OPM Urges FEHBP Insurers to Reduce Costs for Coronavirus Treatment

The Office of Personnel Management said Friday that it is urging insurers minimize the cost to federal employees and retirees enrolled in the federal government’s health insurance program for treatments related to the novel coronavirus.

Last week, House Homeland Security Committee Chairman Rep. Bennie Thompson, D-Miss., sent a letter to the leadership of the Homeland Security and Health and Human Services departments asking them to clarify how they would implement portions of President Trump’s European travel ban and other coronavirus response efforts. Thompson also asked about financial protections for federal workers who contract or are suspected to have contracted COVID-19, citing Trump’s claim that the insurance industry has agreed to waive copays and other treatment costs in connection with the virus.

“The president also announced [last week] that he had ‘met with the leaders of [the] health insurance industry, who have agreed to waive all copayments for coronavirus treatments, extend insurance coverage to these treatments, and to prevent surprise medical billing,’” Thompson wrote. “However, media reports indicate that, in fact, insurance companies may not be waiving copayments for coronavirus treatments. It is also unclear whether copayments or other out-of-pocket costs for coronavirus treatment will be waived for federal employees—such as Transportation Security Officers and other employees of the Department of Homeland Security—who contract COVID-19 as part of their official duties and who receive insurance through the Federal Employees Health Benefits Program.”

On Friday, the Office of Personnel Management told Government Executive that it is urging insurers that participate in FEHBP to take a number of steps to reduce the cost to federal workers and retirees associated with the testing for and treatment of the coronavirus. That includes efforts to eliminate out-of-pocket costs for treatment in-network, and the reduction of costs out-of-network, but the agency apparently stopped short of urging a copay waiver.

“OPM has sent a letter to FEHB program carriers. In this letter we have encouraged carriers to ensure in-network access to members who require treatment for COVID-19 disease or to consider authorizing access to out-of-network services with in-network cost sharing,” said OPM spokesman Dan Marucci. “We have requested implementation of solutions so that out-of-pocket costs are not a barrier to people seeking testing for COVID-19, including waiving cost sharing for testing and telemedicine/telehealth visits.”

Marucci noted that OPM’s efforts could expand as the nature of the outbreak evolves.

“We will continue to work with the FEHB program barriers as this situation evolves to ensure that federal employees and annuitants have access to quality coverage and necessary services/care during this challenging time,” he said.