Additional Guidance for Health Plan Coverage of OTC COVID-19 Tests
… following requirements: Implement a process of direct payment to the preferred (i.e. in-network) pharmacies or retailers so that the participant is not required to submit a claim for reimbursement; and Offer a “direct-to-consumer” shipping program that can be provided through an internet, mail or phone order arrangement and can be offered through a vendor or relationship separate from the health plan itself. The new FAQs recognize that there may be supply shortages, but as long as the plan offers a direct-to-consumer program, the plan can still limit reimbursement for out-of-network tests to …
https://www.epicbrokers.com/insights/additional-guidance-for-health-plan-coverage-of-otc-covid-19-tests/