Skip to main content

Nixon Peabody LLP

  • People
  • Capabilities
  • Insights
  • About
Trending Topics
    • People
    • Capabilities
    • Insights
    • About
    • Locations
    • Events
    • Careers
    • Alumni
    Practices

    View All

    • Affordable Housing
    • Community Development Finance
    • Corporate & Finance
    • Cybersecurity & Privacy
    • Entertainment & Media
    • Environmental
    • Franchising & Distribution
    • Government Investigations & White Collar Defense
    • Healthcare
    • Intellectual Property
    • International Services
    • Labor, Employment, and Benefits
    • Litigation
    • Private Wealth & Advisory
    • Project Finance
    • Public Finance
    • Real Estate
    • Regulatory & Government Relations
    Industries

    View All

    • Aviation
    • Cannabis
    • Consumer
    • Energy
    • Financial Services
    • Healthcare
    • Higher Education
    • Infrastructure
    • Manufacturing
    • Nonprofit Organizations
    • Real Estate
    • Sports & Stadiums
    • Technology
    Value-Added Services

    View All

    • Alternative Fee Arrangements

      Developing innovative pricing structures and alternative fee agreement models that deliver additional value for our clients.

    • Continuing Education

      Advancing professional knowledge and offering credits for attorneys, staff and other professionals.

    • Crisis Advisory

      Helping clients respond correctly when a crisis occurs.

    • DEI Strategic Services

      Providing our clients with legal, strategic, and practical advice to make transformational changes in their organizations.

    • eDiscovery

      Leveraging law and technology to deliver sound solutions.

    • Environmental, Social, and Governance (ESG)

      We help clients create positive return on investments in people, products, and the planet.

    • Global Services

      Delivering seamless service through partnerships across the globe.

    • Innovation

      Leveraging leading-edge technology to guide change and create seamless, collaborative experiences for clients and attorneys.

    • IPED

      Industry-leading conferences focused on affordable housing, tax credits, and more.

    • Legal Project Management

      Providing actionable information to support strategic decision-making.

    • Legally Green

      Teaming with clients to advance sustainable projects, mitigate the effects of climate change, and protect our planet.

    • Nixon Peabody Trust Company

      Offering a range of investment management and fiduciary services.

    • NP Capital Connector

      Bringing together companies and investors for tomorrow’s new deals.

    • NP Second Opinion

      Offering fresh insights on cases that are delayed, over budget, or off-target from the desired resolution.

    • NP Trial

      Courtroom-ready lawyers who can resolve disputes early on clients’ terms or prevail at trial before a judge or jury.

    • Social Impact

      Creating positive impact in our communities through increasing equity, access, and opportunity.

    • Women in Dealmaking

      We provide strategic counsel on complex corporate transactions and unite dynamic women in the dealmaking arena.

    1. Home
    2. Insights
    3. Articles
    4. Departments of Labor, Treasury, and HHS issue FAQs on coronavirus services and telehealth

      Articles

    Article

    Departments of Labor, Treasury, and HHS issue FAQs on coronavirus services and telehealth

    April 16, 2020

    LinkedInX (Twitter)EmailCopy URL

    By Yelena Gray

    The Department of Treasury, Labor, and HHS jointly issued FAQs on FFCRA and CARES Act group and individual market health plans. Yelena Gray discusses the guidance contained in the FAQs.

    On April 11, the Departments of Treasury, Labor, and Health & Human Services jointly issued FAQs addressing the impact of the Families First Coronavirus Relief Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security Act (CARES Act) on group and individual market health plans. Although much of the guidance contained in the FAQs simply clarified certain aspects of the FFCRA and CARES Act, the FAQs did address a few important outstanding questions.

    Coverage Mandate Effective Period

    The Families First Coronavirus Relief Act (FFCRA), as amended by the CARES Act, requires health plans and insurance issuers to cover without cost sharing, prior authorization, or medical management certain COVID-19-related diagnostic tests, services, and products. The period during which the coverage mandate applies begins on March 18 and will end when the COVID-19 public health emergency is no longer in effect. Unless the Secretary of HHS declares the end of the emergency earlier or extends the emergency period, the COVID-19 public health emergency will end on June 16, 2020.

