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Coronavirus

Health insurers directed to ease access to coronavirus testing and treatment under Maryland emergency action

Maryland health insurance officials are using emergency powers to order carriers to reduce barriers and costs to residents during the coronavirus outbreak.

The order, made under a state of emergency Gov. Larry Hogan declared March 5, calls on carriers to ensure people can buy extra supplies of their prescription medications. The order also requires carriers to waive out-of-pocket costs, such as co-pays and deductibles, for testing and to provide access to treatment that doctors deem necessary, even if providers are out-of-network.

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The order was made after three positive cases of COVID-19, the disease caused by the coronavirus, were identified in the state. The Montgomery County residents, a couple in their 70s and an unrelated woman in her 50s, had all become infected on an international cruise in Egypt, state officials said Friday.

There have been over 300 cases reported across the country and at least 17 deaths. As of Saturday, a total of 44 Marylanders have been tested for the disease, with 41 negative. The state stopped listing the number of pending tests online Saturday, though eight of the 44 were pending as of Friday evening.

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As testing ramps up in Maryland and across the country, more cases are expected to be identified.

Officials have said they wanted to ensure testing and treatment are available, and that people do not avoid care because of costs or become saddled with large bills.

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Other states have made similar requests or orders of carriers to at least cover testing, and federal officials said they would require Medicare and Medicaid to cover testing when a doctor orders it.

The order applies only to plans regulated in Maryland, though state regulators are encouraging voluntary compliance for other plans. The state’s insurance regulator has authority over only a portion of policies issued in Maryland, including those sold on the health exchange created under the Affordable Care Act, as well as small and some medium-sized businesses. Large companies that self-insure, which cover the majority of people with workplace-based plans, are regulated by federal authorities.

However, other insurers are taking steps on their own. CareFirst BlueCross BlueShield, the state’s dominant private health insurer and also a manager of many self-insured plans, joined other national carriers in announcing Saturday it would offer expanded access to testing and treatment to its customers.

CareFirst said it would waive prior authorizations and cover testing and services that are medically necessary and in keeping with guidelines from the U.S. Centers for Disease Control and Prevention. It will waive out-of-pocket costs for the services and will allow early refills of medications.

CareFirst officials said they will continue to evaluate ways to lower barriers to care and provide updates on its website.

“The health and well-being of our members, associates and communities are our highest priority,” Brian D. Pieninck, CareFirst president and CEO, said in a statement. “CareFirst is taking action to ensure members will not face barriers to care while seeking testing or treatment for COVID-19. We stand ready to work with our jurisdictions and public health authorities to provide support, data and expertise for the communities that we serve.”

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Officials with Kaiser Permanente, another large carrier in the state, could not immediately be reached for comment.


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