April 02, 2020

CARES Act Coverage Update

On March 27, the President signed the CARES Act (H.R. 748) into law. Section 3201 of the CARES Act expanded the types of COVID-19 testing that fall under the coverage mandate of the FFCRA. According to the Health Affairs Blog, Section 3202 of the CARES Act mandates that all comprehensive private health insurance plans reimburse a test provider based on the rate negotiated between the plan and the provider for in-network providers. For out-of-network providers, plans would fully reimburse the provider based on the provider’s published cash price during a declared public health emergency. Providers that fail to make their price public could face a civil monetary penalty of up to $300 per day.

Section 3702 of the CARES Act repeals the ACA’s requirement that over the counter prescription drugs be supported by a prescription in order to be reimbursed from an HSA or an FSA, effective retroactively to January 1. Section 3701 permits high deductible health plans with an HSA to cover telehealth services before the high deductible, effective March 27.

Section 3221 of the CARES Act generally aligns Substance Use Disorder information use under 42 C.F.R. Part 2 and disclosure rules with the HIPAA Privacy and Security Rules, including the national data breach information rule. The statutory change will be implemented by HHS amendment of the Part 2 and HIPAA rules no later than March 27, 2021.