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,
This week, the Department of Labor, Health and Human Services and the Treasury issued a new set of Frequently Asked Questions (FAQs) confirming that group health plans and issuers must provide 100% coverage of over-the-counter (OTC) COVID-19 diagnostic tests beginning January 15, 2022.
The FAQs are further interpretation of the coverage mandate required by the Families First Coronavirus Response Act (FFCRA), as amended by the Coronavirus Aid, Relief, and Economic Security Act (CARES Act). Under this new guidance, 100% of the cost for COVID-19 tests purchased by an individual for diagnostic purposes on or after January 15, 2022, must be covered without cost-sharing or medical management requirements—even if the test was purchased OTC without a provider prescription or clinical assessment. This requirement continues for the duration of the national public health emergency.