<h2>COVID-19 INFORMATION FOR TOP PROVIDERS</h2>
<p>{showimage=/cms/delivery/media/MCI4NU4EW3AVEA5FQMM6PWCJP7GU:}</p>
<p>For COVID-19 Beneficiaries Information, Click {contentlink=/beneficiaries/resources/COVID-19:here}</p>
<h4>Temporary Coverage of Investigational Drugs for Treatment of COVID-19</h4>
<p>In response to the COVID-19 pandemic, the Defense Health Agency (DHA) has temporarily covered treatment use of investigational drugs under expanded access when for the treatment of COVID-19 and its associated sequelae. This change permits coverage of the investigational drug itself (i.e., the drug itself will now be able to be cost-shared), when for the treatment of COVID-19 or its associated sequelae, in settings approved by the U.S. Food and Drug Administration (FDA) under expanded access (coverage in clinical trial settings continues to be excluded). This coverage will be applied by International SOS in overseas locations for drugs without formal marketing approval when International SOS determines that such usage meets criteria substantially similar to FDA requirements for treatment use of investigational new drugs under this criteria. This change is no longer applicable upon expiration of the President’s declared national emergency for the COVID-19 pandemic. For treatment use of investigational drugs provided by any overseas provider, these provisions are effective March 10, 2020, and will expire upon conclusion of the COVID-19 pandemic, as determined by the Assistant Secretary of Defense for Health Affairs.</p>
<h4>Temporary Coverage of NIAID-Sponsored Clinical Trials for the Treatment or Prevention of COVID-19</h4>
<p>Effective October 30, 2020, TRICARE regulations were temporarily changed to add coverage of clinical trials for the treatment or prevention of COVID-19 or its associated sequelae, {fontweight=500:if the U.S. National Institute of Allergy and Infectious Disease (NIAID) is either the trial sponsor or trial collaborator.} Coverage for COVID-19 clinical trials will last through the end of the President’s declared national emergency for the COVID-19 pandemic. </p>
<p>TRICARE will cost-share all medical care required as a result of participation in NIAID-sponsored studies, including necessary follow-up care and testing that takes place after the period of active treatment on protocol is completed. This includes purchasing and administering all approved pharmaceutical drugs (except for the NIAID-funded investigational agents) and all inpatient and outpatient care, including diagnostic, laboratory, rehabilitation, and home health services not otherwise reimbursed under an NIAID grant program, if the following conditions are met:</p>
<ul>
<li>The patient continues to meet entry criteria for said protocol;</li>
<li>The institutional and individual providers are TRICARE-authorized providers.</li>
<li>In addition to the above requirements, the following conditions must be met for participation in Phase I COVID-19 clinical trials. Attending physician, Primary Care Manager (PCM), or specialist referral to the trial, and the beneficiary’s subsequent acceptance to the trial fulfill these requirements.</li>
<li>Standard treatment has been or would be ineffective, does not exist, or there is no superior non-investigational treatment alternative. </li>
<li>The available clinical or preclinical data provide a reasonable expectation that the treatment will be at least as effective as the non-investigational alternative. </li>
<li>The facility and personnel providing the treatment are capable of doing so by virtue of their experience, training, and volume of patients treated to maintain expertise.</li>
<li>The beneficiary’s participation in such a trial would be appropriate based upon the satisfaction of the above criteria.</li>
</ul>
<h4>Interim Authorization for Billing and Reimbursement of In Vitro COVID-19 Tests for Asymptomatic ADSMs</h4>
<p>TRICARE has authorized the billing and reimbursement of Food and Drug Administration (FDA)-approved COVID-19 in vitro diagnostic tests, using Reverse Transcription Polymerase Chain Reaction (RT-PCR) for asymptomatic Active Duty Service Members (ADSMs). These tests {fontweight=500:must be} ordered by a TRICARE-Authorized Provider and require a {fontweight=500:specific referral under the Supplemental Health Care Program (SHCP),} which needs to be coordinated closely with the ADSM’s Primary Care Managers (PCMs) and TRICARE-Authorized Providers overseas. {fontweight=500:Note:} The lack of FDA-regulated tests outside of the U.S. is a unique situation, and providers are authorized to follow the established guidelines/standards of care for COVID-19 testing for the country, host-nation, and/or regional health authority (e.g., World Health Organization), where the patient is treated. {fontweight=500:Coverage for these tests has been extended until the Defense Health Agency (DHA) determines the interim authorization is no longer necessary.} Providers should use CPT code 87635 or subsequent codes, if renumbered. Please {fontweight=400;contentlink=/contact-us:contact} your TOP Regional Call Center if you have any questions or need assistance.</p>
<h4>Provider Operating Hours</h4>
<p>International SOS understands that Providers may need to close their practice or adjust their services and/or operating hours due to the ongoing Coronavirus (COVID-19) pandemic. We also understand that circumstances and guidelines may change rapidly and often with short notice. If there will be a critical change in your operations, please notify International SOS as soon as possible by {contentlink=/contact-us:contacting} your TOP Regional Call Center (listen carefully to the prompts for the best option to serve you) to speak with a member of the TOP Provider Support Services (TPSS) team.</p>
<h4>TRICARE Waives Copayments, Cost Shares and Deductibles for Medically Necessary COVID-19 Testing</h4>
<p>TRICARE is waiving copayments, cost shares, and deductibles for medically necessary COVID-19 diagnostic testing and associated services and supplies, retroactive to March 18, 2020. If you have already been tested, you can file a claim for reimbursement. Not all testing is considered medically necessary. For more information, visit <a href="https://www.tricare.mil/Costs" target="_blank">tricare.mil/costs </a>or <a href="https://www.tricare.mil/HealthWellness/HealthyLiving/Coronavirus" target="_blank">TRICARE's COVID-19 Guidance Page</a>. Note: COVID-19 diagnostic testing and associated services and supplies must follow host nation guidelines. Please {contentlink=/contact-us:contact} your TOP Regional Call Center if you have any questions or need assistance.</p>
<h4>Temporary Uniform Service ID Card Policy Changes</h4>
<p>Due to COVID-19’s impact on travel and access to military installations, the U.S. Department of Defense (DOD) has made temporary modifications to Uniform Service ID card policies. TOP Network or Non-Network Providers are asked to accept and honor beneficiary Uniform Service ID cards that expired between January 1, 2020 and July 31, 2021 only, through:</p>
<ul>
<li>August 31, 2021 for all Foreign Affiliates and their dependents;</li>
<li>October 31, 2021 for dependents of Active Duty Uniformed Service members, and for Reserve and National Guard Uniformed Service members and their dependents; and </li>
<li>January 31, 2022 for Retirees and their dependents, and all other populations.</li>
</ul>
<p>Uniform Service ID cards that expired before January 1, 2020 or after July 31, 2021 have not been extended and will not be accepted. Please note that the minimum age for initial child ID card issuance has been raised from 10 to 14. If you have any questions or need assistance verifying a beneficiary’s eligibility for TRICARE covered services, please {contentlink=/contact-us:contact} your TOP Regional Call Center and listen carefully to the prompts for the best option to serve you.</p>