LOUISIANA BANS INSURANCE PLAN COST SHARING FOR CORONAVIRUS TESTING
DAVID JACOBS, THE CENTER SQUARE
BATON ROUGE — The Louisiana Department of Insurance has invoked an emergency rule that requires health insurance companies to pay for COVID-19 testing with no cost sharing, the insurance commissioner said Thursday.
“This effort will ensure Louisiana policyholders will have seamless access to testing, pharmaceuticals and care throughout Louisiana,” Commissioner Jim Donelon said.
According to Donelon, under Emergency Rule 36, insurers must:
• Waive cost sharing for COVID-19 testing when ordered in accordance with CDC guidelines. Insurers also are prohibited from requiring prior authorization for testing.
• Permit early refills, except for drugs in certain drug classes like opioids, when consistent with doctor and/or pharmacist approvals.
• Prohibit the use of step therapy, which is when insurers require members to try cheaper drugs first before stepping up to more expensive medications.
• Enhance access to mail order pharmaceuticals.
• Continue to ensure network adequacy given the anticipated increase in demand due to COVID-19.
The order mandates some actions insurers say they were already taking voluntarily. Jeff Drozda, CEO of the Louisiana Association of Health Plans, told a state Senate committee last week that members were waiving co-pays and prior authorization requirements for coronavirus testing, lifting limits on 30-day refills of medications, and encouraging members to order their drugs by mail.
“The health plans are exclusively focused on the COVID-19 right now,” Drozda said.
Federal lawmakers this week approved the Families First Coronavirus Response Act, which requires most forms of health insurance to cover COVID-19 testing without cost-sharing and creates mechanisms to pay for COVID-19 testing for uninsured people.
Symptoms of COVID-19, the illness caused by the new coronavirus, can include fever, coughing and trouble breathing. Most people who have it develop only mild symptoms. But some people, usually the elderly and those with other medical complications, develop more severe symptoms, including pneumonia, which can be fatal.