White House expands coverage for essential diagnostic services

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Centers for Medicare & Medicaid Services and the Departments of Labor and the Treasury issued guidance to enable Americans with private health insurance to get coverage of COVID-19 diagnostic testing and other related services, including antibody testing, at no cost.

Issued on April 11, the guidance implements the recently enacted Families First Coronavirus Response Act and Coronavirus Aid, Relief, and Economic Security Act, which require that private health issuers and employer group health plans cover COVID-19 testing and certain related items and services furnished during the COVID-19 pandemic, with no out-of-pocket expenses.

The guidance requires group health plans and group and individual health insurance to cover diagnostic testing and certain related items and services provided during a medical visit with no cost sharing. This includes urgent care visits, emergency room visits, and in-person or telehealth visits to the doctor’s office that result in an order for or administration of a COVID-19 test.

Covered COVID-19 tests include all FDA-authorized COVID-19 diagnostic tests, COVID-19 diagnostic tests that developers request authorization for on an emergency basis, and COVID-19 diagnostic tests developed in and authorized by states.

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