Yes. Nothing in the FFCRA prevents a state from imposing additional standards or requirements on health insurance issuers with respect to the diagnosis or treatment of COVID-19, to the extent that such standards or requirements do not prevent the application of a federal requirement. Excepted Benefits Sections 2722 and 2763 of the PHS Act, section […]

Yes. Serological tests for COVID-19 are used to detect antibodies against the SARS-CoV-2 virus and are intended for use in the diagnosis of the disease or condition of having current or past infection with SARS-CoV-2, the virus which causes COVID-19. The Food and Drug Administration (FDA) currently believes such tests should not be used as […]

Section 6001(a) of the FFCRA, as amended by section 3201 of the CARES Act, requires plans and issuers to provide coverage for the following items and services: (1) An in vitro diagnostic test as defined in section 809.3 of title 21, Code of Federal Regulations, (or its successor regulations) for the detection of SARS-CoV-2 or […]

Plans and issuers are required to comply with section 6001 of the FFCRA as of March 18, 2020, the date of enactment of the FFCRA. 9 This means that, beginning March 18, 2020, plans and issuers must provide coverage for the items and services described in section 6001(a) of the FFCRA and Q3 below that […]

Section 6001 of the FFCRA, as amended by section 3201 of the CARES Act, applies to group health plans and health insurance issuers offering group or individual health insurance coverage (including grandfathered health plans as defined in section 1251(e) of the Patient Protection and Affordable Care Act). The term “group health plan” includes both insured […]

No. PHS Act section 2705, which was incorporated by reference into ERISA section 715 and Code section 9815, as well as the nondiscrimination provisions of ERISA section 702 and Code section 9802 originally added by the Health Insurance Portability and Accountability Act (HIPAA), prohibit discrimination based on one or more health factors. Offering, only to […]

No. If the employer uses an arrangement that provides cash reimbursement for the purchase of an individual market policy, the employer’s payment arrangement is part of a plan, fund, or other arrangement established or maintained for the purpose of providing medical care to employees, without regard to whether the employer treats the money as pre-tax […]

The Departments have received a number of complaints and reports that participants, beneficiaries, and enrollees are being denied contraceptive coverage in violation of the requirements under PHS Act section 2713. Examples include plans and issuers, as well as their pharmacy benefits managers: • Denying coverage for all or particular brand name contraceptives, even after the […]