Texas Governor Greg Abbott and the Texas Department of Insurance (TDI) are asking that health insurers and maintenance organizations operating in Texas waive costs associated with testing and telemedicine visits intended to diagnose coronavirus cases.

According to a statement issued by the governor's office Tuesday morning, Abbott and TDI are also requesting that insurers report actions related to consumer cost-sharing and access to services so the TDI can make consumers aware of what benefits are available.

"We must ensure no Texan is denied access to testing resources relating to coronavirus," Governor Abbott wrote. "Texans who are concerned that they may have coronavirus should seek medical attention in the most appropriate setting, and telemedicine is a good first medical encounter for anyone experiencing mild symptoms. Consulting a physician from home is a practical way to avoid getting sick, prevent the spread of the virus, and help ensure that emergency rooms are available for those who truly need them. We appreciate the collaboration of health insurers operating in Texas to enhance our state's proactive approach to addressing any potential outbreaks of COVID-19. The State of Texas is unwavering in our commitment to protecting the health and safety of all Texans."

Abbott and TDI have specifically requested insurers take the following actions related to COVID-19:

Waive co-payments, co-insurance, and deductibles for testing that is consistent with guidance issued by the Centers for Disease Control and Prevention (CDC).

  • Waive consumer cost-sharing and facilitate expanded use of telemedicine.
  • Cover necessary medical equipment, supplies, and services.
  • Waive penalties, restrictions, and claims denials for necessary out-of-network services.
  • Waive requirements for pre-authorization, referrals, notification of hospital admission, or medical necessity reviews for care consistent with CDC guidance.
  • Allow extra time for health providers and facilities to file claims.
  • Authorize payment to pharmacies for up to a 90-day supply of any prescription medication for individuals, regardless of when the prescription was filled.

According to TDI, Scott & White Health Plan has already begun waiving cost-sharing for medically necessary testing for COVID-19, as have these insurers:

  • Aetna (CVS)
  • Blue Cross and Blue Shield of Texas
  • Cigna Health of Texas, Inc.
  • Community Health Choice, Inc.
  • Golden Rule Insurance (UHC)
  • Humana Health Plan of Texas, Inc.
  • Molina Healthcare Insurance Company of Texas
  • Oscar Insurance Company
  • Superior Health Plan (Centene)
  • United Healthcare Insurance Company

"These waived costs would specifically impact individuals covered by state regulated insurance plans," TDI stated Tuesday. "Families concerned about coronavirus who receive benefits through Medicaid and CHIP will be able to access testing ordered by a physician at no cost. Additionally, the Employees Retirement System of Texas, the Teacher Retirement System of Texas, The Texas A&M University System, and The University of Texas System have been asked to provide these same benefits to employees and retirees covered by their PPO and HMO plans."

TDI is advising Texans to contact their plan administrator to confirm their benefits.

I certainly don't want to add to the hype and hysteria over COVID-19 currently plaguing the nation (no pun intended), but there have been at least 24 confirmed cases of the novel coronavirus in the Lone Star State. Hopefully these measures will make diagnosis and treatment easier and more affordable for those most likely to contract the disease, particularly our seniors.

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