Caremark: COVID-19 FAQs and resources

At CVS Caremark, our top priority is providing our members timely, safe access to their medications. Towards that end, we are working side-by-side with our pharmacy benefit management clients — employers, health plans, government agencies and other payors — to maintain continuous service throughout the COVID-19 pandemic.

    Steps we have taken
     

    • We have eased early refill restrictions on 30-day prescription maintenance medications and are reminding members of plan options such as free home delivery of 90-day supplies from CVS Caremark Mail Service Pharmacy.

    • Understanding that it may be harder for members to visit their health care providers during the COVID-19 outbreak, we are extending previously-approved prior authorizations for most medications set to expire before June 30. For example, if a current prior authorization is set to expire on May 15, the expiration date will be extended to August 15. This will not only provide our members peace of mind, but also help to reduce the volume of phone calls and other administrative burdens on physicians’ offices and pharmacies.

    Securing the drug supply chain
     

    We are committed to filling prescriptions for plan members in a timely way.

    • We continue to closely monitor the global manufacturing environment. At this time, we do not see any disruptions to the supply chain, as a result of COVID-19, that will affect our ability to fill prescriptions.

    • We will continue to use analytics to monitor usage trends so that we can anticipate, and adjust to, future needs well in advance.

    • We are working with clients to implement new measures to balance the burgeoning interest in off-label use of certain medicines to treat COVID-19 pneumonia with the ongoing needs of members who use these drugs for chronic conditions. With client consent, we are setting appropriate limits on the quantity of these medicines — hydroxychloroquine, azithromycin, one protease inhibitor and albuterol inhalers — for potential use in treating COVID-19. Members who already take these medicines for approved uses, including treatment of lupus, rheumatoid arthritis, HIV and asthma, will be able to bypass the new quantity limits.

    Medication access
     

    The CDC encourages people to stay at home as much as possible. CVS Health provides convenient options to avoid visiting the pharmacy for refills or new prescriptions.

    CVS Caremark is working with all PBM clients to waive early refill limits on 30-day prescription maintenance medications.

    Read more about how CVS Health is working to ensure medication access for patients.

    Ensuring business as usual
     

    We are minimizing the number of people in our CVS Caremark Mail Service Pharmacy and CVS Specialty pharmacy locations to enable greater social distancing in an effort to keep them safe.

    • We are encouraging colleagues whose roles enable virtual work to work from home, while making changes in scheduling and infrastructure to support social distancing for colleagues whose roles require them to work on-site.

    • We are working with government agencies and regulatory bodies to make it possible for our pharmacists to work remotely.

    At CVS Caremark, we will continue to provide the best possible service to help ensure that our members have timely, safe access to their medications.

    Frequently asked questions (FAQ)

    How can I continue to access my medications through CVS Caremark or CVS Specialty?

    Despite the uncertainty surrounding COVID-19, our goal is to ensure members have timely, safe access to their medications.

    • Effective June 15, select clients elected to continue to waive early refill limits on most 30-day prescription maintenance medications and encourage plan members to take advantage of 90-day benefits where applicable.

    • Understanding that it may be harder for members to visit their health care providers during the COVID-19 outbreak, we are working with clients to extend previously approved prior authorizations for most medications set to expire before June 30. For example, if a current prior authorization is set to expire on May 15, the expiration date will be extended to August 15. This will not only provide members peace of mind, but also help to reduce the volume of phone calls and other administrative burdens on physicians’ offices and pharmacies.

    • Members can access free home delivery of prescriptions from CVS Caremark Mail Service Pharmacy. We are also encouraging clients to work with their account teams to take advantage of these tools to help improve member access.

    • CVS Specialty patients can have their medications delivered to their homes with no delivery charge. Patients with chronic and complex conditions also can get support for their unique needs from our specially trained nurses and clinical pharmacists, using secure messaging online or through our CVS Specialty app.

    How is CVS Caremark helping protect supply of medicines potentially useful for COVID-19 treatment?

    We are working with clients to implement new measures to balance the burgeoning interest in off-label use of certain medicines to treat COVID-19 pneumonia with the ongoing needs of members who use these drugs for chronic conditions. With client consent, we are setting appropriate limits on the quantity of these medicines — one protease inhibitor and albuterol inhalers — for potential use in treating COVID-19. Members who already take these medicines for approved uses, including treatment of lupus, rheumatoid arthritis, HIV and asthma, will be able to bypass the new quantity limits.

    If I opt into having my medications delivered through CVS Caremark, CVS Specialty or CVS Pharmacy, does the delivery require a signature?

