No Surprises for COVID–19 Tests Act

Bill: 117-hr-6851
Sponsor: full_name: Rep. Pallone, Frank, Jr. [D-NJ-6]
Introduced: 2022-02-25
Policy area: Health
Subjects: Cardiovascular and respiratory health

Emergency medical services and trauma care

Employee benefits and pensions

Health care costs and insurance

Health care coverage and access

Infectious and parasitic diseases

Medical tests and diagnostic methods
Latest action: action_date: 2022-02-28
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2022-02-25
action_desc: Introduced in House
text: <p><b>No Surprises for COVID-19 Tests Act</b></p> <p>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.</p> <p>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.</p>

tv_txt: I 117th CONGRESS 2d Session H. R. 6851 IN THE HOUSE OF REPRESENTATIVES February 25, 2022 Mr. Pallone (for himself and Mr. Scott of Virginia ) introduced the following bill; which was referred to the Committee on Energy and Commerce , and in addition to the Committees on Ways and Means , and Education and Labor , for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned A BILL 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.

1. Short title This Act may be cited as the No Surprises for COVID–19 Tests Act . 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.