CMS memo removes cost sharing on COVID-19 tests, eases Rx refill limits

The Centers for Medicare and Medicaid Services this week offered guidance to insurers and the industry related to the COVID-19 outbreak and how to best serve patients during the pandemic.

As commercial insurers announce COVID-19 diagnostic tests as covered benefits, waiving the cost-sharing that would apply, CMS issued a memo to Medicare Advantage and Medicare Part D plans to cover COVID-19 testing, treatment and prevention for their members. .

“The President directed CMS to make sure Medicare Advantage beneficiaries have access to the healthcare services they need during this time,” said CMS administrator Seema Verma. “Today we announced guidance to Medicare Advantage and Part D plans to remove barriers that could prevent or delay beneficiaries from receiving care. 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.”

The memo calls for waiving cost-sharing on COVID-19 tests and for treatments in doctor's offices and emergency rooms, as well as treatments delivered via telehealth. It also removed prior authorization requirements and prescription refill limits and relaxed restrictions on home or mail delivery of prescription drugs. The memo also sought to improve telehealth access. 

The agency said it would work with pharmacies and providers to treat patients without limiting their options during the outbreak in order to keep them healthy and help prevent the spread of the disease.