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Coronavirus Resources

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Coronavirus disease 2019 (COVID-19) is an emerging illness.  Many details about this disease are still unknown, such as treatment options, how the virus works, and the total impact of the illness.  New information, obtained daily, will further inform the risk assessment, treatment options and next steps.  We always rely on our provider partners to ensure the health of our members, and we want you to be aware of the tools available to help you identify the virus and care for your patients during this time of heightened concern.

Important Update: Temporary Medicaid Plan Waivers Expiring July 1, 2021

Important Update: Temporary Medicare Plan Waivers Expiring July 1, 2021

Temporary Medicaid Plan Waivers Expiring for Applicable COVID-19 Treatment and Telehealth Services on July 1, 2021

As we continue to address the COVID-19 pandemic, we want to update you on important changes for our Medicaid plans. Last year, we instituted temporary prior authorization waivers for select services to ensure critical care could be quickly delivered to our members during a time of heightened need. On July 1, 2021, these temporary waivers will expire and our members’ Medicaid plan benefits will be reinstated for the following services:

COVID-19 Treatment Related Services

  • COVID-19 treatment related services (those billed with a confirmed ICD-10 diagnosis code) will continue to be eligible for coverage at this time, in accordance with the member’s plan benefits.
  • Beginning July 1, 2021, prior authorization will be required for COVID-19 treatment related services, in accordance with CMS guidance and plan benefits.

Telehealth Services

Prior authorization requirements will continue to be waived for COVID-19 testing, screening services and vaccinations.

We continue to work in close partnership with state, local and federal authorities to serve and protect our members and communities during the COVID-19 pandemic, including ensuring that our providers have relevant and up-to-date information. We value your partnership during these unprecedented times.

This guidance is in response to the current COVID-19 pandemic and may be retired at a future date.

Temporary Medicare Plan Waivers Expiring for Applicable COVID-19 Treatment and Telehealth Services on July 1, 2021

As we continue to address the COVID-19 pandemic, we want to update you on important changes for our Medicare plans. Last year, we instituted temporary member cost share liability and prior authorization waivers for select services to ensure critical care could be quickly delivered to our members during a time of heightened need. On July 1, 2021, these temporary waivers will expire and our members’ Medicare plan benefits will be reinstated for the following services:

COVID-19 Treatment Related Services

  • COVID-19 treatment related services (those billed with a confirmed ICD-10 diagnosis code) will continue to be eligible for coverage at this time, in accordance with the member’s plan benefits.
  • Beginning July 1, 2021, prior authorization will be required for COVID-19 treatment related services in accordance with CMS guidance and plan benefits.
  • Providers should also resume collecting Medicare member liability at the point of service for applicable treatment related services on July 1, 2021 onward.

Telehealth Services

  • Any services that are not otherwise restricted and can be delivered virtually will continue to be eligible for telehealth coverage at this time.
  • Beginning July 1, 2021, prior authorization requirements will be reinstated for applicable services delivered via telehealth.
  • Providers should also resume collecting Medicare member liability at the point of service for all telehealth services on July 1, 2021 onward, in accordance with the member’s plan benefits.
  • Providers should reflect telehealth care on their claim form by following standard telehealth billing protocols in their state.
  • For further coding guidance for telehealth services, we recommend following what is being published by:

Prior authorization requirements and member cost share liability (copayments, coinsurance and/or deductible cost share amounts) will continue to be waived for COVID-19 testing, screening services and vaccinations.

We are working in close partnership with state, local and federal authorities to serve and protect our members and communities during the COVID-19 pandemic, including ensuring that our providers have relevant and up-to-date information. We value your partnership during these unprecedented times.

This guidance is in response to the current COVID-19 pandemic and may be retired at a future date.

 

COVID-19 Public Health Emergency Extended by Federal Government in to 2021

On October 5, 2020, HHS Secretary Alex Azar renewed the COVID-19 Public Health Emergency. This extends flexibilities and funding tied to the public health emergency (PHE) to continue through January 21, 2021.

With this renewal the various testing, screening, billing, and telehealth coverages that were implemented in response to the COVID-19 Public Health Emergency earlier this year will be extended to Trillium members through late January, until the PHE is either terminated or extended again. This extension does not affect Trillium's additional Medicare coverages that are set to expire on December 31, 2020.

In accordance with this extension, Trillium has updated its information and guidance for COVID-19-related information posted on this page.

If you have any questions about this extension or the covered benefits impacted by it, please contact Provider Services at 1-877-600-5472 (TTY: 711) for Trillium OHP or 1-844-867-1156 (TTY: 711) for Trillium Advantage.

Guidance:

  • Know the warning signs of COVID-19. Patients with COVID-19 have reported mild to severe respiratory symptoms. Symptoms include fever, cough, and shortness of breath. Other symptoms include fatigue, sputum production, and muscle aches.  Some individuals have also experienced gastrointestinal symptoms, such as diarrhea and nausea, prior to developing respiratory symptoms.  
  • However, be aware that infected individuals can be contagious before symptoms arise. Symptoms may appear 2-14 days after exposure.
  • Instruct symptomatic patients to wear a surgical or isolation mask and promptly place the patient in a private room with the door closed.
  • Health care personnel encountering symptomatic patients should follow contact precautions, airborne with N95 precautions, and wear eye protection and other personal protective equipment.
  • Refer to the CDC’s criteria for a patient under investigation for COVID-19.  Notify local and/or state health departments in the event of a patient under investigation for COVID-19.  Maintain a log of all health care personnel who provide care to a patient under investigation.
  • Monitor and manage ill and exposed healthcare personnel.
  • Safely triage and manage patients with respiratory illness, including COVID-19.  Explore alternatives to face-to-face triage and visits as possible, and manage mildly ill COVID-19 cases at home, if possible. 

Take Action:

  1. Be alert for patients who meet the criteria for persons under investigation and know how to coordinate laboratory testing.
  2. Review your infection prevention and control policies and CDC's recommendations  for healthcare facilities for COVID-19.
  3. Know how to report a potential COVID-19 case or exposure to facility infection control leads and public health officials.  Contact your local and/or state health department to notify necessary health officials in the event of a person under investigation for COVID-19.
  4. Refer to the Centers for Disease Control and Prevention (CDC) and the World Health Organization for the most up-to-date recommendations about COVID-19, including signs and symptoms, diagnostic testing, and treatment information.
  5. Be familiar with the intended scope of available testing and recommendations from the FDA.

Last Updated 5.15.2020