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Archive for Items Categorized 'Compliance'

Public Health Emergency To End May 11, 2023

From Blue Cross Blue Shield of Arizona

During the COVID-19 federal Public Health Emergency (PHE), Blue Cross® Blue Shield® of Arizona (BCBSAZ) aligned with the Centers for Medicare and Medicaid Services (CMS) expanded health benefit coverage guidelines, such as covering COVID-19 testing and testing-related services at no out-of-pocket cost. 

As the incidence of COVID-19 cases has diminished, CMS announced May 11, 2023, end to the PHE. Effective May 11, 2023, BCBSAZ benefits will return to standard benefit provisions. 

What this means for Blue Cross Blue Shield of Arizona Customers:

COVID-19 testing and testing-related services (including telehealth visits for these services) will return to the standard benefit. Depending on your client’s benefit plan, they may have cost-share responsibilities.

Over-the-counter COVID-19 test costs will no longer be reimbursed.

Standard requirements for pre-service review of COVID-19 testing, treatment, and admissions to post-acute care facilities will be reinstated.

Approved COVID-19 vaccines will be covered as preventive services with no out-of-pocket costs when obtained in-network. Out-of-network (OON) vaccines will incur standard OON charges. 

If you have questions regarding your plan’s standard benefits, please consult your benefit booklet on your online member portal at azblue.com/MyBlue

Reminder: Medicare Part D Disclosures due by March 1, 2022 for Calendar Year Plans

Group health plan sponsors are required to complete an online disclosure
form with the Centers for Medicare & Medicaid Services (CMS) on an annual basis and at other select times, indicating whether the plan’s prescription drug coverage is creditable or non-creditable.

This disclosure requirement applies when an employer-sponsored group
health plan provides prescription drug coverage to individuals who are
eligible for coverage under Medicare Part D.

The plan sponsor must complete the online disclosure within 60 days after
the beginning of the plan year. For calendar year health plans, the deadline
for the annual online disclosure is March 1, 2022.

To determine whether the CMS reporting requirement applies, employers
should verify whether their group health plans cover any Medicare-eligible
individuals (including active employees, disabled employees, COBRA
participants, retirees, and their covered spouses and dependents) at the start of each plan year