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CARES Act Dx & Preventive Care

The Coronavirus Aid, Relief, and Economic Security Act (the CARES Act) was signed into law on March 27, 2020, and the CARES Act includes the following provisions that affect benefits under your group health plan:

  • COVID-19 Testing. The CARES Act amends the previously enacted Families First Coronavirus Response Act by expanding coverage for COVID-19 testing, with no patient cost sharing, to include coverage of non-FDA-approved tests and further specifies how tests should be paid, as follows:
    • If the health plan has a negotiated rate with the provider in effect before the public health emergency, such negotiated rate shall apply throughout the period of the public health emergency. If the health plan does not have a negotiated rate with the provider, the plan shall reimburse the provider in an amount that equals the cash price for such service as listed by the provider on a public internet website, or the plan may negotiate a rate with such provider for less than the cash price.
    • These provisions are in effect during the COVID-19 Emergency Period.
  • Coverage of Preventive Services and Vaccines. The CARES Act includes a provision requiring group health plans to cover (without cost-sharing) any qualifying coronavirus preventive service, meaning an item, service, or immunization that is intended to prevent or mitigate coronavirus disease 2019, effective 15 business days after the U.S. Preventive Services Task Force issues a rating of “A” or “B” for the item or service or when an immunization has in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention.