No Surprises for COVID–19 Tests Act
Bill: H.R.6851 | Sponsor: Rep. Pallone, Frank, Jr. (D-NJ)
Policy area: Health

Summary:
No Surprises for COVID-19 Tests Act
This bill extends the temporary period during which private health insurance plans must cover testing and related services for COVID-19 without cost sharing. It also temporarily applies certain consumer protections against surprise billing to such testing and related services.
Finally, beginning on May 1, 2022, insurance plans without a negotiated price for COVID-19 testing services are no longer required to pay providers the published cash price for such services.

To amend the Families First Coronavirus Response Act and the CARES Act 
   to establish new coverage and payment rules for certain COVID-19 
    diagnostic tests and related items and services, and for other 
                               purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``No Surprises for COVID-19 Tests 
Act''.

SEC. 2. ESTABLISHING NEW COVERAGE AND PAYMENT RULES FOR CERTAIN COVID-
              19 DIAGNOSTIC TESTS AND RELATED ITEMS AND SERVICES.

    (a) Extension of Coverage Requirement.--Section 6001(a) of the 
Families First Coronavirus Response Act (42 U.S.C. 1320b-5 note) is 
amended in the matter preceding paragraph (1) by striking ``any portion 
of the emergency period defined in paragraph (1)(B) of section 1135(g) 
of the Social Security Act (42 U.S.C. 1320b-5(g)) beginning on or after 
the date of the enactment of this Act'' and inserting ``the period 
beginning on the date of the enactment of this Act and ending on 
December 31, 2023''.
    (b) Payment and Billing Rules for Items and Services Furnished 
After End of Public Health Emergency.--
            (1) In general.--Section 3202 of the CARES Act (42 U.S.C. 
        42 U.S.C. 256b note) is amended--
                    (A) in subsection (a), in the matter preceding 
                paragraph (1), by inserting ``that are furnished before 
                May 1, 2022,'' after ``(Public Law 116-127)'';
                    (B) in subsection (b)(1), by striking ``emergency 
                period declared under section 319 of the Public Health 
                Service Act (42 U.S.C. 247d)'' and inserting ``period 
                beginning on the date of the enactment of this 
                subsection and ending on April 31, 2022''; and
                    (C) by adding at the end the following new 
                subsection:
    ``(c) Application of Surprise Billing Provisions.--
            ``(1) In general.--Except as provided in paragraph (2), the 
        provisions of sections 2799A-1 and 2799B-1 of the Public Health 
        Service Act (42 U.S.C. 300gg-111, 300gg-131), 716 of the 
        Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1185e), and 9816 of the Internal Revenue Code of 1986 shall 
        apply to items and services described in section 6001(a) of 
        division F of the Families First Coronavirus Response Act 
        (Public Law 116-127) furnished on or after May 1, 2022, and 
        before January 1, 2024, to an enrollee of a group health plan 
        or group or individual health insurance coverage by a provider 
        that does not have a negotiated rate in effect with such plan 
        or coverage (as applicable) as if such items and services were 
        emergency services furnished by a nonparticipating provider in 
        an emergency department of a hospital.
            ``(2) Nonapplication to over-the-counter tests.--Paragraph 
        (1) shall not apply with respect to any over-the-counter test 
        specified in the guidance document published by the Department 
        of Labor on January 10, 2022, entitled `FAQs about Affordable 
        Care Act Implementation Part 51, Families First Coronavirus 
        Response Act and Coronavirus Aid, Relief, and Economic Security 
        Act Implementation' or any other over-the-counter test 
        specified by the Secretary pursuant to section 6001(a)(1) of 
        the Families First Coronavirus Response Act.
            ``(3) Definitions.--In this subsection, the terms 
        `emergency services' and `nonparticipating provider' have the 
        meanings given such terms in subparagraphs (C)(i) and (G), 
        respectively, of sections 2799A-1(a)(3) of the Public Health 
        Service Act (42 U.S.C. 300gg-111(a)(3)), 716(a)(3) of the 
        Employee Retirement Income Security Act of 1974 (29 U.S.C. 
        1185e(a)(3)), and section 9816(a)(3) of the Internal Revenue 
        Code of 1986.''.
            (2) Implementation.--Notwithstanding any other provision of 
        law, the Secretaries of Health and Human Services, Labor, and 
        the Treasury may implement the amendments made by this 
        subsection by subregulatory guidance or otherwise.
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