|Texas Health Insurers Respond to COVID-19|
Texas Medicaid Managed Care Plans Bring out the Best of the Texas Medicaid Program
Managed Care Plans are connecting Texans to the personalized care and support they need to stay safe and healthy and to live their lives to the fullest.
Check out TAHP's video to learn more.Watch Here
Texas Medicaid Managed Care Plans Support Patients During COVID-19
During this crisis, Medicaid Managed Care Plans are connecting Texans to the personalized care and support they need to stay healthy.
See TAHP's infographic to learn more.View Here
Texas Health Plans are Committed to Curbing the COVID-19 Virus
Texas health plans are committed to curbing the virus and helping Texans receive the testing and care they need to stay healthy during the pandemic.
Check out TAHP's video to learn more.Watch Here
Texas Health Plans Respond to COVID-19
Texas health plans are heavily invested in the health of the Texas communities in which we live and serve, and we are doing all we can to keep Texans safe and support our provider partners.
See TAHP's infographic to learn more.View Here
The COVID-19 pandemic poses unprecedented challenges for Texas and our nation, touching every facet of American life. Texas health plans are heavily invested in the health of the Texas communities in which we live and serve, and we are doing all we can to keep Texans safe and support our provider partners. Here are some ways health plans are taking action to help Texans get access to the prevention, testing, and treatment they need to stay healthy:
For the growing number of Texans infected or worried about being infected with COVID-19, Texas health plans are providing peace of mind. Health insurance providers moved swiftly to proactively eliminate patient cost sharing for COVID-19 testing and treatment – no copay, no coinsurance required.
The leaders of our industry have committed to accelerating access to care. Prior authorization is being waived for those seeking testing or treatment of COVID-19. This will speed patients’ access to appropriate treatment.
COVID-19 is threatening to overwhelm our health care system with infected patients. By waiving cost-sharing for telehealth services and expanding telemedicine programs, health insurance providers are facilitating care for the many Americans who are at home and need care. Telehealth is especially beneficial for patients who are at a higher risk when leaving home to commute to the doctor’s office. For doctors, expanded telehealth eases the burden on our health system, allowing hospitals to care for people who need it most, while limiting the exposure of health care workers to the disease. It also means they can stay in business and keep seeing patients who need their care. And many doctors are being paid at the same rate as an in-person visit during this national emergency to help contain the spread of the virus.
Health insurance providers are partnering with hospitals to enhance their capacity to provide care for the most vulnerable patients in the most affected and at-risk regions so they can more effectively manage an increasingly complex and uncertain environment. We are simplifying and accelerating the discharge and transfer of patients from hospitals to the safest available, clinically appropriate post-acute care facility or home. And several health insurance providers are building new pathways to support the most financially vulnerable hospitals through this crisis.
Across the country, health insurance providers are delivering support to their communities to ensure that vulnerable populations stay safe and healthy. Individual companies have made financial contributions directly to community organizations, including those working to help feed children and older Americans as well as to groups providing emergency health services for the most vulnerable. And managed long-term services and supports (MLTSS) plans are calling for policy solutions that would improve access for America’s most vulnerable patients: From providing additional support and personal protective equipment to caregivers, to expanding telehealth access, to increasing flexibility in Medicaid benefits to address the COVID-19 public health emergency.
Thousands of licensed medical experts work for health insurance providers. Several insurance providers are offering incentives to their medical professionals to serve on the front lines in the fight against the COVID-19 pandemic.
The Texas Association of Health Plans, its member companies, and our employees are heavily invested in the health of the Texas communities in which we live and serve, and we are fully committed to meeting this challenge. Texas health plans are working to help contain the virus, ensure people have coverage for and access to needed testing, and help patients who are infected receive the care and treatment they need. Here are some ways Texas health plans and other TAHP members are taking action:
Aetna will waive co-pays for all diagnostic testing related to COVID-19 for Commercial, Medicare, and Medicaid lines of business. Self-insured plan sponsors will be able to opt-out of the program at their discretion.
Aetna is offering zero co-pay telemedicine visits for any reason, and it is extending its Medicare Advantage virtual evaluation and monitoring visit benefit to all fully insured members. People diagnosed with COVID-19 will receive a care package. CVS Health is also offering several programs to help people address associated anxiety and stress. Additionally, Aetna is reimbursing all providers for telemedicine at the same rate as in-person visits for applicable telehealth codes, including for mental health care services.
Aetna will waive member cost-sharing for inpatient admissions at all in-network facilities for treatment of COVID-19 or health complications associated with COVID-19. This policy applies to all Aetna-insured commercial plan sponsors and is effective immediately for any such admission through June 1, 2020.
Aetna is also waiving member cost-sharing for inpatient admissions at all in-network and out-of-network facilities for treatment of COVID-19 or health complications associated with COVID-19.
Aetna is working closely with partner hospitals to help transfer and discharge members with issues unrelated to COVID-19 from hospitals to safe and clinically appropriate care settings where they can continue to have their needs addressed. This will help hospitals and emergency rooms make room for more patients, especially those suffering from COVID-19.
Aetna is streamlining its provider credentialing process so there can be more health care professionals caring for patients.
Aetna is also paying the amount of the cost-sharing the member would have ordinarily paid related to COVID-19 testing or inpatient treatment so there is no financial impact on the provider.
CVS Health announced it is extending all member cost-sharing and co-pay waivers for inpatient admissions for treatment of COVID-19 or health complications associated with COVID-19 for members of Aetna-insured Commercial, Medicare Advantage, and applicable Medicaid plans. Additionally, Aetna is extending all member cost-sharing waivers for in-network telemedicine visits for outpatient behavioral and mental health counseling services. These actions, which were scheduled to expire on June 1, have been extended through Sept. 30.
The company is also taking additional steps to eliminate out-of-pocket costs for primary care services for Medicare Advantage members. Effective from today through September 30, 2020, Aetna is waiving member out-of-pocket costs for all in-network primary care visits, whether done in-office and via telehealth, for any reason, and encourages members to continue seeking essential preventive and primary care during the pandemic. Additionally, Aetna has extended the waiver of early refill limits on 30-day prescription maintenance medications for all members with pharmacy benefits administered through CVS Caremark through Sept. 30.
