State Health Plan Board Approves Emergency Authority to Respond to COVID-19

Friday, March 13, 2020

State Treasurer Dale R. Folwell, CPA, announced today that the State Health Plan (Plan) Board of Trustees (Board) authorized the Treasurer and executive administrator to take actions within their authority to preemptively address and quickly respond to COVID-19 for the benefit of Plan members without consultation with the Board.

Subsequent to the Board action, the Plan made the following changes to medical and pharmacy benefits for members enrolled in the 80/20 Plan, 70/30 Plan and High Deductible Health Plan:

Medical Benefit Enhancements:

  • Expanded virtual access to doctors – Visits to providers that previously required a face-to-face encounter can now be performed virtually so long as they are a medical necessity and meet criteria. This will further encourage the use of virtual visits and allow providers to monitor members at home, minimizing the spread of infection and easing the burden on emergency rooms. You will need to contact your provider to determine if these services are available.
  • Waived prior authorizations for covered services related to COVID-19 that are ordered by a provider, medically necessary, and consistent with Centers for Disease Control and Prevention (CDC) guidance related to COVID-19.
  • Eliminated the member cost-share for COVID-19 testing to ensure there are no cost barriers to testing.

Pharmacy Benefit Enhancements:

  • Increased access to maintenance medications by waiving the early medication refill limits on 30-day prescription maintenance medications. Member cost-sharing will apply as normal.
  • Waived CVS home delivery charges for medications so members do not have to leave their homes to pick up their medications.

The Board’s full resolution may be found here. Additional information may also be found on the Plan’s website under Coronavirus.

If you are not signed up to receive the free Member Focus e-newsletter, which keeps members updated on Plan policies and actions, please click here to subscribe to ensure you receive important announcements regarding your benefits.