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The DC Chamber is Sharing the Below Information from our Circle Partner CareFirst BlueCross BlueShield


As this health crisis progresses, CareFirst continues to work to ensure we are doing all we can to rapidly address the complexities and urgent challenges our communities face as a result of COVID-19.

​Below is information on the actions that we have taken to date to help ensure that our members, our accounts, and health care delivery system, and communities are able to battle this crisis.

Changes to Coverage:

  • Covering testing, visits relating to testing, and treatment of COVID-19 at zero cost share - that is, without copays, coinsurance, or deductibles.

  • Enhanced coverage of virtual visits to ensure members and providers continue to have access during this challenging time.

  • Zero cost share access for all telehealth visits to in-network providers for medically appropriate services. Physicians and other health care professionals who conduct video visits are reimbursed at the same level as an in-network visit for these telehealth visits.
  • Zero cost share access to CareFirst Video Visit.  
  • Temporarily reimbursing for telephonic consultations provided by physicians and nurse practitioners for primary, OB/GYN, family practice, and pediatrics.
  • Temporarily reimbursing behavioral health providers for phone calls

  • Waived early medication refill limits on 30-day prescription maintenance medications and have worked with our pharmacy partners to provide free delivery of medications and assist with mailing prescriptions.

All of these changes apply to our fully insured members, and we are working with our self-insured plan sponsors to encourage similar policies.
 
Support and Flexibility for our Members and Accounts :

  • Last week, we announced financial flexibility for our risk members and groups that are experiencing economic hardship. CareFirst customers can request a deferral of up to two months of premium with due amounts carried forward with no interest or penalty. The deferred premium would be satisfied over time through scheduled periodic payments.

Changes to Relieve Administrative Burden on Health Care System:

  • No prior authorizations for tests or treatments that are medically necessary and consistent with CDC guidance for members diagnosed with COVID-19.
 
  • Adjusted several utilization management policies and practices to reduce administrative burdens on the healthcare system and have relaxed our authorization requirements for hospital admissions, surgeries, and hospital transports. In addition, we are honoring prior authorizations for elective surgeries for a period of up to 12 months, contingent on member eligibility. 
 
  • Expanded the scope of our contracted lab partners to support access to COVID-19 testing.

Supporting the Health Care Delivery System:

  • Built a web resource for members, businesses, health care providers, and other community members who may have questions about COVID-19, which can be accessed at www.carefirst.com.

  • To extend the reach of our provider community, we are contacting CareFirst’s most vulnerable and at-risk members to better prepare them to navigate the COVID-19 pandemic. Members have been identified based on their clinical conditions, demographics, age, core target status, social vulnerability index score, and several other factors, across all lines of business, geographies, and PCMH attribution status. We identified over 160,000 members living in all 50 states with demonstrated health risks high enough to place them on the CareFirst outreach list. To date, our nurses have conducted 15,000 outbound calls with a 40% reach rate. Support, education, assistance with community resources and securing appropriate supplies of medications have been key priorities. These efforts are ongoing.

  • Developed a data tool to support local health departments and hospitals. To support local health departments and hospital resources in the identification and analysis of populations at higher risk to the effects of COVID-19, as well as ongoing surge readiness and management, CareFirst has utilized health indicators and member data to develop an interactive web-based resource. This tool and accompanying resource support have been made available to every hospital and health department in the region. I have attached a static sample of this tool.

  • Volunteer Assistance: As hospitals are reaching capacity at an alarming rate and demand for medical professionals substantially increases across the region, we have implemented a paid volunteer program that offers licensed nurses and behavioral health clinicians working at CareFirst the opportunity to volunteer their services to support direct patient care.

Supporting Our Community:
  • We are taking aggressive action to support the community at large. We announced a $2 million investment in nonprofit organizations working on the front lines to provide relief for communities’ health, social and economic needs that may arise during the COVID-19 pandemic. The funds will help close gaps in medical care access, minimize food insecurity and support the needs of populations disproportionately impacted during the crisis.
  • We’ve worked with the Baltimore Sun to take the paywall away from coronavirus and COVID-19 coverage through May 15.

As a not-for-profit healthcare company, we are committed to continuing this work and identifying new ways to fulfill our mission and work to assist our members, our accounts, our communities and the health care delivery system through this crisis. 

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