OCI urges health insurers to waive out-of-pocket costs for coronavirus testing, treatment

Third case confirmed in Wisconsin

stethoscope, doctors, healthcare

Last updated on March 12th, 2020 at 12:59 pm

The Wisconsin Office of the Commissioner of Insurance has asked health insurers to waive any out-of-pocket costs for lab testing and medical visits associated with the coronavirus.

In a recent notice, the OCI outlined a series of measures for insurers, self-funded plans and cooperative health to take to remove barriers to testing and treatment of the coronavirus (COVID-19). The state agency requested health plan issuers waive patient cost-sharing for COVID-19 laboratory and radiology tests, provider office visits, urgent care center visits, hospital visits and emergency room visits when the basis for the visit is related to testing for the virus.

“Costs should not be a barrier to people receiving necessary treatment,” Gov. Tony Evers said in a news release. “We will continue to monitor the situation and take the necessary steps to address this evolving public health challenge.”

The Wisconsin Department of Health Services on Tuesday announced that an individual in Dane County has tested positive for COVID-19, which is the third confirmed case in the state and second in Dane County. The affected individual was exposed while traveling within the U.S. and is currently isolated at home, DHS said. The other confirmed case is in Pierce County.

“We are working with our local health departments to make sure everyone who has been in contact with our confirmed cases is notified,” said state health officer Jeanne Ayers. “We continue to urge state residents to take precautions to avoid illness.”

If the virus begins spreading to more communities, DHS said officials will consider temporary closures of child care facilities and schools, workplace social distancing and teleworking, and canceling mass gatherings.

The OCI also instructed all health plan issuers to verify that their provider networks are prepared to respond to a possible increased need for health care services if the coronavirus spreads more widely throughout the state. If they aren’t, OCI requested health plan issuers make exceptions to provide access to an out-of-network provider at the in-network cost-sharing level.

Telehealth could also play a critical role in delivering health services, OCI said.

“Given that COVID-19 is a communicable disease, some insureds may be using telehealth services, if offered, instead of in-person health care services,” the notice said. “Health Plan Issuers are reminded to review provisions in current policies regarding the delivery of health care services via telehealth and ensure their telehealth programs with participating providers are robust and will be able to meet any increased demand.”

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Lauren Anderson
Lauren Anderson covers health care, nonprofits, education and insurance for BizTimes. Lauren previously reported on education for the Waukesha Freeman. She graduated from the University of Wisconsin-Madison, where she studied journalism, history and African studies. In her free time, Lauren enjoys spending time with family and friends and seeing live music wherever she can.

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