CVS Health opened 44 new COVID-19 test sites at select CVS Pharmacy drive-thru locations across Texas. The opening of additional test sites across the state and country will be announced by the end of the month. These new sites will utilize self-swab tests and mark the next phase of the company's nationwide COVID-19 testing strategy, announced April 27. CVS Health expects to have up to 1,000 locations across the country offering this service by the end of May, with the goal of processing up to 1.5 million tests per month, subject to availability of supplies and lab capacity.
Aetna, a CVS Health company, will waive out-of-pocket costs for in-network primary care and specialist telehealth visits for all Individual and Group Medicare Advantage plan members through September 30, 2020.
At the Heart of Health (6/8/20)
Aetna: COVID-19 FAQs and Resources (4/8/20)
AmeriHealth Caritas will cover and waive cost-sharing for testing and in-network, inpatient, acute care treatment of COVID-19. AmeriHealth Caritas has also expanded access to telehealth services by video and phone.
AmeriHealth Caritas is focused on improving the health and wellbeing of underserved communities at this time of crisis and is conducting “well-check” outreach to vulnerable members and helping connect them to their providers and community resources.
Blue Cross and Blue Shield of Texas (BCBSTX) is waiving member cost-sharing, including deductibles, copayments and coinsurance, related to treatment for COVID-19 for treatment received April 1 through May 31, 2020. The waiver applies to costs associated with COVID-19 treatment at in-network facilities and treatment for out-of-network emergencies for all HCSC fully insured group plan, individual and family plan, Medicare (excluding Part D plans), Medicare Supplement, and Medicaid members. BCBSTX will work in partnership with self-funded employer groups that decide to offer the same waivers.
I n response to the COVID-19 pandemic and in support of Texas community foundations and nonprofits, Communities Foundation of Texas announced a $1 million donation from Blue Cross and Blue Shield of Texas to help with COVID-19 relief efforts through their newly created Collaborative Grant Fund
Blue Cross and Blue Shield of Texas gifted a $1 million grant to the Texas Restaurant Association’s TX Restaurant Relief Fund, an initiative of the Texas Restaurant Association Education Foundation in response to the COVID-19 pandemic.
On Oct. 7, Blue Cross and Blue Shield of Texas announced that it will take further action to support its members, customers and communities during the COVID-19 public health emergency by providing approximately $104 million in relief to fully insured Texas employer customers in the form of a premium credit. In addition to the premium credit, other relief steps taken by BCBSTX include adjustments made to initial 2021 individual and group rates to provide further financial relief for group plans, individuals, and their families — delivering approximately $109 million in savings, as well as extensions of the waivers of cost-sharing for telehealth services as well as COVID-19 testing and treatment — delivering approximately $181 million in savings for members and their families.
Staying Covered During COVID-19 (5/13/20)
Cigna is covering the cost of coronavirus testing, waiving all co-pays or cost-shares for fully insured plans, including employer-provided coverage, Medicare Advantage, Medicaid, and individual market plans available through the Affordable Care Act. Organizations that offer ASO plans will also have the option to include coronavirus testing as a preventive benefit.
Cigna is waiving customers’ out-of-pocket costs for COVID-19 testing-related visits with in-network providers, whether at a doctor’s office, urgent care clinic, emergency room or via telehealth, through May 31, 2020.
The company is making it easier for customers with immunosuppression, chronic conditions or who are experiencing transportation challenges to be treated virtually by in-network physicians with those capabilities, through May 31, 2020.
Cigna is waiving prior authorizations for the transfer of its non-COVID-19 customers from acute inpatient hospitals to in-network long term acute care hospitals to help manage the demands of increasingly high volumes of COVID-19 patients.
Cigna is waiving customer cost-sharing and co-payments for COVID-19 treatment through May 31. The policy applies to customers in the U.S. who are covered under Cigna’s employer/union sponsored insured group health plans, insured plans for U.S. based globally mobile individuals, Medicare Advantage, and Individual and Family Plans. Cigna will also administer the waiver to self-insured group health plans.
Cigna has launched a pilot program to increase social connectivity among its Medicare Advantage (MA) customers during the COVID-19 pandemic by proactively reaching out to its Medicare customers to monitor their general health and well-being as well as daily needs during COVID-19, including food, housing and transportation. Customers will be able to opt-in to receive follow-up calls from the same Cigna representative to help cultivate meaningful connections.
Cigna is providing medications to Washington University School of Medicine in St. Louis to initiate a clinical trial that will evaluate antimalarial and antibiotic treatments for COVID-19. The researchers plan to enroll 500 patients over the course of the study.
Cigna has launched Dental Virtual Care, which will be available through Cigna’s growing network of dental providers who offer teledentistry. Cigna Dental Virtual Care will be available this month to over 16 million dental customers enrolled in Cigna’s employer-sponsored insurance plans at no cost through May 31, 2020.
Cigna Foundation and New York Life Foundation have partnered to launch the Brave of Heart Fund to help the spouses, domestic partners, children, and parents of the frontline healthcare workers who gave their lives in the fight against COVID-19. Cigna has contributed $25 million and has provided behavioral and emotional health support to the families to help them cope.
Cigna is launching its new COVID-19 Customer Protection Program to further safeguard its customers from unexpected costs for COVID-19 care through "surprise" or "balance" bills from out-of-network health care providers. The program will ensure out-of-network health care providers are promptly reimbursed at reasonable, market-based rates, as applicable; work to support and resolve any surprise or balance billing issues by out-of-network providers; report excessive and/or egregious billing practices to state and federal regulatory officials and associationsand to otherwise exercise full legal options, including appropriate litigation actions; and increase awareness and advocate for broader consumer protections against surprise billing for COVID-19 and beyond.
Cigna is expanding its digital capabilities to help rapidly identify and assist customers who arrive in ER settings with COVID-19 symptoms and support those who are actively recovering at home. Cigna has partnered with Collective Medical to identify customers, in real-time, checking into emergency care settings with COVID-19 symptoms and connect them with support programs. Customers with mild to moderate COVID-19 symptoms can now access Medocity for Cigna, which allows customers to track their symptoms, connect with care advocates and access behavioral and emotional supportive resources.
Cigna has launched the Cigna Care Card to help clients provide financial assistance to keep employees healthy and supported during this challenging time. The new offering will make it easier for employers to support the well-being and peace of mind of employees and their families by designating a tax-free dollar amount to cover expenses incurred as a result of COVID-19.