    Our national delivery partners are also working to implement new policies for deliveries requiring signatures, including for shipped medications, which can help our members adhere to recommended social distancing practices and avoid potential exposure to the virus.

    For example, in lieu of obtaining actual signatures, UPS will now enter a code and the name of the recipient so that the member does not have to physically sign via the UPS hand-held device, which can help minimize contact.

    Am I at risk for COVID-19 from shipped packages or products?

    We are still learning about the novel Coronavirus that causes COVID-19 and how it spreads. At this time, the WHO and CDC have stated that the likelihood of novel Coronavirus contaminating cardboard or other shipping containers is low. Our shipping carriers follow CDC guidelines to protect their employees and recipients of our orders, and this includes best practices for cleaning, social distancing and sanitizing. Our shipping suppliers have largely relaxed the requirement for a physical signature for orders that would normally require one. We are sourcing additional personal protective equipment such as gloves and masks for our staff, and training staff on its proper and effective use. We regularly sanitize the bins that transport orders throughout pharmacy processes. For more information, please check the CDC website.

    How is CVS Caremark ensuring business continuity?

    We have robust business processes in place to help preserve the capacity of our CVS Caremark mail service pharmacies and ensure service continuity.

    • Our mail service operations are organized into two main functions that occur in separate physical facilities: receiving orders and processing/filling orders.

    • Regional Order Creation Centers (ROCCs) exist to intake new orders that are mailed to CVS Caremark, scanning and electronically imaging these prescriptions. ROCCs, which are located strategically across the country, enable us to electronically transmit prescriptions to the most appropriate mail service pharmacy for dispensing.

    • We have implemented robust and flexible business continuity plans within our CVS Specialty pharmacies to ensure continuous service to patients – including accelerating shipment of existing orders and building a backup model to ensure service is not disrupted if we need to temporarily close one of our facilities.

    What happens if a CVS Caremark or CVS Specialty facility is closed due to COVID-19 exposure?

    To ensure continuity of care and avoid disruption in patient service, if a facility is ultimately closed due to potential exposure to someone with COVID-19, prescriptions will be transferred and filled at another operational site.

    How is Accordant continuing to assist members?

    We have taken important steps to ensure Accordant members continue to have access to important care as well as information about COVID-19.

    Since early February, Accordant has been regularly educating and providing guidance to members to help them throughout the COVID-19 outbreak. This includes information about social distancing, infection prevention, helping to address medication refills and coordinating with doctors and care teams on patient care and concerns related to the virus, among many other issues.

    Is Coram still providing infusion care to patients and what steps are they taking to protect patients?

    Coram is continuing to provide nursing care to patients requiring infusion care in the home and our ambulatory infusion suites (AIS). Coram also has put into place a number of proactive measures and preventive health precautions to help ensure continuity of care for patients while protecting both patients and our Coram providers.

    • We are proactively contacting all patients who visit our ambulatory infusion suites before their scheduled visits to screen for possible infection or exposure to COVID-19 and are rescheduling those potentially impacted for home visits when appropriate.

    • We have increased the frequency of cleaning services at all infusion suites and have also enacted a patient screening process prior to all home visits

    • Coram in-home care providers are also up-to-date and utilizing infection protocols and proactive prevention techniques, including personal protection equipment, to minimize exposure and community-based transmission of COVID-19.

    • For those residing in an area with travel restrictions or a curfew, we are working with local officials and law enforcement and have documentation to ensure we are still able to deliver medications and care to our patients.

    • Coram providers are also now using video conferencing technology to train, educate and assess your members requiring infusion care in inpatient or home settings when Coram providers are not able to enter a facility and/or when a face-to-face visit is not required.

    Is CVS doing anything else to support patients, providers, and hospitals during the coronavirus pandemic?

    • CVS Health’s infusion care business, Coram, is working with hospitals and providers, including UCLA Health in California, to support solutions for creating much-needed hospital bed capacity during the COVID-19 pandemic.

      • In California, estimates suggest that the state will need to add 50,000 hospital beds.https://www.gov.ca.gov/2020/04/06/governor-newsom-announces-progress-in-expanding-hospital-capacity-to-fight-coming-surge-in-covid-19-cases/

      • Coram is already working with UCLA Health to identify and begin transitioning stable patients to home-based nursing care and is scaling this approach in other markets with high rates of COVID-19.

    • Coram has enhanced its existing home infusion capacity and capabilities to help transition eligible IV-therapy patients to home-based care. This includes enhanced clinical monitoring, virtual support and oversight through telehealth to complement existing personalized in-home support, coordination and administration of medications and supplies.

