Key Questions About the New Medicaid Eligibility Pathway for Uninsured Coronavirus Testing

Issue Brief
  1. Pub. L. 116-127 (March 18, 2020), https://www.congress.gov/116/plaws/publ127/PLAW-116publ127.pdf.

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  2. Pub. L. 116-136 (March 27, 2020), https://www.congress.gov/116/bills/hr748/BILLS-116hr748enr.pdf.

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  3. 42 U.S.C. § 247d (a).

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  4. CMS, Families First Coronavirus Response Act, Coronavirus Aid, Relief, and Economic Security Act Frequently Asked Questions, question 46 (posted 4/13/20), https://www.medicaid.gov/state-resource-center/downloads/covid-19-section-6008-CARES-faqs.pdf.

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  5. Id. at question 9.

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  6. Id. at question 16.

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  7. Id. at question 8. By contrast, these items and services are covered only during a visit that results in an order for or administration of a coronavirus test in the private insurance context. 42 U.S.C. § 1320b-5 note (specifying that group and individual health plan coverage is limited to tests and “[i]tems and services furnished to an individual during health care provider office visits. . . urgent care center visits, and emergency room visits that result in an order for or administration of” a testing product, “to the extent such items and services relate to the furnishing or administration of such product or to the evaluation of such individual for purposes of determining the need of such individual for such product.”).

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