Cigna is eliminating cost-sharing for all primary care, specialty care, and behavioral health care in-office or telehealth visits for COVID-19 and non-COVID-19 care for all Medicare Advantage and Individual and Family Plans. Additionally, Cigna is making enhancements to its Medicare Advantage meal plan benefits to further protect customers during this pandemic and underscore the company's continued commitment to enabling access to simple, affordable, and predictable health care.
Community First Health Plans compiled a list of at-home learning resources for its members to ensure children’s learning continues at home as well as information on alternatives to school lunches.
CFHP COVID-19 At Home Learning Resources (3/17/20)
CFHP Coronavirus News Page (3/16/20)
Community Health Choice is optimizing access and removing potential barriers to member screening and diagnostic testing for COVID-19 by providing access to testing without prior authorization and waiving copays and member cost-sharing on FDA-approved testing for COVID-19. The plan is also sending 50% prepayment of provider incentive annual payments to over 209 practices.
Community is also increasing access to outpatient services for COVID-19 by encouraging the use of telemedicine services, ensuring its members are aware of telemedicine benefits, Community’s nurse advice line, and waiving copay and member cost-share for telemedicine services of any modality for any reason for 90 days, including for Marketplace and DSNP members (continue zero cost telemedicine services); for Marketplace, DSNP, and CHIP members (waive member copay/cost-share for telemedicine services provided by network providers); and for STAR members (access to and coverage of telemedicine services provided by network providers). Community is also increasing accessibility to maintenance medications and waiving early medication refill limits on maintenance medications.
Community is extending $0 copays for telehealth services, COVID-19 testing and treatment through Sept. 30, 2020, for CHIP and Marketplace plans.
Cook Children’s Health Plan (CCHP) has a dedicated COVID-19 resource page to share the most current information with Members and Providers.
Here CCHP's Members can find information they can trust and resources to help their families during these challenging times. Members are encouraged to check back often, as CCHP is continually updating this site to make sure the most current information is available. Application assistance is also available by phone to those who may need help with applying for healthcare for children. CCHP's Member Services team is available and ready to direct families to the appropriate assistance.
Providers can view additional COVID-19 information on the CCHP Provider News page. Updates related to HHS extensions and flexibilities are continually updated on this site in an effort to communicate quickly and efficiently with Providers. Provider communications regarding COVID-19 updates are sent by email in an effort to keep our Provider community engaged and informed.
El Paso Health is encouraging the use of telemedicine services not requiring prior authorizations for telemedicine, telehealth, and telephonic services for certain medical and behavioral health services with in-network PCPs. Telephonic services are approved through April 30, 2020. Telemedicine, Telehealth, and Telephonic services do not require a prior authorization with an in-network PCP. Copays for these services do not apply to CHIP Members.
El Paso Health has also compiled a list of at-home learning resources for its members.
Member Letter – COVID-19 Update (3/18/20)
FirstCare Health Plans is waiving all member cost-sharing for care related to COVID-19, which includes testing, telehealth services, outpatient office visits, and inpatient hospital stays. The policy is effective March 6, 2020 and applies to fully insured Commercial Group and Individual policies, as well as Medicare plan members.
All telehealth medical care is also covered at a $0 copayment, whether the service is provided through the member’s in-network physician, or through MDLIVE.
FirstCare Health Plans has also amended its prescription drug policies to ensure an uninterrupted supply of medication during the COVID-19 threat.
Humana is waiving all out-of-pocket costs associated with COVID-19 testing for Medicare Advantage, Medicaid, and commercial employer-sponsored plans. Self-insured plan sponsors will be able to opt-out. The company is also waiving telemedicine costs for all urgent care for the next 90 days, and is allowing early refills on regular prescription medications.
Humana is waiving member cost share for all telehealth services delivered by participating/in-network providers.
Humana is waiving consumer costs for treatment related to COVID-19-covered services. Costs related to treatment for COVID-19, including inpatient hospital admissions, will be waived for enrollees of Medicare Advantage plans, fully insured commercial members, Medicare Supplement, and Medicaid. The waiver applies to all medical costs related to COVID-19 treatment, as well any FDA-approved medications or vaccines.
Humana is providing financial and administrative relief for the health care provider community facing unprecedented strain during the coronavirus pandemic. Humana is also expanding its policy of suspending prior authorization and referral requirements, instead requesting notification within 24 hours of inpatient (acute and post-acute) and outpatient care.
The Humana Foundation, Humana’s philanthropic arm, is deploying $50 million in immediate short and long-term relief in partnership with national and community service organizations to help those disproportionately impacted by the COVID-19 health crisis. The commitment, the largest in the Foundation’s history, will be split between organizations that support essential workers, food security, behavioral health, and community-based organizations.
Humana is eliminating out-of-pocket costs for office visits so that Medicare Advantage members can reconnect with their healthcare providers. To reduce barriers, Humana is waiving in-network primary care costs, not only for COVID-19 costs, but all primary care visits for the rest of 2020. In addition, the company is waiving member costs for outpatient, non-facility based behavioral health visits through the end of year. The plan is extending telehealth cost share waivers for all telehealth visits—PCP and specialty, including behavioral health, for in-network providers through 2020. Humana is also sending safety kits including masks and health information advice to members’ homes to support members who need to access the healthcare system or other essential services in the community.
Humana has partnered with Uber Health, Papa, Coalition to End Social Isolation and Loneliness, and the NASA-funded Translational Research Institute for Space Health (TRISH) on “Far from Alone,” a public health awareness campaign to address health-related social needs and promote understanding of loneliness and social isolation—issues that are exacerbated by the Coronavirus pandemic.
Humana announced that the company will mail more than 1 million in-home preventive care screening kits to members in 2020, helping increase access to routine screenings that many members have put off during the pandemic. Humana’s new initiative, which triples the number of screening kits sent to members, comes as many people have postponed all but the most necessary health procedures during COVID-19, limiting doctors’ appointments and emergency room visits.
Magellan has expanded telehealth services to help support clients during the COVID-19 pandemic by permitting all credentialed and contracted behavioral health providers to conduct telehealth video sessions for all routine services and certain psychological testing, applied behavior analysis (ABA), intensive outpatient programs (IOP) and partial hospitalization program (PHP) services.
