Home 5 Articles 5 Major Insurer Claims It Has No Obligation to Pay for Pooled COVID-19 Testing

Free COVID-19 testing is a powerful and very compelling policy. The problem, of course, is that somebody has to pay for coronavirus testing. And the insurance companies have been designated as that somebody. However, loopholes in the free testing mandate imposed on insurers are starting to emerge, first with regard to coverage of employer workplace screening tests and now on the issue of sample pooling. The Free Testing Mandate & the Loophole The starting point in the recent controversy is a piece of federal relief legislation called the Families First Coronavirus Response Act (FFCRA) which requires insurers to pay for COVID-19 tests without imposing any copayments, deductibles, coinsurance or other cost-sharing. Technically, the requirement, i.e., Section 6001 of FFCRA) applies only to tests that a healthcare provider deems “medically appropriate.” The “medically appropriate” language has been turned into something of a loophole to get around the free testing mandate. However, it was not the insurers but the Administration that created it. On June 23, the Departments of Labor, Health and Human Services (HHS) and Treasury issued joint guidance (FAQ 5) clarifying that Section 6001 does not apply to “testing conducted to screen for general workplace health and safety (such as employee “return […]

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