To Our Valued Clients and Partners:
HMA has committed to providing you with regular updates related to the COVID-19 outbreak and the ways we are augmenting our services to support you and your members. This is the latest update from our organization. Please know that our team, as always, is available to discuss any plan changes or answer any questions we can to support you. Feel free to reach out to your Account Manager, to me or any member of our team if you need more information.
Coverage for COVID-19 Testing and Treatment
As of this morning, many states have announced that state-regulated health insurers will cover treatment and testing for COVID-19. While self-funded health plans are not required to make these changes, many are choosing to do so to make it easy for members to receive the care they may need. You can expect that your Account Manager will reach out to you or your broker this week to ask if you would like to make plan changes and if so, to provide you with the documentation needed to initiate these changes. Our forms will provide you with options to amend your plan for testing only, both testing and treatment, as well as determine whether you would like to enhance benefits for treatment and testing provided out-of-network.
Please note that yesterday (3/11/20), the IRS provided guidance allowing for full coverage of COVID-19 treatment and testing in high deductible health plans with HSAs. This means that employers can choose to waive all cost-sharing for members on these plans, just as many are doing for their other plan options. We are also working closely with our HSA partner, HealthEquity, to ensure claims they handle process correctly.
Cost of COVID-19 Testing and Treatment
Many of you have reached out seeking information on the cost of coverage for COVID-19. Unfortunately, there is limited information currently available on COVID-19 related costs.The Centers for Medicare and Medicaid Services (CMS) only released codes to allow providers to bill separately for COVID-19 within the past week. CMS has not yet set the price for what Medicare will pay for these services. This may have a bearing on what providers charge for testing as well as what the allowable rates for testing will be. Further, many different sites are being established for testing – these sites vary from pharmacies to community health centers to labs to hospitals. Going further, there is speculation that tests could occur in settings such as high school gyms, community shelters, and other locations, so this is yet another extremely fluid aspect of responding to COVID-19. We do not yet have clarity on the variability in cost for testing at these various locations.
Estimating treatment costs is also challenging. Doctors’ office visits, ER visits, and hospital stays are likely to be similar in cost to treatment for other conditions. If you would like data on average costs for any of these types of care our analysts are happy to provide you with this information. If our health system is over-burdened by COVID-19, it may become necessary for alternative sites of care to be utilized for treatment (as noted above).
You have our commitment to communicate updates as more information on cost becomes available.
HMA Readiness to Serve Members Who Have COVID-19
As noted in our prior communication, HMA’s Pandemic Response Plan was enacted several weeks ago to ensure that our team is ready to support you and your members.
- Our Customer Care team will provide members with information about what to do if the member is concerned they have contracted COVID-19 as well as to educate them about their benefits for testing and treatment. Our team will also direct members to resources included in their health plans such as NurseLine, MDLIVE telehealth, or community provided telemedicine.
- As soon as we are aware that a member has tested positive for COVID-19, we will immediately engage a Case Manager to work with the member through their recovery. Please note that we are happy to take referrals from you or your team if you become aware that one of your members has COVID-19.
- We are already mining claims data to identify members receiving treatment for respiratory conditions and have established protocols to flag members with COVID-19 diagnoses. As we identify these members, we will reach out proactively from Case Management. We have also established processes to track claims for COVID-19 so we can make sure that testing and treatment are processed according to client intent and plan benefits.
- Our leadership team is actively monitoring COVID-19 via our command center to ensure that we provide proactive service to customers through this public health emergency. We’re tracking the condition across the U.S. and internationally to ensure that we’re ready as additional hot spots emerge. We’ve been in touch with all of our partners in our entire HMA value stream. We are monitoring our partners’ business continuity responses to ensure our total response supports you as needed..
We’re Here for You
In the current environment, we know having accurate and timely information regarding COVID-19 (the coronavirus) is crucial. We understand that during trying times, proactive, two-way communication is vital and the strength and depth of our partnerships are critical. We’re committed to doing everything we can to make sure you get what you need. Our team is doing our very best to anticipate and respond as the virus continues to affect more Americans.
Thank you for your continued trust in our organization. Our focus, dedication, and support are unwavering as we navigate these unique times. We hope you and your loved ones remain safe and healthy. Please reach out to your HMA Account Managers if you have any questions or if there's anything we can do to help.
Thank you,
Lindsay Harris
Chief Growth Officer
