Cares Act

CARES ACT AND HOW IT WORKS:

On March 27, 2020, the president signed the Coronavirus Aid Relief, and Economic Security Act (CARES Act) responding to COVID-19 pandemic. The first of these Sections 3201 clarifies a requirement enacted in the families First Coronavirus Response Act, passed a week earlier, states that commercial

health insurance plans must cover COVID-19 testing without imposing any cost-sharing on enrollees. This provision on its own, however, does nothing to prevent an out-of network testing entity (such as a clinical laboratory, hospital, or provider’s office) from balance billing a patient for the difference.

Section 3202 of the CARES Act is aimed at addressing this issue and to guarantee out-of-network testing entities receive payment.

The law mandates health plans to pay an out-of-network provider of COVID-19 testing “an amount that equals the cash price for such service as listed by the provider on a public internet website.” Altogether, as part of the FFCRA, PPPHCEA, and CARES Act, the U.S. Department of Health and Human Services (HHS), will provide claims reimbursement to health care providers generally at Medicare rates for testing uninsured individuals for COVID-19 and treating uninsured individuals with a COVID-19 diagnosis.

If you do not have insurance

If you are uninsured and receive COVID-19-related testing and/or treatment services, your provider may have submitted a claim to the Health Resources & Services Administration (HRSA) for reimbursement of these services. Providers who participate in and are reimbursed from the HRSA COVID-19 Uninsured Program are not allowed to "balance bill" individuals who do not have health care coverage (uninsured). If you receive a bill in which a portion of that bill is paid for by HRSA, you may not be responsible for the remainder of the bill if the rendered service was for COVID-19 testing and/or treatment.

If you received a bill and were charged for COVID-19 testing and/or treatment services and the bill shows HRSA reimbursement for those services, please contact your health care provider to discuss how best to resolve payment of your bill. (If your provider has questions they can visit the HRSA COVID-19 Uninsured Program site .) Please note that if your provider didn't submit a bill for your COVID-19-related testing and/or treatment to the HRSA COVID-19 Uninsured Program or the care was not eligible for reimbursement from the program, you may be responsible for full payment of the bill about your business here.