    Antibody Tests Included in Mandate

    Generally, the tests that the FFCRA requires to cover include in-vitro tests that are used in the diagnosis of the SARS-CV-2 virus and the COVID-19 disease it causes. The Departments clarified that serological tests for COVID-19 that are used to detect antibodies against the novel virus must also be covered without cost-sharing or prior authorization. They noted, however, that to date, the FDA approved only one emergency application for a serological test.

    The FFCRA also requires coverage of items and services that are provided during a diagnostic office, emergency room, or urgent care visit so long as the visit results in the administration of or order for the COVID-19 test, provided the products relate to the furnishing or administration of the test or evaluating the individual for the need of the testing. The attending health care provider (and not the plan, issuer, or a hospital) must determine what services are necessary. The FAQs point out that often a provider might order preliminary tests for other possible illnesses before testing for COVID-19 (e.g., a flu or blood test). So long as those tests ultimately lead to the administration of a COVID-19 test, the plan must cover the preliminary testing without cost sharing.

    Non-Traditional “Visits” Within Scope

    A diagnostic “visit” for these purposes includes the administration of the test in non-traditional settings, such as drive-through screening and testing sites where licensed health care providers are administering the test. According to the FAQs, employers may offer COVID-19 testing at their on-site clinics or through an employee assistance program (EAP). The testing will not cause the clinics or EAPs to provide substantial medical services and lose their status as excepted benefits.

    Non-Enforcement of Prior Notice of SBC Changes

    In the event that a group health plan is amended mid-year causing the information contained in the plan’s summary of benefits and coverage (SBC) to be no longer accurate, the ACA requires that the plan provide advance notice of at least 60 days. Because most health plans are required to waive cost-sharing for COVID-19 testing and diagnostic services, and many plans are making elective changes (e.g., cost-sharing waivers for telehealth or for inpatient COVID-19 treatment), the Departments recognized that applying the 60-day advance notice period becomes impossible during the public health emergency. Therefore, the Departments announced a non-enforcement policy for plans that are modified mid-year to provide greater coverage for the diagnosis and treatment of COVID-19 and coverage of telehealth on a first dollar basis without a 60-day day notice. The plans must provide notice of the changes to the participants as soon as reasonably practicable. Plans that wish to extend the enhancement beyond the period of the public health or national health emergency must, however, comply with generally applicable disclosure and plan documentation requirements. Further, the Departments caution that they will take enforcement action against plans and issuers that try to reduce other benefits or increase cost sharing in an attempt to recoup their cost of providing COVID-19 testing and telehealth.

    Plan sponsors should work with their advisors and third-party administrators to make appropriate coverage adjustments and notify participants of the changes. They should also be on a lookout for further guidance the Departments intend to issue as more questions emerge.

    Practices

    Employee Benefits & ERISAEmployee Benefit Plan AuditsLabor, Employment & Benefits

    Insights And Happenings

    • Alert

      DEA proposes regulations for prescribing controlled substances via telemedicine

      March 2, 2023
    The foregoing has been prepared for the general information of clients and friends of the firm. It is not meant to provide legal advice with respect to any specific matter and should not be acted upon without professional counsel. If you have any questions or require any further information regarding these or other related matters, please contact your regular Nixon Peabody LLP representative. This material may be considered advertising under certain rules of professional conduct.

    Subscribe to stay informed of the latest legal news, alerts, and business trends.Subscribe

    • People
    • Capabilities
    • Insights
    • About
    • Locations
    • Events
    • Careers
    • Alumni
    • Cookie Preferences
    • Privacy Policy
    • Terms of Use
    • Accessibility Statement
    • Statement of Client Rights
    • Purchase Order Terms & Conditions
    • Nixon Peabody International LLC
    • PAL
    © 2025 Nixon Peabody. All rights reserved