CMS directs Medicare Advantage plans to waive some rules amid coronavirus outbreak

CMS is telling Medicare Advantage plans to waive certain requirements to help prevent the spread of COVID-19, the disease caused by the novel coronavirus, among beneficiaries.

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CMS issued a memorandum March 10 outlining the requirements Medicare Advantage plans have to waive, including:

  • Cost-sharing for COVID-19 tests
  • Cost-sharing for COVID-19 treatments delivered in physician offices, emergency rooms and via telehealth
  • Prior authorization requirements
  • Prescription refill limits
  • Restrictions on home or mail delivery of prescription drugs
  • Restriction on telehealth services

CMS Administrator Seema Verma said the guidance removes “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.”

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