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OPM calls on federal health insurers to prioritize coronavirus response

As federal agencies are being encouraged to implement telework and leave plans to protect employees from the threat of coronavirus, the Office of Personnel Management has also called on federal health insurance carriers to mitigate the potential costs associated with COVID-19 testing and treatment.

OPM released a letter to all FEHB carriers March 13 to urge carriers to prioritize both communication about the dangers of coronavirus and to consider actions to “minimize barriers to testing and treatment for FEHB members who are affected by the COVID-19 outbreak.”

Specifically, the letter requests that carriers relax referral or preauthorization requirements when covering testing, specialized care, medical ambulance transportation and early refills for prescription medication.

Meanwhile, OPM expects carriers to prioritize the review and approval for a COVID-19 vaccine or treatment once it becomes available.

The letter also calls for carriers to ensure that their medical transportation and in-network providers are equipped to handle federal employees that are potentially infected with coronavirus or to offer out-of-network services through cost-sharing to make sure that employees have access to necessary care at a reasonable cost.

Those carriers that offer high-deductible health plans have been asked to “strongly consider providing health benefits associated with testing for and treatment of COVID-19 without a deductible, or with a deductible below the minimum deductible for an HDHP.”

The letter also tells carriers to communicate regularly with federal enrollees, some of which have already done so, about the protective measures employees can take to prevent the spread of the virus and how to seek care if they believe they have it, including calling healthcare providers and accessing telehealth options, rather than going out in public.

According to guidance issued by the Centers for Disease Control, people who believe they may have coronavirus should remain at home except to seek medical attention and call ahead to their healthcare provider before going in to get treatment. Patients are also being asked to wear a mask when going into a treatment facility and to notify the state or local health department of their condition.

In addition to keeping the federal workforce covered and informed, OPM also requested that carriers make sure their own workforces are monitored to continue coverage operations and notify OPM should a disruption of normal services occur.

OPM does not mandate that health insurers alter their coverage, but the agency is also set to go into negotiations with health insurance providers for the 2021 coverage year this spring and summer, when coronavirus is likely to still be a major concern.

And though OPM has also issued continual guidance to agencies on their coronavirus response, choices to telework or grant leave to employees have been left up to the discretion of individual agencies.

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