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CMS to Allow COVID-19 Care Coverage on Catastrophic Plans

On March 18, 2020, the Center for Medicare and Medicaid Services (CMS) issued FAQs announcing that it would not take enforcement action against any health issuers that revises its catastrophic plan to permit pre-deductible no cost-sharing coverage for COVID-19 related care.

Prior to this announcement, catastrophic plans were prohibited from providing pre-deductible coverage for essential health benefits. To assist in the diagnosis and treatment of COVID-19, until further notice, catastrophic plans may cover COVID-19 related care before the participant meets his or her deductible.

Typically, a health issuer cannot revise its product coverage mid-year, but to facilitate the response to coronavirus, the Department of Health and Human Services (HHS) is also suspending enforcement action for mid-year product changes related to the diagnosis and treatment of COVID-19. This relief, however, does not apply to health issuers to make other non-COVID-19 changes to offset the cost of increasing COVID-19 benefits.

For more information on evolving compliance regulations in the wake of the COVID-19 pandemic, visit our OneDigital Coronavirus Advisory Hub, or reach out to your local OneDigital advisory team.

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