The Louisiana Department of Insurance (LDI) issued Emergency Rule 37, a package of regulations to address COVID-19 issues. The regulation applies to all HMOs, MCOs, PPOs, TPAs, PBMs and all other entities licensed by the LDI. It provides for the following:
For geographic accessibility requirements, the LDI waives plan’s obligations to comply with those requirements except for:
- Emergency services
- Services related to the testing or treatment of COVID-19, and
- Services that have not been ordered postponed by Healthcare Facility Notice #2020-COVID19-ALL-006 on March 18, 2020, and
- Services ancillary to any of the above.
For telemedicine services, plans must:
- Waive limits on the use of audio-only telephone consults in the provision of telemedicine, to the extent allowed by OCR and DHHS guidance;
- Waive coverage limits that would restrict access to providers included in the plan’s telemedicine network;
- Cover mental health services provided via telemedicine, to the extent those services would be covered if they were in person; and
- Waive coverage limits that require provider-to-provider consults and cover telemedicine consults between a patient and a provider, to the extent those services would be covered if they were in person.
For member cost sharing, the plans are directed to evaluate in-network and out-of-network requirements and take appropriate steps to ensure that patients in surge areas are not subject to unreasonable cost-sharing requirements due to access limits.
A copy of the rule is available here:
Written By: Cullen J. Dupuy & Katherine M. Cook