Congress has enacted the Families First Coronavirus Response Act and the Coronavirus Aid, Relief and Economic Security Act, which require a group health plan to cover coronavirus testing and mitigation services and vaccines.  The following is a summary of the material provisions.

Coverage of Diagnostic Testing.  Effective March 27, 2020, a plan must cover the cost of a diagnostic test for the detection of the virus that causes COVID-19 and the administration of such a test that (i) is approved, cleared or authorized under the Federal Food, Drug and Cosmetic Act, (ii) the test developer has requested, or intends to request, emergency use authorization under the Federal Food, Drug and Cosmetic Act, (iii) is developed in and authorized by a State or (iv) the United States Secretary of Health and Human Services determines appropriate.  A plan must cover such test at 100%.  It cannot impose any deductible, copayment or coinsurance, require prior authorization or impose other medical management requirements.

Rapid Coverage of Preventive Services and Vaccines for Coronavirus.  Effective on the date that is 15 days after an appropriate recommendation from the United States Centers for Disease Control and Prevention, a plan must cover without cost sharing (including deductibles, copayments and coinsurance) any qualifying coronavirus preventive service.  The term “qualifying coronavirus preventive service” means an item, service or immunization that is intended to prevent or mitigate COVID-19 and that is (i) an evidence based item or service that has in effect a rating of “A” or “B” in the current recommendations of the United States Preventive Services Task Force, or (ii) an immunization that has in effect a recommendation from the Advisory Committee on Immunization Practices of the Centers for Disease Control and Prevention with respect to the individual involved.