Magellan is also providing free access to one of its digital cognitive behavioral therapy, RESTORE®, for members who are experiencing sleep difficulty and insomnia related to the COVID-19 pandemic.
Magellan has opened a free national 24-hour crisis line for all first responders and healthcare workers who are serving on the front lines battling the coronavirus pandemic.
Memorial Hermann Health Plan is waiving all co-pays and cost shares related to requested COVID-19 diagnostic screening and has created a dedicated clinical triage nurse line to help direct care. The plan is also lifting up refill-to-soon edits to chronic medications and allowing a 90-day supply temporarily.
Molina Healthcare is waiving all COVID-19-related out-of-pocket expenses for its Medicare, Medicaid, and Marketplace members nationwide, following up on its previous announcement last month about waiving all member costs associated with testing for the coronavirus, which causes COVID-19. Refill timing will be relaxed to allow refills at least up to 7 days early, and Molina will allow 90-day prescription volumes when filled at CVS pharmacies. Click here for a short video with information about Molina’s COVID-19-related actions.
Molina has also created the Coronavirus Chatbot, an enhanced digital tool available to members looking for current insight, risk factors, live help, and appropriate action to take if symptoms are present. The tool can be found on Molina’s website , its member portal, and mobile app.
Molina has also accelerated $150 million in payments to providers. Additionally, Molina has extended all previously approved prior authorizations until September 1, 2020. Molina has also enabled providers to be paid the same amount for servicing members via telehealth as they would have for in-person service, and has expedited credentialing to ensure providers are able to see members for any health care reason. Molina has also provided personal protective equipment in many markets and continues efforts to seek and provide PPE where it is most needed.
Molina has contributed $20,000 to the North Texas Food Bank to help replenish necessary food supplies for area residents experiencing high levels of unemployment or reduced income due to the current pandemic.
On June 8, Molina announced that it will continue waiving all out-of-pocket costs associated with COVID-19 testing and treatment for its Medicare, Medicaid, and Marketplace members nationwide through December 31, 2020.
Oscar will waive cost-sharing for the treatment of COVID-19 for its Individual and Small Group members through May 31, 2020.
Oscar is waiving cost-sharing for diagnostic testing for COVID-19, including the cost of the test and administration of the test, at both in-network and out-of-network facilities when recommended by a healthcare provider.
Oscar is offering telemedicine services at no cost to most members through its Doctor on Call service.
Oscar has also launched the first testing center locator for COVID-19 in the United States. It is free and accessible to the general public, and it is being updated daily to reflect both in-network and out-of-network facilities in the 29 markets that Oscar operates in. The tool builds on its at-home risk assessment survey.
Oscar has entered into a partnership with Uno Health to help its Medicare Advantage members unlock financial assistance, helping members achieve an average financial assistance of more than $5,000 per member.
Oscar Shares Update on COVID-19 (3/6/20)
Parkland Community Health Plan (PCHP) is waiving copays, coinsurance and deductibles for visits and costs associated with COVID-19 testing.
PCHP has expanded access to telehealth and is waiving member deductibles, copays and coinsurance for telehealth visits through designated telehealth partners and COVID-19 testing related visits.
To help keep going the care during the COVID-19 response, HHSC is authorizing providers to use telephone medical evaluation and management services delivered through April 30, 2020. In addition, behavioral health services can be delivered by telephone through April 30, 2020.
Scott & White Health Plan is waiving all member out-of-pocket copays and cost-sharing for telemedicine eVisits and tests for the diagnosis of COVID-19 and is committed to providing its members with access to all their prescription medication needs. This applies to fully insured Commercial Group and Individual policies, as well as Medicare plan members. Self-insured or administrative services only (ASO) employer groups will be permitted to opt out of this additional preventive coverage at their discretion. Members of self-insured groups should contact their Human Resources Department for information.
Sendero Health Plans has waived all member costs for the testing and treatment of COVID-19 with in-network providers and laboratories, which includes free telemedicine for all members.
Sendero is also providing free prescription delivery through larger pharmacies, allowing early refills for maintenance medications, extending provider claims submission deadlines, and working with providers to expand telemedicine and help ensure capacity for care.
Dell Children’s Health Plan is waiving any normally required cost shares for Medicaid members — including copays, coinsurance and deductibles — for COVID-19 testing and visits associated with the COVID-19 test (including visits to determine if testing is needed).
For 90 days effective March 17, 2020, DCHP will waive any normally required member cost shares for telehealth visits, including visits for mental health or substance use disorders, for Medicaid members. Any normally required cost sharing will be waived for members receiving care from providers through internet video and audio services.
For 90 days effective March 19, 2020, Dell Children’s Health Plan will cover telephonic-only visits with in-network providers.
Dell Children’s Health Plan is also providing coverage for members to have an extra 30-day s upply of medication on hand.
COVID-19 Information from DCHP (3/26/20)
Superior HealthPlan is covering COVID-19 testing and screening services for STAR, STAR+PLUS, STAR Health, STAR Kids (Medicaid), CHIP, STAR+PLUS Medicare-Medicaid Plan (MMP), Allwell from Superior HealthPlan (Medicare), and Ambetter from Superior HealthPlan (Marketplace) members and is waiving all associated member cost-share amounts for COVID-19 testing and screening. Superior will not require prior authorization, prior certification, prior notification, or step therapy protocols for these services. Additionally, telehealth visits with a doctor in Superior’s network are available at no cost or cost sharing for most members.
Superior HealthPlan is providing assistance to network providers in Texas who are seeking relief amid the COVID-19 pandemic through the Small Business Administration (SBA) and the CARES Act by sharing access to a dedicated online portal of Provider Financial Support & Resources, where network providers can research benefits they may be eligible for and work directly with experts to apply for them.
Superior is coordinating the donation of 1 million meals a month for the next 12 months in Texas. Superior has also partnered with 16 food banks, providing a total of $120,000 to help organizations effectively address food assistance needs in their communities.
Superior will be purchasing 3,750 gift cards with a value of $35 for use on essential items and will deliver the cards to dozens of local providers and other community organizations for distribution to individuals in need.
