On February 4, the tri-agencies (DOL, HHS and Treasury) issued new FAQs on the requirement for group health plans and issuers to cover over-the-counter (OTC) COVID-19 tests without cost-sharing, prior authorization, or other medical management requirements. We discussed the tri-agencies’ initial FAQs in our prior blog post.
The coverage requirement is still in place, but these new FAQs provide clarifications in response to the tri-agencies’ receipt of stakeholder questions—primarily about the “safe harbor” permitting the limit of reimbursements to $12 per test (or actual cost, if less) if the test is purchased outside a direct coverage program.