COVID swap being inserted into vial America's Health Insurance Plans is calling on moregovernment support to cover the cost of COVID-19 tests, which itsays could be between $6 billion and $25 billion annually. (Photo:Shutterstock)

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The COVID-19 pandemic has created a lot of confusion foremployers (and everyone else, for that matter), including what theycan and can't ask about employees' personal health, as well as whatscreening measures they can legally implement. Many employers haveopted to make COVID-19 testing a requirement for employeesreturning to work, raising another question: who's responsible forpaying for such tests?

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The Department of Health and Human Services, in conjunction withthe Department of Labor, and Department of the Treasury states,this week released new guidance that answers this question andmany others.

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Related: Will insurance cover it? COVID-19 testing confusioncontinues

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The Families First Coronavirus Response Act(FFCRA), as well as the CARES Act, both included provisions relatedto cost-sharing for COVID-19 treatments and tests. Among them was arequirement that insurers cover the cost of testing–but only whenordered by an individual's health care provider.

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According to the guidance, "testing conducted to screen forgeneral workplace health and safety (such as employee "return towork" programs), for public health surveillance for SARS-CoV-2, orfor any other purpose not primarily intended for individualizeddiagnosis or treatment of COVID-19 or another health condition isbeyond the scope of section 6001 of the FFCRA."

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Insurers may opt to pay for such tests anyway, as aprecautionary measure. America's Health Insurance Plans, however,is calling on more government support to cover the costs, which itsays could be between $6 billion and $25 billion annually.

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The guidance also addresses the issue of balance billing relatedto testing. While the CARES Act is clear in its prohibition ofbalance billing for testing, the guidance notes that "section3202(a) of the CARES Act does not preclude balance billing foritems and services not subject to section 3202(a), although balancebilling may be prohibited by applicable state law and otherapplicable contractual agreements."

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In addition, the guidance also clears the way for largeemployers to offer telehealth benefits to employees not eligiblefor employer-sponsored health insurance. "In light of the criticalneed to minimize the risk of exposure to and community spread ofSARS-CoV-2, for the duration of any plan year beginning before theend of the public health emergency related to COVID-19, theDepartments are providing relief for a group health plan (andhealth insurance coverage offered in connection with a group healthplan) that solely provides benefits for telehealth or other remotecare services from the group market reforms under part 7 of ERISA,title XXVII of the PHS Act, and chapter 100 of the Internal RevenueCode (the Code).

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"This relief is limited to telehealth and other remote careservice arrangements that are sponsored by a large employer (asdefined under section 2791(e)(2) of the PHS Act) and that areoffered only to employees (or their dependents) who are noteligible for coverage under any other group health plan offered bythat employer."

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Emily Payne

Emily Payne is director, content analytics for ALM's Business & Finance Markets and former managing editor for BenefitsPRO. A Wisconsin native, she has spent the past decade writing and editing for various athletic and fitness publications. She holds an English degree and Business certificate from the University of Wisconsin.