Superior donated $65,000 and 450 disaster kits to YWCA El Paso del Norte Region (YWCA) to support the organization's efforts to provide quality childcare services to essential workers.
Superior is supporting members dealing with social isolation due to COVID-19. The plan is offering a free online tool that enables hospitals, social workers, healthcare providers, care coordinators and other residents to quickly and easily find free or low-cost resources and services. Superior is also providing access to myStrength, a 24/7 online tool for members to take care of their mental health. To learn more about resources that may be available to address social isolation or loneliness, visit Superior's behavioral health resources page.
Since March, Allwell from Superior HealthPlan has waived pre-authorizations, co-pays and other costs related to coronavirus testing, screening and medically necessary treatment. Allwell has also waived prescription refill limits, and members are able to refill prescriptions prior to their refill date during this crisis. Effective July 1, Allwell is now offering a number of expanded benefits including waiving in-network member costs for all primary care visits for the rest of 2020; waiving member costs for outpatient, non-facility-based behavioral health visits; extending telehealth cost share waivers for all telehealth visits (primary care, specialty, and behavioral health) for in-network providers for the remainder of 2020 (this does not include inpatient hospital, behavioral health facility or urgent care visits); extending meal benefits for members who are eligible due to a chronic condition or recent discharge may receive an additional 14 meals delivered to their home at no cost; increasing annual wellness visit incentives for some members at no cost; and more.
Centene and Quartet Health announced a nationwide expansion of their existing partnership to help members quickly and easily access the behavioral health care they need. The nationwide expansion will enable members to seamlessly access quality behavioral health care from providers located in their areas who serve their unique clinical needs. To support members who want access to care from their homes during the COVID-19 pandemic, all scheduled appointments will be with providers who support virtual care.
Texas Children’s Health Plan (TCHP) has taken multiple actions to engage and inform its members on the novel coronavirus. TCHP has created a COVID-specific website in English and Spanish for members. TCHP has proactively engaged providers with updates from the state on flexibilities to ensure continuity of care, including communication and education on telemedicine and telehealth options. TCHP has also launched a COVID-specific commercial into the market.
Texas Children’s Health Plan has seen record enrollment into it’s telemedicine platform, Texas Children’s Anywhere Care. TCHP is sending communications out via direct mail, email and text to its members to promote the service.
UnitedHealthcare is waiving all associated costs for COVID-19 testing for Medicare Advantage, Medicaid, and commercial members. UnitedHealthcare is also waiving member cost sharing for the treatment of COVID-19 through May 31, 2020 for its fully insured commercial, Medicare Advantage, and Medicaid plans. Starting March 31, 2020 until June 18, 2020, UnitedHealth will also waive cost sharing for in-network, non-COVID-19 telehealth visits for its Medicare Advantage, Medicaid, and fully insured individual and group market health plans.
UnitedHealthcare is also opening a special enrollment period for some of its existing commercial customers beginning March 23 through April 6 due to the COVID-19 pandemic. UnitedHealthcare is also suspending prior authorization requirements to a post-acute care setting through May 31, and suspending them when a member transfers to a new provider through May 31.
UnitedHealth Group is taking steps immediately to accelerate nearly $2 billion in payments and other financial support to health care providers in the U.S. to help address the short-term financial pressure caused by the COVID-19 emergency.
UnitedHealth Group has been asked to assist the U.S. Department of Health and Human Services in distributing an initial $30 billion in emergency funding to health care providers seeking assistance under the CARES Act.
UnitedHealth Foundation awarded $2.5M to the National Health Care for the Homeless Council, including a $100,000 award to the Houston branch of that organization. United Health Foundation is also committing $5M in partnerships with the CDC Foundation, Direct Relief, and the American Nurses Foundation to support America’s health care workforce. The foundation is partnering with the AARP Foundation to launch a $5M partnership to address social isolation and food insecurity among seniors nationwide. Overall, United is committing nearly $70M to fight COVID-19 and support impacted communities.
WellCare Health Plans, a subsidiary of Centene, is covering COVID-19 testing and screening services for Medicaid, Medicare and Marketplace members and is waiving all associated member cost share amounts for COVID-19 testing and screening. Prior authorization, prior certification, prior notification or step therapy protocols is not required for these services.
We know how difficult it can be to balance work, childcare, self-care, and keeping your family safe. TAHP’s Covered @ Home website provides resources, fun activities, and tips for Texas families adjusting to life at home.
Texas’s Division of Emergency Management and Department of State Health Services have released a COVID-19 Test Collection Site map to help Texans locate test collection sites in their community. The interactive map displays detailed information on public and private mobile, walk-in, and drive-thru test collection sites around the state and includes additional helpful information.
Frontline workers like doctors, nurses, grocery store employees, delivery drivers, and others are working day and night across our Texas communities to help keep our neighbors safe, healthy, and fed. Each of these people are our heroes and deserve our deepest thanks. Please mail a letter or send an electronic note via Plaingood to support them today.
Over 25 million Americans have lost their jobs due to COVID-19, and many who were let go have also lost their employer-paid health coverage at a time when they need it most. If you have lost your job and are facing uncertainty about how you’re going to continue receiving health coverage, your options include purchasing a new plan, temporarily continuing the plan you had at work, and checking your eligibility for health coverage through a government program. Check out the Texas Department of Insurance’s health coverage page or call them at 1-800-252-3439 to evaluate your options and make the best decision for yourself and your family.
Texas Health and Human Services has launched a new, toll-free mental health support line to help Texans experiencing anxiety, stress, or emotional challenges due to the COVID-19 pandemic. You can call the Statewide COVID-19 Mental Health Support Line 24 hours a day, 7 days a week at 833-986-1919. Operated by the Harris Center for Mental Health and IDD, the support line offers confidential, trauma-informed support and psychological first aid to those experiencing stress and anxiety related to COVID-19.
Acadian has implemented enhanced dispatch protocols to prescreen for suspected exposure or viral epidemiology. Additionally, Acadian continues to follow CDC guidelines and sanitizing vehicles after each transport, in addition to ensuring their employees have access to the proper personal protective equipment to minimize their risk of exposure.
COVID-19 Statewide Information (3/18/20)
CEO Letter to Healthcare Partners (3/12/20)
COVID-19 FAQ (3/11/20)
DentaQuest has launched a dental consultation hotline for residents of Texas, Oregon, Kentucky and Alabama during the COVID-19 pandemic. The service is available at no cost to callers and open to those who have questions about a wide range of oral health topics.
