Blue Cross Blue Shield of Massachusetts Takes Steps to Help Expand Inpatient Capacity During Coronavirus Pandemic
BOSTON, March 25, 2020 /PRNewswire/ -- To facilitate inpatient capacity across the health care system during the COVID-19 state of emergency, Blue Cross Blue Shield of Massachusetts ("Blue Cross") has removed prior authorization requirements and moved to a notification-only requirement for inpatient levels of care including Acute, Long Term Acute (LTAC), Acute and Subacute Rehabilitation (Rehab), and Skilled Nursing Facility (SNF) admissions. Medical necessity reviews will not be performed for these inpatient levels of care through June 23, 2020. Notifications by facilities will allow Blue Cross nurses to assist members during their care transitions, including to the home.
Additionally, if a member is being evaluated or treated for suspected or confirmed COVID-19, Blue Cross will remove all referral and authorization requirements for outpatient care. This applies to in- and out-of-network providers and also to face-to-face and telehealth/virtual/telephonic visits.
"We want to decrease the administrative burden on clinicians as they're faced with this unprecedented public health challenge," said Bruce Nash, MD, chief physician executive and senior vice president of health and medical management at Blue Cross. "These additional steps we've taken will support care teams in establishing an appropriate treatment plan for each patient, while preserving availability of necessary inpatient care for all patients."
Blue Cross has also taken the following steps to expedite access to care and testing related to COVID-19 for duration of the Massachusetts declared public health emergency:
- Covering all medically necessary covered services with in-network providers, via phone (telephonic) or virtually (telehealth), at no cost to members.
- Waiving member cost share (co-pays, co-insurance and deductibles) for medically necessary COVID-19 testing, counseling, vaccines (when available) and treatment at doctor's offices, urgent care centers and emergency departments, in accordance with the Centers for Disease Control and Massachusetts Department of Public Health guidelines. Any medically necessary treatment for COVID-19 is covered under a member's health plan within the United States or internationally.
- Removing any administrative barriers, such as prior authorizations and referrals, for medically appropriate treatment for COVID-19.
- Increasing access to prescription medications. Members have access to early refills of their prescription maintenance medications. We will ensure formulary flexibility if there are shortages or access issues.
- Staffing and promoting a dedicated member help line (888-372-1970) for all COVID-19 related inquiries, as well as our 24/7 nurse hotline (888-247-2583), which is available free to all members and offers a safe and convenient clinical resource for minor ailments or questions.
In an effort to keep members informed, the company has launched a regularly updated resource center that includes information about how to stay safe, a downloadable tip sheet for employers, a video featuring a Blue Cross physicians, and answers to frequently asked questions. In addition, Blue Cross' health news site, Coverage, produces timely, original news articles reporting what health consumers need to know about COVID-19.
About Blue Cross Blue Shield of Massachusetts
Blue Cross Blue Shield of Massachusetts (www.bluecrossma.com) is a community-focused, tax-paying, not-for-profit health plan headquartered in Boston. We are committed to the relentless pursuit of quality, affordable health care with an unparalleled consumer experience. Consistent with our promise to always put our members first, we are rated among the nation's best health plans for member satisfaction and quality. Connect with us on Facebook, Twitter, YouTube, and LinkedIn.
SOURCE Blue Cross Blue Shield of Massachusetts
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