Under the Families First Coronavirus Response Act, which was signed into law on Wednesday, March 18, group health plans must cover coronavirus diagnostic services and testing on a first-dollar basis with no preauthorization requirements. This requirement is effective now through the end of the public health emergency period.
Employer group health plans, including grandfathered plans, must provide coverage without imposing any cost-sharing — including deductibles, copayments and coinsurance — or preauthorization requirements for certain items and services relating to the coronavirus.
Specifically, this means that FDA-approved diagnostic products, items and services furnished during a health care provider office visit, whether it is an in-person or telehealth visit, urgent care visit or emergency room visit, must be covered by the employer group health plan without cost-sharing or preauthorization if the visit results in an order for the administration of a COVID-19 test. It is important for employers to know that this “first-dollar” coverage requirement only applies to those items, services and products that relate to the evaluation of the individual as to whether they need to be tested for COVID-19 and to the furnishing or administration of the COVID-19 test.