Advisory Issued on COVID-19 Variant Surge

On January 10, 2022, the Department of Insurance (DOI) issued an advisory to encourage insurers that offer health benefit plans to state residents to take certain immediate measures related to the COVID-19 variant surge.

Specifically, the advisory asks insurers to review current policy provisions regarding the delivery of healthcare services via telehealth to ensure their telehealth programs with participating providers will be able to meet any increased demand. Similarly, insurers are requested to verify if their provider networks are adequate to handle increased healthcare service needs if more COVID-19 cases are diagnosed. Insurers are also reminded that insureds cannot be penalized or charged out-of-network benefit levels unless contracting healthcare providers able to meet the health needs of the insureds are available without unreasonable delay.Specifically, the advisory asks insurers to review current policy provisions regarding the delivery of healthcare services via telehealth to ensure their telehealth programs with participating providers will be able to meet any increased demand. Similarly, insurers are requested to verify if their provider networks are adequate to handle increased healthcare service needs if more COVID-19 cases are diagnosed. Insurers are also reminded that insureds cannot be penalized or charged out-of-network benefit levels unless contracting healthcare providers able to meet the health needs of the insureds are available without unreasonable delay.

The DOI reminds insurers to cover COVID-19 tests for diagnostic purposes and without prior authorization consistent with federal guidance. Insurers are also requested to communicate if temporarily waiving prior authorization requirements for post-acute care and the duration of such waiver.

The memo is directed at insurers, but employers may also want to be aware of this advisory.

COVID-19 Variant Surge Advisory »