COVID-19

CMS Publishes FAQs to Ensure Individuals, Issuers and States have Clear Information on Coverage Benefits for COVID-19

Today, the Centers for Medicare & Medicaid Services (CMS) is posting Frequently Asked Questions (FAQs) on Essential Health Benefits (EHB) Coverage in response to the 2019 Novel Coronavirus (COVID-19) outbreak. This action is part of the broader, ongoing effort by the White House Coronavirus Task Force to ensure that all Americans – particularly those at high-risk of complications from the COVID-19 virus – have access to the health benefits that can help keep them healthy while helping to contain the spread of this disease.

“Amid a serious outbreak like this one, Americans understandably crave the security and peace of mind that comes from understanding exactly how they will be covered.” said CMS Administrator Seema Verma. “Today’s guidance aims to give it to them. Working closely with states and issuers around the country, the Trump Administration will continue to provide pertinent information to strengthen the nation’s response and keep Americans informed.”

Host: "Before I let you go, I want to ask you one more time: Are there gonna be people in this country who don't get a ventilator if they need one? Are you concerned that the actual physical equipment that is needed to serve the people who will get sick is out there...can you reassure everyone that there is not a shortage of ventilators or ICO units?"

Verma: "And that's why the President has taken such a bold and decisive action, right? We're not waiting for this to get worse, we're not waiting for this to be a crisis in our healthcare systems, and that's why the mitigation strategies that he announced last night, limiting travel from Europe, not allowing that, umm...you know, we've given travel advisories on cruise ships. That's why we're taking all of this action, because we don't want to put stress on the healthcare system."

Host: (pause) "...OK...that's not a...direct answer to the question..."

For the record, according to the New York Times:

Michigan:

Governor Whitmer Announces Statewide Closure of All K-12 School Buildings; School building closures will last Monday, March 16 through Sunday, April 5

Today, Governor Gretchen Whitmer announced that in order to slow the spread of Novel Coronavirus (COVID-19) in Michigan, she is ordering the closure of all K-12 school buildings, public, private, and boarding, to students starting Monday, March 16 until Sunday, April 5. School buildings are scheduled to reopen on Monday, April 6. 

As of tonight, the number of presumptive positive cases of COVID-19 in Michigan is 12. 

You may already have seen the simple graphic below (this version was designed by Drew Harris), but if you haven't, here it is: #FlattenTheCurve.

This one, simple graphic instantly explains everything you need to understand about why "social distancing", including the massive cancellations of practically every large (or even medium-sized) public event is happening at a frighteningly fast rate even as I'm typing this.

The NBA? Shut down. Broadway? Shut down. The Capitol? Closed to the public. Entire school districts? Being closed left and right (including our own).

I'm sure you've noticed that I've been posting more frequently about Michigan re. COVID-19 stuff than other states; there's a simple reason--my family and I live here. I'll still be posting major breaking developments for other states as well, of course, but I'm understandably more attuned to what's going on in my own state...

via Michigan Governor Gretchen Whitmer's office:

Whitmer Administration Expands Telemedicine, Urges President Trump to Permit ACA Special Enrollment Period During COVID-19

via the House Ways & Means Committee:

HOUSE DEMOCRATS INTRODUCE FAMILIES FIRST CORONAVIRUS RESPONSE ACT

  • Legislation provides paid leave, establishes free testing, protects health workers, and provides important benefits to children and families

WASHINGTON, DC — House Democrats today introduced the Families First Coronavirus Response Act to bolster the federal government’s response to the coronavirus outbreak and address the severe impacts of the coronavirus on Americans’ personal safety and financial security.

The Families First Coronavirus Response Act, expected to be considered in the House on Thursday, is sponsored by Appropriations Committee Chairwoman Nita M. Lowey (D-NY) and co-sponsored by Ways and Means Committee Chairman Richard E. Neal (D-MA), Education and Labor Committee Chairman Bobby Scott (D-VA), and Energy and Commerce Committee Chairman Frank Pallone, Jr. (D-NJ).

BREAKING: The Centers for Medicare & Medicaid Services is allowing Medicare Advantage plans and Medicare drug plans to waive cost-sharing for #COVID2019 testing, treatments delivered by telehealth, prescription refill limits, among other things.
https://t.co/LXCyroChSU pic.twitter.com/0xhbeGButN

— Shira Stein (@shiramstein) March 11, 2020

Here's the full memo:

The Centers for Medicare & Medicaid Services (CMS) is issuing this information to Medicare Advantage Organizations and Part D Sponsors to inform them of the obligations and permissible flexibilities related to disasters and emergencies resulting from COVID-19.

