Departments Jointly Release FAQs About FFCRA and Cares Act Implementation
April 13, 2020
On April 11, 2020, the Departments of Labor (DOL), Health and Human Services (HHS) and U.S. Treasury (collectively, the Departments) released a series of frequently asked questions (FAQs) to assist employers, health insurance issuers, and other stakeholders regarding implementation of Section 6001 of the Families First Coronavirus Response Act (FFCRA), as amended by Section 3201 of the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). The FAQs can be found here.
FFCRA Section 6001 requires health insurance plans to cover certain services and items related to the testing and diagnosis of the coronavirus (COVID-19) without cost-sharing (including deductibles, copayments, and coinsurance) or prior authorization or other medical management requirements. CARES Act Section 3201 expanded the list of required covered COVID-19 services.
The Departments stipulate that nothing in both Acts prevents a state from imposing additional standards or requirements on health insurance issuers regarding COVID-19 testing as long as they do not conflict with federal law requirements.
Highlights of FAQs
With this release, the Departments issued 14 new FAQs addressing the requirements concerning COVID-19 testing and related services. Items to note include the following:
- Both fully insured and self-funded plans but not retiree-only plans must comply. The requirement to provide free COVID-19 testing related services applies to both fully-insured and self-insured group health plans and health insurance issuers in the individual and group markets, including grandfathered health plans. It does not however, apply to retiree only plans, excepted benefits plans (as defined under the Employee Retirement Income Security Act, the Internal Revenue Code, and the Public Health Service Act), or to short-term limited duration insurance coverage.
- Applies to services ordered through telehealth or other remote care visits. The FAQs provide information regarding the specific types of COVID-19 testing and services that must be provided, including that such services must be provided through both traditional and non-traditional settings. Covered COVID-19 tests include all FDA-authorized COVID-19 diagnostic tests, those diagnostic tests that developers request authorization for on an emergency basis, and diagnostic tests developed in and authorized by states. COVID-19 antibody testing will also be covered. Furthermore, the Departments address how plans and health care issuers can promote the use of telehealth and other remote care services.
- No advance notice needed for certain plan enhancements. The Departments will not enforce the 60-day advance notification requirement to amend the summary of benefits and coverage (SBC) while the COVID-19 public health emergency is in effect, to the extent the health plan is being modified to provide greater benefits coverage with respect to COVID-19 testing and related services (including through telehealth and remote care services). However, the Departments will continue to enforce the 60-day notice requirement with respect to attempts to limit or eliminate benefits or to increase cost-sharing amounts, to offset the costs of providing COVID-19 testing related services.
- EAPs can offer COVID-19 testing. Employee Assistance Programs, or EAPs, in which only limited medical care is provided, can offer benefits for COVID-19 diagnostic testing and services, and still be considered an excepted benefit.
For further information regarding the CARES Act and FFCRA, and the most up-to-date information on COVID-19, please visit our dedicated website at burnhambenefits.com/COVID-19
. The following government websites also include important COVID-19 related Q & As or FAQs that have recently been released:
For additional information, please contact your Burnham Benefits Consultant or Burnham Benefits at 949-833-2983 or email@example.com.
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