Tuesday, March 17, 2020
Insurance Bulletin #210 (Revised)
This bulletin is intended to ensure that health insurance plans regulated by the Department of Financial Regulation continue to provide access to prescription drugs during the COVID-19 pandemic. This bulletin applies to health insurers, as that term is used in 18 V.S.A. § 9402, and pharmacy benefit managers, as that term is used in 8 V.S.A. § 4089j.
On March 13, 2020, the State of Vermont declared a state of emergency related to COVID-19, among other things. The declaration was amended on March 15, 2020 to forbid gatherings of more than 50 people. Governor Scott, in issuing the declaration, highlighted the importance of Vermonters, particularly those at heightened risk of severe symptoms of COVID-19, minimizing close contact with others.
- In order to minimize the need for Vermonters to physically visit pharmacies, the Department is directing insurers to make at least a 30-day supply of medication available to members refilling their prescriptions.
- The Department encourages, but does not require, that insurers make available a larger-than-30-day supply when appropriate.
- Narcotic and specialty medications, as well as short-term prescriptions (such as antibiotics), shall continue to be subject to each insurer’s standard refill policy.
- The Department encourages insurers and PBMs to work with retail pharmacies to offer home delivery services and to expand use of mail-order pharmacy services.
- Insurers and PBMs are reminded that under 8 V.S.A. § 4089j, retail pharmacies must be permitted to fill prescriptions in the same manner and at the same level of reimbursement as mail-order pharmacies.
If patients need assistance picking up prescription medications, please contact your local pharmacy for assistance.
This bulletin expresses the view of the Commissioner until May 13, 2020 unless extended or modified by the Commissioner.
Michael S. Pieciak, Commissioner
March 17, 2020