Insurers don't have to cover COVID-19 tests for 'return to work' programs

Health insurers aren't required to cover COVID-19 tests that are a part of workplace safety or surveillance programs, according to an updated CMS factsheet.

Under the Families First Coronavirus Response Act, private insurers and employer group health plans have to cover COVID-19 testing with no out-of-pocket expenses. CMS clarified in its June 23 update that the regulation requires coverage of items and services only for diagnostic purposes deemed medically appropriate by an individual's healthcare provider.

"Testing conducted to screen for general workplace health and safety (such as employee 'return to work' programs), for public health surveillance for SARS-CoV-2, or for any other purpose not primarily intended for individualized diagnosis or treatment of COVID-19 or another health condition is beyond the scope" of the regulation, CMS said.

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