CMS testing guidelines for uninsured: 5 things to know

CMS issued a document that outlines state requirements for covering the cost of COVID-19 testing for uninsured Americans, and lists flexibilities that states can use to meet the requirements. 

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The Families First Coronavirus Response Act established an optional Medicaid eligibility group to receive federal funds to cover the cost of COVID-19 testing for uninsured Americans. The requirements pertain to that group.

Here are five things to know:

1. States need to provide enrollees with an application that collects contact information, Social Security number, attestation of applicant’s citizenship status, an attestation that the enrollee isn’t covered and a signature. CMS is allowing states to develop a simplified application.

2. States can elect to provide hospital presumptive eligibility for uninsured individuals needing a COVID-19 test. Testing sites that would otherwise not be considered part of the facility can be considered hospitals for the purpose of the hospital presumptive eligibility.

3. The effective date for coverage for eligible uninsured individuals is the date of application, or the first of the month during which the application is made.

4. States have to provide retroactive eligibility for uninsured individuals who are eligible for free testing. The eligibility is retroactive up to three months but no earlier than March 18, or the effective date of coverage in a specific state.

5. States don’t have to use their Medicaid eligibility system for claiming purposes, but must maintain a process to receive provider claims properly. 

Read the full list of requirements here.

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