Important information for providers participating in MagnaCare and Create®

As the COVID-19 outbreak and response continues to rapidly develop, we understand many of you have questions.

Please be advised:

March 27, 2020

At MagnaCare and Create (powered by Brighton Health Plan Solutions), we value our provider partners and appreciate all you are doing to care for our communities during this difficult time. As the coronavirus outbreak continues to evolve, we understand you face increasing demands and changes in your workflow, and we are dedicated to giving you the support you need while also supporting our self-funded clients who are also navigating this unprecedented pandemic. Below we share some important news and guidance.

March 18, 2020 Families First Coronavirus Response Act:

President Trump signed into law the Families First Coronavirus Response Act, effective March 18. This new law requires group health plans, regardless of grandfathered status, to waive cost-sharing (including deductibles, copayments, and coinsurance), or prior authorization or other medical management requirements for COVID-19 diagnostic testing, as well as for in-person and telehealth services related to COVID-19 diagnostic testing.

MagnaCare and Create will process claims for services delivered on or after March 18, 2020 in compliance with this new law.

Please note that telehealth visits on or after March 18, 2020 that lead to a COVID-19 diagnostic test will be considered the same as a virtual visit.

Telehealth/Virtual Office Visits:

Telehealth/virtual services unrelated to COVID-19 needs will be covered in accordance with our clients’ benefit plans. Any office visits billed as office visits will continue to be paid as such. While many of our clients cover these services, we are currently working with our self-funded clients who have expressed interest in adding coverage for telehealth/virtual services to their self-funded plan benefits. Please contact our provider call center at 800.352.6465, to confirm coverage of telehealth/virtual services unrelated to COVID-19 diagnostic testing, and for other provider services.

March 20, 2020 NY State Department of Financial Services (DFS) Insurance Circular Letter No. 8 (2020)

We are working closely with all of our clients to adjust to the changing needs of this pandemic. We are adhering to the guidelines in the March 20th NY DFS Circular Letter for our fully insured business. We are also sharing with our self-funded clients the NY DFS recommendations, which the NY DFS has encouraged but not mandated self-funded plans to implement. All decisions are at the sole discretion of our self-funded clients. Please contact our provider call center at 800.352.6465 with any questions.

As you dedicate yourself to the frontline to protect our communities, we wish you good health. Thank you for your partnership and your commitment to serving our clients and the health care needs of their members during this public health crisis.

We will continue to serve as a resource for information. Please check back here for any updated guidance. Stay safe.

Thank you,

Rondi Rabuse, President of Network

Brighton Health Plan Solutions

Powering MagnaCare and Create®