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Analysis

CMS Lifts Barriers to COVID-19 Tests, Treatments

By John Commins  
   March 11, 2020

MA, Part D plans given option to waive cost-sharing and prior authorizations.

Medicare Advantage and Part D plans have been given the option to waive prior authorization, cost-sharing, and other potential barriers that could delay testing and treatment for the COVID-19 virus, the Centers for Medicare & Medicaid Services said.

"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," CMS Administrator Seema Verma said in a media release.

Under a memorandum issued Tuesday, Medicare Advantage and Part D plans will be given the option of:   

  • 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.

Verma said the waivers allow plans to work with pharmacies and providers to treat patients without burdensome requirements limiting their options during this outbreak.

“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.”

John Commins is a content specialist and online news editor for HealthLeaders, a Simplify Compliance brand.


KEY TAKEAWAYS

MA and Part D plans can now waive cost-sharing for COVID-19 tests, treatments in doctor’s offices and EDs and via telehealth;

CMS is also allowing the plans to waive prior authorizations, prescription refill limits, and to relax restrictions on home deliveries for prescription drugs.


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