This morning the Washington State Insurance Commissioner issued an emergency order requiring temporary benefit modifications related to the COVID-19 outbreak. The changes apply to health carriers and short-term limited duration plans that are defined and regulated by the OIC under RCW 48.43.005 (28) and 48.43.005 (29). The modifications are temporary and unless extended, only apply to the period March 5, 2020 through May 4, 2020. The order does not apply to self-insured health plans and other plans not regulated by OIC. Under the emergency order, the applicable health carriers and plans must:
- Provide coverage for COVID-19 testing to enrollees that meet Centers for Disease Control and Prevention criteria, as adopted by the Washington state Department of Health. Carriers and health plans cannot apply prior authorization requirements to the testing and must cover the testing without applying a deductible or cost-sharing. If the carrier does not have enough in-network providers to provide testing and treatment of COVID-19, the carrier must ensure the patient receives the service within reasonable proximity and at no greater patient cost than if the services were provided in-network.
- Carriers must allow enrollees to obtain a one-time refill of covered prescription medications, prior to the normal waiting period between refills, except for opioid class drugs. The purpose is to reduce avoidable opportunities for exposure and reduce stress on the medical system.