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What is the definition of “health plan” for purposes of complying with the requirement that COVID-19 related services be provided without cost sharing?

Posted by Bonita Hatchett-Bodle

May 1, 2020 2:13:31 PM

Health plans include group health plans and health insurance issuers offering group or individual health insurance coverage (including grandfathered health plans). Group health plans means insured and self-insured group health plans, including private employer group health plans, non-federal governmental plans (such as plans sponsored by states and local governments), and church plans.

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Topics: health plans, FFCRA, CARES Act, COVID-19 medical services

Which tests fall within the definition of “in vitro diagnostic tests” which must be provided without cost sharing under the CARES Act and the FFCRA?

Posted by Bonita Hatchett-Bodle

May 1, 2020 2:11:26 PM

In vitro diagnostic tests include serological tests for COVID-19 that are used to detect antibodies against the SARS-CoV-2 virus, and are intended for use in the diagnosis of the disease or condition of having current or past infection with SARS-CoV-2, the virus which causes COVID-19. If such other testing results in an order for, or administration of COVID-19 diagnostic testing, a health plan must provide coverage for the tests without cost sharing and without imposing prior authorization or other medical management requirements.

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Topics: health plans, FFCRA, CARES Act, COVID-19 medical services

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