Evolution Healthcare (EVHC)

March 18, 2020 by EVHC Editorial Team

New Federal Law Requires Testing for Coronavirus without Cost Sharing

On Wednesday, March 18, 2020, a new federal law was enacted, requiring coverage of testing for the coronavirus without any cost sharing, prior authorization or other medical management requirements.
President Donald Trump signed the Families First Coronavirus Response Act, effective March 18, 2020, through Dec. 31, 2020, which requiresthe following:

  • Self-funded ERISA and church group major medical benefit plans must cover testing for the coronavirus without cost sharing, i.e., deductible, copay or coinsurance.
  • Prior authorization or other medical management requirements, such as medical necessity determinations and out-of-network penalties, must not be imposed.
  • The mandates apply to items and services furnished during a visit at healthcare providers offices, urgent care centers, emergency rooms , or via telehealth consultations (whether by Teladoc® or another provider) that result in an order for or administration of a test for the diagnosis of COVID-19.

1This section of the law does not apply to federal or other governmental benefit plans.

In addition to mandated benefit changes from the new federal law, members of major medical benefit plans administered by Star Marketing & Administration, Inc., may speak with their employer about other benefit changes made for telemedicine services due to COVID-19, if applicable.

For continuing updates on COVID-19, please visit the CDC website.