Medicare Advantage Organizations

Special Requirements

via the Massachusetts Health Connector:

Massachusetts Health Connector offers extended enrollment for uninsured individuals to ease coronavirus fears

BOSTON – March 11, 2020 – To ensure everyone who wants access to covered coronavirus services has it, the Massachusetts Health Connector announced today that uninsured residents can apply and get into coverage through a 45-day window running until April 25.

On March 6, the Division of Insurance announced that Massachusetts health insurers are now required to cover the cost of testing and treatment for members who may be affected by the Coronavirus (COVID-19), including not charging co-pays or deductibles for those services. The Health Connector’s decision to open enrollment to anyone without coverage ensures Massachusetts residents concerned about contracting coronavirus can access necessary services without cost barriers.

A few days ago, in light of HHS Secretary Alex Azar admitting that neither he nor anyone else at the HHS Dept. appears to have the slightest idea about how many Americans have actually been tested for coronavirus, I kiddingly mused:

Maybe I should register CoronaTestCount.net and start up an amateur spreadsheet to track this by state for the HHS Dept...hmmmm...

I was kidding, however, because my own plate is simply too full to take on that task as well.

Fortunately, I don't have to, because someone else has already stepped up to do exactly that. Via Josh Marshall of Talking Points Memo:

Well, this was inevitable:

Michigan announces first presumptive positive cases of COVID-19

Governor Whitmer declares a state of emergency to maximize efforts to slow the spread

LANSING, Mich. – Gov. Gretchen Whitmer, the Michigan Department of Health and Human Services (MDHHS) and the Oakland County Health Division and Wayne County Health Department announced today that two Michigan residents tested presumptive positive for coronavirus disease 2019 (COVID-19), the first confirmed cases in the state. The governor has declared a state of emergency to maximize efforts and assist local governments and officials to slow the spread of the virus.

"We are taking every step we can to mitigate the spread of the virus and keep Michiganders safe," said Governor Whitmer. "I have declared a state of emergency to harness all of our resources across state government to slow the spread of the virus and protect families. It’s crucial that all Michiganders continue to take preventative measures to lower their risk, and to share this information with their friends, family, and co-workers."

Washington becomes 1st state-based marketplace to create a special enrollment opportunity in wake of coronavirus threat. https://t.co/2bYCrboXvl @GtownCHIR

— Sabrina Corlette (@SabrinaCorlette) March 10, 2020

via the Washington Health Benefit Exchange:

Washington Healthplanfinder Announces Special Enrollment Period in Response to Growing Coronavirus Outbreak

 

Here's the full transcript verbatim:

"So, we've told you...we'll tell you what we know and don't know. So there's different types of tests which get sent out. The CDC's test that CDC is sending out, that's that 70...enough to send out 75,000 people, that was sent out last week. Those go to public health labs, about 80 labs in the United States, one in each state at least. Those report results back in to the CDC because they're part of the public health network. The larger quantity of tests that shipped, about 900,000 of the tests that shipped by this weekend, and then so many of the remainder of that 2 point...total, 2.1 million tests...those go to hospitals, private labs, others for testing...they don't currently have to report to us that they've conducted a test or what the result of that test is. The CDC is actively working right now to build that IT connectivity with them so we can gather that information. So right now...I could not give you a number of how many Americans have received a test because many will have received a test through hospitals or non-public health labs, and so...let's work with getting the system, the IT system up through the CDC, you want to get the accurate information as we go. 

Last week it was noted by several healthcare policy experts that if and when a vaccine for the coronavirus (COVID-19) sweeping the entire planet is ever developed, under the Affordable Care Act, insurance companies would be legally required to cover the full cost of it for anyone enrolled in an ACA-compliant policy:

SEC. 2713. COVERAGE OF PREVENTIVE HEALTH SERVICES.

(a) In General.--A group health plan and a health insurance issuer offering group or individual health insurance coverage shall, at a minimum provide coverage for and shall not impose any cost sharing requirements for--

(1) evidence-based items or services that have in effect a rating of 'A' or 'B' in the current recommendations of the United States Preventive Services Task Force;

(2) immunizations that have in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved; and

via David Eggert:

LANSING, Mich. (AP) — Michigan health insurers said Friday they will cover the cost of medically necessary tests for the new coronavirus for people covered under employer and individual health plans, while Gov. Gretchen Whitmer announced the waiving of testing and treatment fees for Medicaid recipients.

...Plans that will waive copays and deductibles for testing costs include Blue Cross Blue Shield of Michigan, Blue Care Network, Priority Health, CVS Health, McLaren and Meridian, according to the governor’s office. The change will not apply — for now — to large employers that self-insure but use insurance companies to administer their benefits.

...Blue Cross Blue Shield will forgo prior authorization rules for diagnostic tests and covered services to treat the disease, set aside refill limits on prescriptions, and expand access to telehealth and a 24-hour nurse hotline.

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