Insurance Commissioner Issues Emergency Rules to Deal With Pandemic Fallout

BATON ROUGE – Louisiana Commissioner of Insurance Jim Donelon on Tuesday announced a temporary mandate requiring insurers to cover post-transfer expenses for recovering COVID-19 patients.

It’s one of several emergency rules the department has issued since Gov. John Bel Edwards declared a statewide public health emergency on March 11.

“Louisiana’s hospitals are on the front line of the fight against the COVID-19, and this order requires insurers to cover post-transfer stays in step-down facilities,” Donelon said. “These existing private health care facilities are being prepared to receive patients from acute care hospitals and increase the availability of beds for COVID-19 patients.”

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Under the rule, patients will pay the same cost-sharing amount in the “step-down” facility that they would have paid had they remained in the acute care hospital. The rule is meant to ensure transfers can occur smoothly and without disrupting facility reimbursement, the insurance department says.

Edwards on Tuesday said a makeshift 1,000-bed step-down facility at the Ernest N. Morial Convention Center in New Orleans will be ready by Sunday, with 1,000 more beds to be added later in the month. The facility will provide care for recovering COVID-19 patients and open up hospital beds for patients with more critical needs, Edwards said.

Donelon has announced a total of six emergency rules in response to the COVID-19 pandemic. A brief summary of the other five:

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March 19: Requires insurers to cover COVID-19 testing without cost sharing. Permits early drug refills and prohibits the use of step therapy, whereby insurers make members try cheaper drugs first before moving up to more expensive medications.

March 23: Loosens restrictions on telemedicine services by, for example, making insurers cover mental health services via telemedicine to the extent they would be covered in-person, except for treatments not appropriate for remote delivery. Requires insurers to evaluate their out-of-network cost sharing to ensure patients “are not unreasonably charged extra” if in-network access becomes limited during the emergency.

March 26: Sets up guidelines for temporary licensing of insurance producers to address the interruption of licensing exams and fingerprint submissions by the governor’s “stay at home” order.

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March 27: Gives businesses the right to demand a “mid-term self-audit” of their commercial policies to see if the policy’s premiums should be reduced based on current factors. The rule is meant to help shuttered or limited businesses that now have lower exposure and could use the extra cash to maintain or restart operations.

March 27: Places a moratorium on policy cancellations and non-renewal by insurers, without absolving consumers or businesses of their ultimate responsibility to pay premiums. Says no policy can be canceled or non-renewed because of a claim that is filed during this emergency.

 

By David Jacobs of the Center Square

 

 

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