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Law360 (June 23, 2020, 9:07 PM EDT ) The U.S. Department of Labor's latest coronavirus guidance, released Tuesday, outlines when group health plans must cover workers' COVID-19 tests and when they don't have to.
Plans must pay for at-home tests for those with symptoms or potential exposure, but they don't have to cover employer-mandated tests for those returning to a workplace, the guidance says.
Plans must cover co-pays for those who get coronavirus tests from medical facilities. If a worker gets more than one coronavirus test, the plan has to cover all of them, the guidance says.
Plans also must fully cover other services administered over the course of determining whether a coronavirus test is appropriate, the guidance says. So, if a doctor orders a flu test and a chest X-ray before calling for a COVID-19 test, the plan must pay for all of it at no cost to the person.
Plans, however, can send people bills after the fact for any services rendered that do not relate to coronavirus testing, the guidance said.
The guidance applies to tests for active infections and tests for antibodies, the DOL has made clear. When the agency refers to "diagnostic tests," it's referring to both types of tests, the DOL said in guidance released April 11.
The coverage requirements spring from the two federal coronavirus relief laws passed this spring, which require group health plans and insurers to fully pay for people's coronavirus tests. The laws did not require plans and insurers to pay for people's coronavirus treatment.
The guidance came out a day after the American Benefits Council, a group health plan lobby, released a survey of about 100 of its corporate members about how their plans have covered the coronavirus.
About 73% of the respondents — large U.S. and multinational corporations — indicated they were fully covering coronavirus treatment "in at least some of the health plans they offer."
About three-quarters of the roughly 27% of employers who aren't fully covering coronavirus treatment said they weren't paying for it without cost-sharing because they don't want to also start fully covering treatment for other serious conditions, such as cancer.
--Editing by Orlando Lorenzo.
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