R.I. requires all health insurers to cover patient copays and expenses for COVID-19 treatment

AT THE PBN 2021 Spring Health Care Summit, R.I. Health Insurance Commissioner Patrick Tigue, top right in the panel screen, discussed how the state is now requiring all health insurance carriers to provide cost-sharing coverage through the pandemic for COVID-19 treatment.

PROVIDENCE Rhode Island is now requiring all health insurance carriers operating in the state to cover out-of-pocket expenses for customers who are seeking COVID-19 treatment, through the remainder of the pandemic emergency.

The policy, effective April 2, was issued in a health insurance bulletin from the Office of the Health Insurance Commissioner.

“Continued efforts are necessary to slow the spread of COVID-19, to address the impact of COVID-19 on providers and consumers and to lower barriers to medically necessary COVID-19 care,” wrote Patrick M. Tigue, the state’s health insurance commissioner.

To that end, the office said, through the duration of the state of emergency, health carriers are required to provide coverage and waive any cost-sharing including deductibles, co-insurance or copayments for inpatient and outpatient COVID-19 treatments at in-network providers and other locations, and at out-of-network providers if a member can’t easily find care in-network.

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The requirement also applies to treatment options that are delivered by telemedicine, he wrote.

The issue of whether carriers should or could continue to cover copays and other expenses traditionally borne by customers came to the forefront in March after Blue Cross & Blue Shield of Rhode Island notified its clients that it would end its policy of covering cost-sharing fees for COVID-19 as of April 1.

The company later reversed its position, after getting feedback from clients, it said.

At the time, of the four major carriers providing health insurance in Rhode Island, United Healthcare of New England, which covers about 165,000 people, had already ended its coverage of out-of-pocket consumer expenses, according the health commissioner.

Neighborhood Health Plan of Rhode Island and Tufts Healthcare, of Watertown, Mass., have continued to provide coverage of those expenses.

Speaking at the Providence Business News Health Care Summit on Thursday, Tigue said that the state had determined it needed consistency among carriers in how to address the pandemic.

“We should have uniformity in the market for the pandemic period,” Tigue said. “Once the emergency period is lifted, insurers will not have that obligation. But as of today, they now all do.”

A spokesman for United Healthcare, contacted Thursday, did not have immediate comment on the new directive.

Mary MacDonald is a staff writer for the PBN. Contact her at macdonald@pbn.com.

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