What medical services must be provided under the CARES Act and the FFCRA without imposing any cost sharing?

Posted by: Bonita Hatchett-Bodle    May 1, 2020 2:17:28 PM

Under the Families First Coronavirus Response Act (FFCRA) and as amended by the Coronavirus Aid, Relief, and. Economic Security Act (CARES Act), health plans must provide coverage and not impose any cost sharing (including deductibles, copayments, and coinsurance), prior authorization, or medical management requirements for the following services during the public health emergency due to COVID-19:

  • An in vitro diagnostic product for the detection of SARS–CoV–2 or the diagnosis of the virus that causes COVID–19, and the administration of such an in vitro diagnostic product, that 1) has been approved, cleared, or authorized under the Federal Food, Drug, and Cosmetic Act (FDA); 2) is a clinical laboratory service performed in a laboratory certified to conduct high-complexity testing and the developer has requested, or intends to request, emergency use authorization under the FDA; 3) is developed in a state that has notified HHS of its intention to review tests intended to diagnose COVID-19; or 4) is another test that HHS determines to be appropriate.
  • Items and services furnished to an individual during healthcare provider visits that result in an order for or administration of an in vitro diagnostic product described above, but only to the extent that those items and services relate to furnishing or administering the in vitro diagnostic products or to determine the need of the individual for such product.

Health plans must comply with the coverage requirement noted above beginning March 18, 2020, and continue to comply during the public health emergency related to COVID-19.

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