COVID-19 Follow Up

BULLETIN 20-06 To: All Health Carriers Re: COVID 19 Follow Up Date: March 10, 2020 On March 5, 2020, Governor Larry Hogan issued a Proclamation declaring a State of Emergency and that a Catastrophic Health Emergency exists in the State of Maryland. On March 6, 2020, the Maryland Insurance Administration issued Bulletin 20-05 regarding COVID 19. On March 9, 2020, changes to Code of Maryland Regulations (“COMAR”) 31.01.02.03 and .06 took effect on an emergency basis. Pursuant to § 2-115 of the Insurance Article and COMAR 31.01.02.05 and 06, the Commissioner is invoking his emergency powers and the provisions of COMAR 31.01.02.06A(5), (6) and (7) and F through K are activated. As a result, health carriers are required to:  Waive any cost-sharing, including co-payments, coinsurance, and deductibles for any visit to diagnose or test for COVID-19 regardless of the setting of the testing.  Waive any cost-sharing, including co-payments, coinsurance, and deductibles for laboratory fees to diagnose or test for COVID-19.  Waive any cost-sharing, including co-payments, coinsurance and deductibles for vaccination for COVID-19, when a vaccine becomes available.  Evaluate a request to use an out-of-network provider to perform diagnostic testing of COVID-19 solely on the basis of whether the use of the out-of-network provider is medically necessary or appropriate.  Consider an adverse decision on a request for coverage of diagnostic services for COVID-19 an emergency case for which an expedited grievance procedure is required under § 15-10A-02 of the Insurance Article. The only prior authorization requirements a health carrier may utilize relating to testing for COVID-19 shall relate to the medical necessity of the testing. The cost-sharing waivers do not apply to a Medicare supplement policy as defined by § 15-901(k) of the Insurance Article. A carrier is not required to waive the deductible for a high-deductible health plan, if the waiver of the deductible would disqualify the plan from being considered a high deductible health plan under federal law. AL REDMER, JR. Commissioner JAY COON Deputy Commissioner LARRY HOGAN Governor BOYD K. RUTHERFORD Lt. Governor 200 St. Paul Place, Suite 2700, Baltimore, Maryland 21202 1-800-492-6116 TTY: 1-800-735-2258 www.insurance maryland.gov These regulations shall be in effect along with those activated in Bulletin 20-05 until the emergency declaration is lifted or the Commissioner issues a Bulletin deactivating the regulations at issue. Questions about this Bulletin may be directed to the Life & Health Unit of the Maryland Insurance Administration at 410-468-2170. AL REDMER, JR. Commissioner By: _ David Cooney Associate Commissioner signature on original