California Department of Managed Health Care All Plan Letter 22-017 on the coverage of COVID-19 therapeutics

On June 14, 2022, the California Department of Managed Health Care (DMHC) issued All Plan Letter 22-017 to provide guidance on how commercial health plans are expected to comply with requirements to cover COVID-19 therapeutics.

 

This article is to inform network providers that at Anthem Blue Cross (Anthem), COVID-19 therapeutics are covered services when medically necessary to treat an enrollee.

 

Anthem follows guidance issued by the federal Department of Health and Human Services, the National Institutes of Health, and the CDC regarding COVID therapeutics that can be effective when administered within five to seven days of the onset of symptoms. Accordingly, Anthem considers access to COVID-19 therapeutics an urgently needed service. To ensure that enrollees for whom a COVID-19 therapeutic is medically necessary have access to these treatments and are given treatment as soon as possible, Anthem has waived any prior authorization requirements with respect to COVID-19 therapeutics.

 

Providers may visit Anthem’s Provider Communications site for updates on COVID-19.

 

More Information on COVID-19 therapeutics

The California Department of Public Health (CDPH) recently issued a COVID-19 Test-to-Treat Playbook. The playbook provides valuable information regarding COVID-19 therapeutics and outlines best practices for providers and others regarding prescribing, as well as provides resources for educating patients regarding therapeutics. You can find the playbook on the CDPH website.

 

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