What has the federal government done in response to the COVID-19 pandemic?
Congress has passed the following legislation:
- Families First Coronavirus Response Act
- Coronavirus Preparedness and Response Supplemental Appropriations Act, 2020
In addition, Congress is considering additional legislation and economic stimulus measures.
How does the Families First Coronavirus Response Act impact what I pay?
Group Health Plans, Self-Insured (Self-funded) Plans and Individual or Group Coverage through the marketplace.
- Requires coverage of testing with no cost-sharing and no prior authorization or other medical management requirements:
- Provider visits (office, urgent care, ER) including telehealth, that result in order or administration of the test
- Must relate to furnishing or administration of those products, or evaluating need for the products
- The test must be medically necessary for COVID-19.
- Provides for 100% of payment for COVID-19 testing with no cost sharing and the deductible does not apply
Medicare Advantage Program
- Provides for coverage of clinical diagnostic lab tests during the emergency with no cost sharing and no prior authorization or utilization management requirements
Medical Assistance (Medicaid)
- Provides for coverage of testing and medical visit related to testing "for which payment may be made under the State plan" with no cost-sharing
- Provides coverage for testing with no cost-sharing
TRICARE, Coverage for Veterans, and Coverage for Federal Civilians
- Provides coverage for testing with no cost-sharing for TriCare, VA, and Federal Civilians
Indian Health Services
- Provides coverage for testing with no cost-sharing for Indians receiving care through Indian Health Service