMS is doing in response to COVID-19, visit the Current Emergencies Website.

Source: National Association of Health Underwriters (NAHU)