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Colorado directs insurers to waive cost-sharing, promote telehealth services for COVID-19 testing

Three more presumptive positive tests confirmed in Colo. Monday
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Posted at 10:45 AM, Mar 09, 2020
and last updated 2020-03-09 18:15:24-04

DENVER – Colorado Gov. Jared Polis has asked the state Division of Insurance to issue formal guidance to health insurance carriers in the state to promote telehealth services and to waive co-pays, deductibles, coinsurance and cost-sharing for people to be tested for COVID-19.

In a news release issued Monday morning, the governor’s office said it issued the directives to the Colorado DOI about coverage costs in order to ease financial uncertainty among Coloradans who might not have the financial means to cover a necessary doctor’s visit should they need to be tested for the novel coronavirus (COVID-19).

MORE: Coronavirus in Colorado: COVID-19 cases, locations and live updates across the state

“Our administration is taking swift action to ensure Coloradans can get tested for COVID-19 without financial fear,” Polis said in a statement. “We are all in this together, and we must continue working together to protect our health and safety. This important step will help ensure cost barriers do not stand in the way of people getting tested. The earlier that we can diagnose and isolate those testing positive for COVID-19, the better we can prevent it from spreading.”

The directives from DOI to insurance carriers only applies to those on the state marketplace that are regulated by DOI. The state says that people who have employer-based coverage need to contact their employer about what might be covered. Plans covered by DOI have a “CO-DOI” notation in the bottom corner of the insurance card.

Under the directives, insurance carriers have been advised to remind Coloradans of the telehealth services available to them and have been advised that they need to cover in-network telehealth services related to COVID-19 “at no cost share, including co-pays, deductibles, and coinsurance that would normally apply to the telehealth visit.” More information on the services is available by clicking here and scrolling to Page 3.

Another directive – which stems from federal directives saying that COVID-19 tests are essential health benefits – orders carriers to provide COVID-19 testing “without the requirement that consumers pay co-pays, deductibles or co-insurance.”

Those payments would be waived for in-network office visits, in-network urgent care visits and emergency room visits if someone is looking to be tested for the virus. And if in-network providers do not conduct COVID-19 testing, carriers must cover out-of-network testing as well, according to the state.

And carriers are also being directed to cover a one-time early refill of any “necessary prescriptions” for people – not including drugs that are more likely to be abused, like opioids – in the chance that they have to quarantine themselves at home.

The release said that the Division of Insurance would be issuing emergency regulations to formalize all three directives.

In Colorado, people could be tested for COVID-19 under three circumstances:

· They have fever or symptoms of a lower respiratory illness and have been in contact with someone confirmed to have the virus within 14 days of the onset of symptoms.
· The have fever or symptoms of a lower respiratory illness, have had other diagnoses ruled out, and recently traveled to an area with high infection rates within 14 days of becoming symptomatic.
· They have a severe acute respiratory illness, such as pneumonia, that requires hospitalization and has no other explained diagnosis.

As of Sunday afternoon, there were eight “presumptive positive” tests for COVID-19 in Colorado and 247 negative tests. Of the eight, two cases are in Denver County, three in Douglas County, one in Eagle County, one in El Paso County and one in Summit County, who was relocated to Jefferson County to be isolated.

But on Monday morning, the Colorado Department of Public Health and Environment said a ninth person had come back as "presumptive positive" for COVID-19 — a woman in her 50s in Larimer County who has been diagnosed with pneumonia.

By 4 p.m. Monday, two more presumptive positive cases and one indeterminate case of COVID-19 – in addition to the Larimer County case announced Monday morning – have been confirmed in Colorado, making that three presumptive positive cases and one indeterminate case announced on Monday. There are now 284 negative tests in Colorado, 11 presumptive positive cases and the lone indeterminate case.

“CDPHE and local health agencies are working to gather more information and contact any individuals who have had close contact with the patient. The investigation is just beginning and more information will be released as it becomes available.”

“We have been studying this issue and felt this was the proper time to take this step,” Colorado Insurance Commissioner Michael Conway said in a statement. “Everyone has a role to play in addressing this public health issue and costs should not be a deterrent from getting tested. We look forward to working with insurers and the public.”

Update on Denver’s COVID-19 preparedness

At a news conference Monday morning, Denver Mayor Michael Hancock said there are still only two presumptive positive cases in Denver, but that eight people were quarantined – all of whom had contact with the two presumptive positive people.

Hancock was joined by Denver Executive Director of Public Health and Environment Bob McDonald and Executive Director of the Office of Emergency Management Matthew Mueller to discuss where the city sits as of Monday in regard to its preparations for a COVID-19 response.

Hancock ordered the Emergency Operations Center to be partially activated in order to coordinate operations responses and messaging for the city and county.

Mueller said that the city had been doing outreach to food and entertainment establishments across the city and would be installing new signs to encourage hand-washing in most public spaces, and encouraging businesses and residents to be proactive to prevent the spread of the virus.

The officials said they would be looking at options for city employees to possibly work from home should that become necessary and that the task force announced last week had been looking at all scenarios to determine what next steps might be needed to protect the population and the economy in Denver.

Mueller said the emergency operations center would be running “as long as this takes.” The focus by the officials is four-fold, he said: public health and protective safety measures; public information and messaging to all the community; looking at the economic impacts to city businesses and residents; and maintaining the continuity of government operations.

Hancock said there were no current plans to postpone or cancel this weekend’s St. Patrick’s Day parade, as San Francisco has done. But the elderly and immune-compromised are encouraged not to go in public if they feel they are at risk or sick.

The officials said they were also focusing on people experiencing homelessness in Denver and had boots on the ground to try to contact those people. They said they would also be providing shelters and other organizations that serve the homeless with more sinks, soap and sanitizer if they need them.

They said they continued to be in constant contact with the CDC and CDPHE and were trying to go “above and beyond” the current guidance for municipalities in order to “limit this the best we can.”

For more COVID-19 resources, head over to the CDPHE's page or the CDC's page.