COVID-19 Updates for Providers

As a reminder, we encourage you to visit the COVID-19 page on our provider website to access resources designed to aid you in conducting operations during the pandemic, including any updates on COVID-19-related coverage, policies, and procedures; our COVID-19 coding grid; and our Interim Telemedicine and Telehealth Payment Policy.

Recent updates to the COVID-19 page include:

  • Quantity limits for Ivermectin — Ivermectin is not approved by the Food and Drug Administration (FDA) for the prevention of treatment of COVID-19. Effective beginning Oct. 7 for Harvard Pilgrim commercial members, dispensing of Ivermectin oral tablets is limited to 20 tablets within 90 days. Requests to exceed quantity limits will only be approved for FDA-approved indications or those supported by compendia; requests to exceed quantity limitations for experimental or investigational use will be denied.
  • COVID-19 Antibody Test Medical Policy — Harvard Pilgrim has published COVID-19 Antibody Test guidance for providers. In order to be considered medically necessary, COVID-19 antibody testing must be ordered by the member’s treatment physician or appropriately licensed care professional; the test must be FDA approved or have FDA emergency use authorization; and the test must be necessary to make decisions required to treat a members’ immediate medical condition. For complete information, please refer to the COVID-19 Antibody Test Medical Policy.
  • Massachusetts Bulletin 2021-08 — Harvard Pilgrim will continue to waive cost-sharing for COVID-19 treatment for Massachusetts commercial members in accordance with Massachusetts Division of Insurance Bulletin 2021-08.Please continue to let us know how we can support you by contacting the Provider Service Center at 800-708-4414 or your Provider Relations Consultant or Contract Manager as appropriate.

Please continue to let us know how we can support you by contacting the Provider Service Center at 800-708-4414 or your Provider Relations Consultant or Contract Manager as appropriate.


Publication Information

Annmarie Dadoly,
Editor

Joseph O’Riordan,
Writer

Kristin Edmonston,
Production Coordinator