OCI urging insurers to reduce barriers to coronavirus testing

Commissioner Mark V. Afable

The Office of the Commissioner of Insurance is urging health insurers in the state to reduce potential barriers to access COVID-19 testing. 

In a bulletin sent to insurers, Insurance Commissioner Mark Afable calls the novel coronavirus outbreak an urgent public health challenge. He’s asking health insurers to waive any cost-sharing for COVID-19 laboratory and radiology testing. 

Health plan issuers are also being requested to waive cost-sharing for any visits to provider offices, urgent care centers, hospitals or emergency rooms related to testing for the disease. 

These insurers are also being asked to review internal operations to be sure they’re ready to respond to more cases in Wisconsin. Only one person has been confirmed to have the disease in the state, and that individual has made a full recovery. But the state Department of Health Services is currently testing 12 more people for COVID-19 and state and local health officials have been preparing for a larger impact. 

“As the COVID-19 situation continues to evolve, health plan issuers should continually assess their readiness and make any necessary adjustments,” Afable said in his message. 

The agency notes that some patients may turn to telehealth services as an alternative to in-person visits amid the outbreak of the virus. Afable is encouraging insurers to ensure their telehealth programs “are robust and will be able to meet any increased demand.” 

Scientists are working toward a vaccine for COVID-19, though it’s not expected to be ready for months. OCI is requesting that health insurers “immediately cover the immunization at no cost-sharing for all covered members” if a vaccine is created. 

Along with these steps, the agency is also asking insurers to “make expedited formulary exceptions” if the insured patient is being treated for the virus with prescription drugs not listed in the list of pre-approved drugs. Exceptions are also being encouraged if shortages of formulary drugs occur. 

Plus, health insurers are being asked to “be flexible on prescription drug supply limitations and early refill limitations,” due to the potential need for quarantines. OCI is requesting they allow insured patients to fill and refill prescriptions for up to a 90-day supply, and allow early refills without extra authorization. 

More than 109,000 cases of COVID-19 have now been reported around the world, and at least 3,800 people have died from the disease. But more than others 60,000 have recovered. 

Track the state’s efforts in response to COVID-19: http://www.dhs.wisconsin.gov/outbreaks/index.htm

–By Alex Moe