MedCost continues to closely monitor the COVID-19 pandemic and has successfully deployed our business continuity plan to protect the health of our employees while safeguarding our ability to perform the services our clients, health plan members and providers rely on. MedCost remains fully operational, with substantially all of our employees transitioned to a remote work environment, so that business operations may continue uninterrupted for the foreseeable future.
While your MedCost Account Manager has been working directly with you to address your specific circumstances and needs during this challenging time, another source for current information is our COVID-19 webpage. Please check it regularly, and contact your Account Manager if you have any questions or concerns.
Here are some important developments we want to share with you:
CARES Act
The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) was signed and took effect on Friday, March 27, 2020. In addition to the much-publicized stimulus and economic provisions, the CARES Act also includes several changes relevant to self-funded health plans. Specifically, the Act clarifies the required benefits for out-of-network COVID-19 testing, expands the list of products eligible for reimbursement from HSA and FSA accounts, authorizes (but does not require) High Deductible Health Plans to cover all telehealth services without cost sharing, and requires that certain health plans cover COVID-19 vaccines within 15 days of availability of an approved vaccine. We have updated our COVID-19 webpage with further details regarding these changes.
Continuation of Health Coverage for Furloughed Employees
MedCost encourages clients who are considering a furlough or other employment action to consult with their legal counsel. Our legal department is available, through your Account Manager, to coordinate with your legal counsel regarding these topics.
If a furlough results in a loss of coverage under the Plan, the employee becomes eligible for COBRA. The determination of when a loss of coverage occurs has not changed. Employers should review their Plan’s provisions regarding coverage, eligibility, and leaves, as well as any applicable company policies for further details.
If a furloughed employee does lose coverage and elects COBRA, an Employer may decide to continue to cover its portion of the premium, thus keeping the employee’s premium cost the same, even while they are on COBRA. For clients utilizing MedCost for COBRA administration, our team is prepared to assist. Please contact your Account Manager for further information.
OptumRx Implements Quantity Limit for Hydroxychloroquine
Hydroxychloroquine has recently been featured in the news as a potential treatment for moderate to severe COVID-19 illness. The use of hydroxychloroquine and chloroquine in COVID-19 is causing increased utilization and risk of drug shortage.
Clients using OptumRx as their PBM should be aware that OptumRx is implementing a quantity limit for hydroxychloroquine to preserve continued supply for chronic users with existing conditions while ensuring access for treatment of COVID-19 when appropriate. This policy goes into effect March 31, 2020.
Hydroxychloroquine will be limited to 30 tablets within a 90-day time period with an automatic bypass for members who have utilized at least a 60-day supply within the past 120 days. Chloroquine will be limited to 30 tablets within a 90-day time period. Members newly starting on hydroxychloroquine for rheumatoid arthritis or systemic lupus will be able to request quantities beyond 30 tablets through a manual override process.
OptumRx will message pharmacists at the point of dispensing to encourage filling for appropriate COVID-19 use.
MedCost Support for Our Clients, Health Plan Members, and Provider Network
While MedCost is supporting our clients as they navigate to ensure the best care for their employees and manage the bottom line, we also are supporting the emerging needs of the provider community as they work to offer the quickest, most effective care for patients. MedCost has communicated to providers that we don’t have the authority to make decisions unilaterally without our clients’ direction. To that end, we will continue to work closely with you to offer additional flexibility and special considerations where we can to support the communities in which we all live and work.
In addition, MedCost continues to collaborate with our valued partners like Teladoc, myStrength, OptumRx and our preferred Stop Loss carriers to support and communicate changes in their processes that may affect you and your members during this pandemic.