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COVID-19 Update: Telehealth Cost-Share Waiver Extended

September 16, 2020

We continue to monitor the COVID-19 pandemic and are committed to helping our employer customers and members stay informed. We have an update to the telemedicine cost-share waiver end date. As always, members should call the number on their ID card for answers to their specific benefit questions. 

  • The cost-share waiver for telehealth will be extended through Dec. 31, 2020

Currently, there is no projected end date for the Office of Superintendent of Insurance (OSI) rule that requires cost-share waiver for COVID-19-related testing and treatment for fully insured and Interagency Benefits Advisory Council (IBAC) members. 

Initiative

Effective Date

Projected End Date

COVID-19 Testing

3/7/20

Cost-share waiver ends with the end of the Health and Human Services (HHS) public health emergency

For fully insured and IBAC members: There is no end date for New Mexico’s rule requiring cost-share waiver for COVID-19-related testing and treatment

COVID-19 Testing-related Visits

3/18/20

Cost-share waiver ends with the end of HHS public health emergency

For fully insured and IBAC members: There is no end date for New Mexico’s rule requiring cost-share waiver for COVID-19-related testing and treatment

Telemedicine

3/18/20

Cost-share waiver is extended through 12/31/20* (The requirements of the OSI will continue to apply to COVID-19-related testing and treatment delivered by telemedicine for fully insured and IBAC members)  

For Medicare (not Part D) and Medicare Supplement plans: Cost-share waiver ends 12/31/20

COVID-19 Treatment

4/1/20

Cost-share waiver ends 10/23/20 (The requirements of the OSI will continue to apply for COVID-19-related testing and treatment for fully insured and IBAC members.)

Interfacility Transfer

4/1/20

9/30/20

Prior Authorization extended on previously approved elective surgeries, procedures, therapies and behavioral health services

Services scheduled between 1/1/20 and 6/30/20

12/31/20

Chest CT Scan

3/2/20

End of HHS public health emergency

*Date change/extension

As we let you know in April, self-funded customers (ASO) who aligned with Blue Cross and Blue Shield of New Mexico (BCBSNM) decisions for fully insured members would continue that alignment unless we were notified.

  • BCBSNM will extend the cost-share waiver for telehealth through Dec. 31, 2020.

What this means for your ASO groups

An ASO account’s prior decision to waive cost-share for telehealth will be extended through Dec. 31, 2020, unless the account makes a request to BCBSNM to end the cost-share waiver.

If your ASO clients would like to make a change from their original decision, please contact your account executive no later than Wednesday, Sept. 23. If you don’t communicate that change by Sept. 23, your client’s decision will continue as currently coded. Change decisions made after Sept. 23  cannot be accommodated for an Oct. 1 effective date.

COVID-19 Testing and the CARES Act

As a reminder, COVID-19 testing and testing-related visits are covered at no cost-share for fully insured and ASO members until the end of the federal public health emergency, as required by the Families First Coronavirus Response Act.