      • Coram’s skilled nurses will provide and coordinate care for patients with a range of conditions that may require infusion therapy, including hydration and nutritional support, anti-infectives and/or several specialty medications for chronic condition management.

      • Examples of the range of personalized care to be provided by Coram nurses include daily visits and monitoring, medication administration, IV catheter line care, lab draws, and other ongoing care and educational support via telehealth.

      • Additionally, Coram is working with home health agencies to enable care for patients with high-acuity needs that may require additional clinical oversight, monitoring and in-person care.

    Why are CVS Health and Coram launching this strategy?

    Amid the COVID-19 pandemic, hospitals are looking for ways to help create more bed capacity and transition certain patients out of inpatient settings. For decades, Coram has provided important infusion care and nutrition services to patients – at-home or in outpatient ambulatory infusion centers – and now more than ever, our specialized Coram nurses can play a vital role in ensuring important continuity of care for patients requiring IV-therapy at home. That is why we are working with hospitals and providers, including UCLA Health, to help transition eligible IV-therapy patients to home-based care.

    Altogether, this will help create hospital bed capacity for treating those impacted by COVID-19. In addition, by working to transition patients out of hospital or outpatient settings, we can also help minimize their risk of exposure to COVID-19.

    How many patients does CVS Health expect to move from hospital to home-based care?

    
Individual hospitals and health systems face different challenges, and we are working to create additional bed capacity based on their needs and the changing landscape. At UCLA Health alone, we are scaling our capabilities to help transition upwards of 100 patients to home-based care.

    How quickly can CVS Health implement this program and begin transitioning appropriate patients to quality home-based care?

    We are already mobilized and engaging with UCLA Health, among others.

    As the landscape and need continues to evolve, we are also actively working to scale, or shift, this strategy to other geographies with high rates of COVID-19 – leveraging our relationships with local home health agencies, when appropriate.

    What precautions are being taken to ensure that Coram nurses entering patient homes operate safely and minimize possible disease transmission risk to and from patients?

    Coram in-home care providers are up-to-date and utilizing infection protocols and proactive prevention techniques, aligned to CDC guidance, to minimize exposure and community-based transmission. In addition to protective precautions, we are leveraging virtual care to help keep our health care providers and patients safe, while ensuring continuity of care. For example, we are conducting proactive outreach to each patient prior to being seen to understand potential COVID-19 infection or exposure and to ensure continued safety for our clinicians and our patients. In addition, we have provided appropriate PPE to all Coram clinical personnel and are working to ensure we continue to have adequate supply of PPE on hand.

    What is Return Ready™?

    As state and local governments continue to relax stay-at-home orders and reopen economies, employers and universities are looking to us for support in returning employees to worksites and students, faculty and staff to campuses. Central to our solution is COVID-19 testing for ongoing business continuity. With flexible options for testing, including drive-thru testing at CVS Pharmacy locations and/or bringing testing onsite, organizations can design a customized testing strategy to meet their unique needs.

    At the core of Return Ready’s comprehensive, end-to-end solution is configurable COVID-19 testing that allows employers or universities to choose who, how, where and when to test their employees or students. In addition to testing, the solution includes: 

    • Clinician-informed protocols and guidance for symptom checking and temperature screenings;

    • Onsite licensed professionals for COVID-19 testing and support;

    • Turnkey employee and student communications toolkit;

    • Digital tools for test scheduling and sharing of results;

    • Integrated reporting and analytics across testing locations;

    • Onsite immunization clinic with CDC-recommended vaccination services, such as the seasonal flu vaccine; and

    • Access to add-on solutions such as thermal scanners, digital symptom monitoring and contact tracing technology.

    Learn more about Return Ready.

    How does the testing component of the solution work?

    Organizations have the flexibility to choose from a number of COVID-19 testing options. The testing technology options include point-of-care testing with results in a few minutes or third-party lab processed testing with results in a few days. The organization can choose to offer testing onsite — and in a safe testing environment set up by CVS Health — or in the local community at one of the 1,400 CVS Pharmacy drive-thru testing locations.. For example, some organizations with high-density populations working in close proximity that need rapid results may choose on-site, point-of-care testing overseen by licensed CVS Health professionals to receive immediate alerts of positive results for contact tracing. Others may prefer lab-processed tests, with results in a few days, conducted either onsite or at a nearby CVS Pharmacy testing location, which enables organizations to test a large number of individuals quickly and/or ensures convenience for those with a distributed workforce.

    Return Ready also includes an analytics dashboard for ongoing oversight and trends across worksite location(s), along with state and federal reporting of test results, as required.

    07.03.20