DentaQuest has also donated $1M to organizations supporting relief efforts for underserved populations and regions hit hardest by COVID-19, including communities that are experiencing disproportionate effects of the pandemic.
DentaQuest donated $50,000 to Feed Texas Food Banks serving Central Texas, Houston, San Antonio, El Paso and North Texas.
Update on COVID-19 (3/27/20)
LogistiCare is helping to provide transportation for healthcare workers to and from the hospitals and home care and enabling mobilization of staff to provide home care. LogistiCare has also partnered with large payers and states to provide their members to and from grocery stores.
LogistiCare is deploying a host of relief programs aimed to support our transportation providers as they battle the front lines of this pandemic. LogistiCare is tracking volumes to offer millions of dollars in bridge loans to assist with working capital needs, as well as temporarily assisting in providers' insurance. The company is temporarily suspending any fees associated with timely filing and eliminating any denials and/or late-fee charges. LogistiCare is also working with its clients to adjust minimum credentialing requirements to expedite the recruitment of additional transportation providers. The company has extended the time for submission of non-essential driver credentialing and training requirements in order to support and maintain our transportation providers.
COVID-19 & Essential Transportation (3/31/20)
Lyft launched Essential Deliveries, a new pilot initiative where government agencies, local non-profits, businesses and healthcare organizations can request on-demand delivery of meals, groceries, life-sustaining medical supplies, hygiene products and home necessities — all delivered by Lyft drivers.
Lyft has also expanded access to non-emergency medical transportation (NEMT).
Lyft has launched the LyftUp Scooter Critical Workforce Program to provide the first-responder, healthcare, and transit workforce with free scooter trips as they serve the public on the frontlines against COVID-19.
Lyft has committed $6.5 million to COVID-19 response efforts, focusing specifically on initiatives that support drivers and vulnerable communities.
Lyft will connect drivers with One Medical’s Essential Workers program, for access to a free 30-day trial membership, on-demand virtual care at no cost, and access to COVID-19 testing. Lyft drivers will have complimentary access to One Medical’s virtual care platform, which includes on-demand digital COVID-19 screenings, on-demand video visits, secure provider messaging and more virtual health resources 24/7.
Supporting Our Community (3/20/20)
MCNA Dental and its affiliate, Healthplex, have donated $250,000 to community-based organizations operating in Texas and eight other states. Their goal is to support the communities, families, and individuals who are facing challenges to their financial and physical health due to the coronavirus pandemic.
MCNA COVID-19 Update (3/18/20)
MTM is helping to deliver meals to individuals who are unable to leave their homes due to quarantine or health restrictions.
Optum has significantly expanded the availability of telehealth visits and increased the number of providers available to see patients virtually to increase access to behavioral and mental health treatment for its members. In March, Optum began to recruit new providers and accelerate approvals of providers interested in offering virtual care through its online platform. Since then, the number of providers participating in this network has increased by more than 45%, bringing the number of certified virtual visit providers to more than 10,000, and the numbers continue to grow. In addition, the number of appointments scheduled by members through Optum’s virtual visit platform is 52% higher than pre-COVID-19 averages. Optum will continue to expand its telehealth capabilities through May 31, 2020.
Optum’s Employee Assistance Program (EAP) is providing members resources they need online or over the phone. Optum EAP is seeing increased demand from members seeking emotional, financial and work-life support, typically four to eight weeks from the peak impact in any region. The most frequent requests for assistance from members include addressing opportunities to better manage stress and anxiety, addressing relationship issues, identifying child or elder care, and accessing home-schooling resources.
Optum has also opened a free Emotional Support Help Line (866-342-6892) to support people with tips on self-care and connections to local resources.
Optum has launched the Virtual Community Center wellness program to give older adults across the country free access to online exercise, nutrition and mental health classes geared for their age group.
Prime is hiring roughly 200 new contact center staff, with start dates as early as May and June, with a focus in some of the geographic areas economically hit by business closures as states try to prevent the spread of COVID-19.
Prime Coronavirus Update (3/31/20)
Project Amistad established a Special COVID-19 Response Team to transport passengers who are receiving dialysis and are positive for COVID-19. In El Paso, Project Amistad is also transporting residents in need of transportation to COVID-19 testing sites. The team members have received additional training and have been issued Personal Protective Equipment (PPE).
UnitedHealthcare Dental continues to evolve its products and services to improve access to oral care, while lowering costs. The latest offering includes teledentistry services designed to reduce unnecessary emergency room (ER) visits and more efficiently get patients to the most appropriate setting for in-person care. In addition, UnitedHealthcare Dental is providing important financial support to employers and network dentists in response to COVID-19.
Veyo is working with third-party partners to provide non-medical transportation (e.g. grocery shopping or prescription pickup) for their populations. Furthermore, Veyo is working with state governments and agencies to determine ways we might provide additional services to the members that we serve. For members who are unable to leave their homes during this time, we are able to utilize our resources for food bank/grocery delivery, prescription delivery, and medical/household equipment and supply delivery, and other logistics services that might be requested.
Veyo is also coordinating and providing transportation for medical personnel to or from a healthcare facility.
Veyo has created a specialized fleet of drivers to transport COVID-19 infected/suspected patients to and from life-sustaining medical appointments with the aim of alleviating the extreme stress that has been placed on the non-emergency ambulance industry.
3M, in partnership with the Trump Administration, will be importing 166.5 million respirators over the next three months to support healthcare workers in the United States. 3M and the Administration worked together to ensure that this plan does not create further humanitarian implications for countries currently fighting the COVID-19 outbreak, and committed to further collaborate to fight price gouging and counterfeiting.
3M partnered with Ford Motor Company to increase the production of 3M’s powered air purifying respirators (PAPRs) to help meet a surge in demand for personal protective equipment due to the COVID-19 outbreak. The collaboration led to production of an all-new PAPR design.
3M also partnered with Cummins to increase the production of PAPRs.
3M is providing $20 million in financial support to frontline healthcare workers, vulnerable populations disproportionately affected by the virus and medical research initiatives. 3M’s investment will be directed to community partners working to address critical needs during this global crisis.
