New Guidance From the DOL on FFCRA and CARES Administration

On June 22, 2020, the Departments of Labor (DOL) and Health and Human Services (HHS), issued new frequently asked questions (FAQs) regarding the implementation of the Families First Coronavirus Response Act (the FFCRA), the Coronavirus Aid, Relief, and Economic Security Act (the CARES Act), and other health coverage issues related to COVID-19.

The FAQs include:

Group health plans. The FAQs confirm that the requirements of FFCRA regarding coverage for specific items and services related to COVID-19 diagnostic testing, apply to both insured and self-insured group health plans.

Covered tests.  The FFCRA requires plans and issuers to provide coverage for an in vitro diagnostic test for the detection of or the diagnosis of COVID-19, and the administration of such a test, that:

  • is approved, cleared, or authorized under the Federal Food, Drug, and Cosmetic Act;
  • the developer has requested, or intends to request, emergency use authorization under section 564 of the Federal Food, Drug, and Cosmetic Act unless and until the emergency use authorization request has been denied or the developer of such test does not submit a request under such section within a reasonable timeframe;
  • is developed in and authorized by a state that has notified the Secretary of HHS of its intention to review tests intended to diagnose COVID–19; or
  • other tests that the Secretary of HHS determines appropriate in guidance.

Attending health care provider. The FAQs clarify that a health care provider does not need to be directly responsible for providing care to the patient to be considered an attending provider, as long as the provider makes an individualized clinical assessment to determine whether the test is medically appropriate for the individual per currently accepted standards of medical practice.

Testing for employment purposes. The FAQs clarify that testing conducted to screen for general workplace health and safety, and that is not primarily intended for individualized diagnosis or treatment of COVID-19 or another health condition is beyond the scope of the FFCRA.

Multiple tests. Plans and issuers are required to cover multiple diagnostic tests for COVID-19.

The FAQs also cover facility fees, reimbursements, telehealth and remote care services, mental health benefits, and wellness programs. The DOL and the HHS update the guidance often. Feel free to call us with questions.