3M released a new methodology for identifying health plan members at high risk for complications if they were to contract the COVID-19 virus. Health plans can use this analysis to segment their populations and better identify and prioritize those members. If high-risk populations can be encouraged to act quickly if they have symptoms—or to take extra precautions if they are asymptomatic—the ability to fight this pandemic can be strengthened. To view the analysis online, click here.
3M Outlines Latest COVID-19 Response (3/31/20)
The Advisory Board has opened up all it’s COVID-19 content and resources to the public, including web conferences on various COVID-related issues.
Bayer donated U.S. Government's fight against COVID-19 with a donation of 3 million tablets of the drug Resochin (chloroquine phosphate) to the U.S. Government to aid in the fight against COVID-19.
Bayer also donated one million products to support the health of underserved communities. The products, including over-the-counter medications and multivitamins, will be delivered directly to Americans who can’t easily access them today by way of partnerships with Direct Relief and, in subsequent weeks, Feeding America.
Berkeley Research Group (BRG) is part of a consortium of leading healthcare companies that launched the COVID-19 Research Database, a secure repository of HIPAA-compliant, de-identified and limited patient-level data sets made available to public health and policy researchers to extract insights to help combat the COVID-19 pandemic.
Fraud and Abuse: COVID-19 and Telehealth (4/27/20)
Summary of Fourth COVID-19 Bill (4/22/20)
CARES Act Emergency Fund (4/8/20)
Second COVID-19 Legislative Package (3/20/20)
Biogen has committed $10 million to support global response efforts and communities around the world impacted by the COVID-19 pandemic. The funds will be used to address immediate critical needs, with the majority of donations going to support non-profit organizations in the U.S.
Biogen is part of a consortium that will build and share a COVID-19 biobank to help scientists study a large collection of de-identified biological and medical data to advance knowledge and search for potential vaccines and treatments. Biogen will help employees who wish to volunteer connect with the project.
Cenikor Foundation has remained open during the COVID-19 pandemic to provide support to those who are recovering from or battling an addiction. Cenikor’s facilities will remain open for admissions and have capacity to accept clients. Additionally, Cenikor will be working with clients who need accommodation with deductibles and co-pays to ensure they can receive the necessary help during these trying times.
Edifecs has launched a dashboard that provides the ability to analyze claims information from COVID-19 test data. The dashboard, which is built into the Edifecs Visualizer part of XEngine Server Manager & SpecBuilder tools, allows customers to synthesize data related to COVID-19 testing to ensure scalability and prioritization of testing while understanding and tracking economic impacts.
HHAeXchange has worked hand-in-hand with our payer and provider clients to quickly adapt its platform to effectively manage care in the rapidly evolving COVID-19 crisis. HHAeXchange is offering a simple and easy-to-use Caregiver Screening tool in order to help providers quickly identify caregivers showing signs of COVID-19 and take immediate action to prevent the spread of COVID-19. Additionally, HHAeXchange has enabled COVID-19 missed visit reasons, allowing providers to report visits missed as a result of COVID-19 circumstances and giving payers the visibility they need to track and identify missed visit trends.
Holland & Knight’s COVID-19 Response Team is available to help address business, regulatory and legal issues companies may face related to COVID-19. In addition to legal memos and analysis of the CARES Act, State and Local Orders summaries and more than 275 timely publications, Holland & Knight’s centralized COVID-19 hub offers curated topics of interest and upcoming webinars that may be valuable to businesses.
Coronavirus Response - CARES Act Summary (3/30/20)
Mazars has launched a tool to help small businesses calculate the amount they are eligible to receive from the Paycheck Protection Program (PPP). This tool is available for small businesses, CFOs, and accounting firms to help them navigate the complex and dynamic program, increasing the speed of the application process.
Medline is working to ensure access and delivery of medical supplies to support doctors and nurses on the frontlines of the pandemic by alleviating strain on the supply chain. Medline has also been actively coordinating with industry and government agencies and is contributing to national PPE distribution efforts in pandemic hot spots as part of FEMA’s Project Airbridge.
Addressing COVID-19 in Nursing Homes (3/22/20)
Merck has launched a medical service volunteer program to enable employees who are licensed medical professionals to aid in the fight against COVID-19 while maintaining their base pay. Merck will support its employees around the world who are uniquely qualified to provide medical services and wish to aid communities affected by the COVID-19 pandemic. Merck is collaborating with The Health Management Academy to identify facilities with the greatest need and triage potential qualifying volunteers to serve.
Merck has committed $3 million to help health systems better meet the needs of pregnant women before, during and following delivery while tackling COVID-19.
Merck is continuing to ensure access to Merck medicines at no cost for eligible patients through its Merck Patient Assistance Program by assessing patients’ real-time financial situations, providing assistance with expiring enrollments, and offering new options to collect signatures on enrollment forms. Merck has placed a temporary $0 co-pay for certain products for eligible privately insured patients who are enrolled in the Merck Access Program. In addition, Merck has relaxed certain refill restrictions related to coupon use, and all existing coupon programs remain available to privately insured eligible patients.
Merck and IAVI are developing an investigational vaccine against SARS-CoV-2 to be used for the prevention of COVID-19. This vaccine candidate will use the recombinant vesicular stomatitis virus (rVSV) technology that is the basis for Merck’s Ebola Zaire virus vaccine, ERVEBO® (Ebola Zaire Vaccine, Live), which was the first rVSV vaccine approved for use in humans. Merck has also signed an agreement with the Biomedical Advanced Research and Development Authority (BARDA) to provide initial funding support for this effort. IAVI and Merck will work together to advance the development and global clinical evaluation of a SARS-CoV-2 vaccine candidate designed and engineered by IAVI scientists. The vaccine candidate is in preclinical development, and clinical studies are planned to start later in 2020. Merck will lead regulatory filings globally. Both organizations will work together to develop the vaccine and make it accessible and affordable globally, if approved.
Mitchell Williams Between the Lines blog provides updates and summaries on various regulatory issues related to COVID-19.
COVID-19 Guidance for Texas Businesses (4/16/20)
Telemedicine to Combat COVID-19 (3/16/20)
Newgen Software announced that several leading banks and credit unions in the United States have chosen the Newgen Loan Origination Software for SBA Paycheck Protection Program to process loans quickly and seamlessly. The software can be deployed within hours for each financial institution, enabling financial institutions to promptly help small businesses with their loan requirements.
NTT Data has partnered with the City of Austin Texas to create an application that allows citizens to self-assess, electronically schedule COVID-19 tests, facilitate faster testing identification and check in to securely obtain test results. The solution will use anonymized data to help Austin get a clearer picture of how the COVID-19 pandemic is impacting citizens and proactively allocate resources to the hardest hit areas.
Sharecare in partnership with IPsoft and NTT DATA has launched a free interactive screening solution that allows people to self-screen for COVID-19 symptoms and receive accurate “next steps” guidance. The solution will ease the strain on healthcare organizations.’
NTT DATA has partnered with Enli to deliver a patient management program that helps healthcare organizations record, manage, and monitor patients at risk for, or who have already contracted, COVID-19. The COVID-19 Care Coordination (EC3) program is currently recording, managing, and monitoring patients under investigation or diagnosed with coronavirus in 14 states.
NTT Data has produced solutions for covid-19 virtual screening , covid-19 test tracking and management , patient care coordination , social media listening, security , accelerated virtual desktop solutions and virtual workplace management.
NTT DATA launched a comprehensive COVID-19 Pandemic Response Portfolio of services designed to enable a safe return to work, school, and life for businesses, employees, and citizens.
Option Care Health is on the frontlines of the COVID-19 pandemic, working in collaboration with the nation’s hospitals and clinical teams to ensure patients continue to receive vital care. Option Care Health provides essential infusion services that enable patients to transition home from the hospital sooner, freeing up beds for critically ill COVID-19 patients.
Option Care has entered into an expanded partnership with Regence Health to ease access to care and provide additional options for high-risk patients who rely on infusion therapy. This collaboration enables members who currently receive their infusion therapy services in a hospital outpatient setting the ability to transition care to their home or an Option Care Health Infusion Suite.
PopHealthCare is closely monitoring updates related to COVID-19. At this time, we are continuing to offer identified members at-home medical care through our CareSight service. Our advance practice providers treat many older members with chronic conditions, the most vulnerable population that has been encouraged to stay home by the CDC. CareSight offers members access to in-home medical care, along with the opportunity to avoid a visit to the hospital, urgent care, or their doctor’s office where they may be exposed to a virus.
PopHealthCare’s care team is reaching out to 100% of members via phone to provide telephonic medical, behavioral, and social support at this critical time. Texas members may call PopHealthCare any time day or night at (800) 406-5640 to discuss their health conditions, get help with their medications, and receive guidance for managing anxiety while staying safe at home.
Quest Diagnostics is one of the leading suppliers of COVID-19 tests in the US. As of April 20, Quest has performed and reported results of more than 940,000 diagnostic COVID-19 tests. Quest is able to perform up to 50,000 diagnostic COVID-19 tests per day or approximately 350,000 tests per week. Quest’s test capacity outpaces demand and they have not experienced a test backlog for about a week. Quest has also begun performing antibody testing for COVID-19 using blood samples.
Quest Diagnostics is taking extra measures to ensure individuals who are the most vulnerable to adverse COVID-19 outcomes have special VIP-level access to the company's 2,250 patient service centers across the US, through its “Piece of Mind” program.
Quest received emergency use authorization (EUA) from the U.S. Food and Drug Administration (FDA) for the Quest Diagnostics Self-collection Kit for COVID-19 (self-collection kit). The self-collection kit is for individuals to self-collect a nasal specimen at home or in a health care setting when determined to be appropriate by a health care provider.
Quest launched a new suite of Return to Work services built around large-scale workforce COVID-19 testing. The services are designed to help organizations access and act on COVID-19 laboratory insights in order to foster safer workplace environments for their employees as the nation begins to restart the U.S. economy. The Quest Diagnostics Return to Work services feature access to COVID-19 diagnostic and antibody testing and related capabilities, from event staffing to digital results reporting. For more information, visit www.QuestforHealth.com.
FDA Authorizes Quest Diagnostics COVID-19 Nasal Specimen Self-Collection Kit for Emergency Use (5/28/20)
Sarepta Therapeutics has entered into a Cooperative Research and Development Agreement (CRADA) with the United States Army Medical Research Institute of Infectious Diseases and the Department of Defense’s lead laboratory for medical biological defense research to utilize Sarepta’s proprietary RNA platform to identify potential treatments for COVID-19.
Sarepta’s Response to COVID-19 (3/19/20)
UCB has expanded their existing Patient Assistance Program (PAP) to help eligible patients who have been impacted by COVID-19 by expediting enrollment to help ensure uninterrupted access to their medicines at no cost. This change will help patients experiencing difficulty affording UCB medicines due to job loss, job furlough, or loss of insurance coverage during this unprecedented time.
UCB is working with the Seattle Structural Genomics Center for Infectious Disease to identify crystal structures of SARS-CoV-2 proteins. In addition to providing funding support to organizations in need, UCB has donated safety glasses, gloves, disposable lab coats, protective suits and gowns, and bags of strip PCR tubes from their labs to be used by healthcare institutions and researchers.
UCB is also supporting healthcare professionals in our company who wish to volunteer their expertise in line with local government needs and guidance.
UCB Statement on COVID-19 Outbreak (3/24/20)
Honoring it’s pledge to the White House, Walgreens has dedicated temporary space at select locations, outside of the stores, where non-Walgreens health personnel will administer COVID-19 testing. Walgreens has expanded testing to Arizona, Florida, Illinois, Kentucky, Louisiana, Michigan, Tennessee and Texas.
Walgreens expanded the Walgreens Find Care™ platform to include new features and telehealth service providers, connecting patients and customers with more options to get convenient and affordable access to care from their computers and mobile devices.
To address the rising need for home delivery, Walgreens has partnered with Postmates to expand on-demand delivery to service consumers nationwide. With this expansion, consumers in cities across the country can get health and wellness items, including select over-the-counter medications, and other household essentials and convenience products they need delivered to them from more than 7,000 Walgreens stores.
Walgreens is also offering select products at its more than 7,300 pharmacy drive-thrus nationwide to provide greater convenience while also helping to promote social distancing.
Walgreens Update on COVID-19 Testing (3/22/20)