The New Jersey Department of Health (NJDOH) has issued a Standing Order for COVID-19 Testing to allow individuals to undergo testing for SARS-COV-2, the virus that causes COVID-19, without a prescription.
Bulletin 20-24 expands the requirements in 20-03 (issued 3/10/2020) to require carriers to cover, without cost-sharing, without prior authorization or other medical management requirements, any SARS-COV-2 molecular test authorized pursuant to the NJDOH standing order, to ensure that cost-sharing is not a barrier to consumers receiving screening and testing for COVID-19 as procedures expand and develop.
This requirement includes such testing administered at any in or out-of-network community-based, county testing, or private testing site, (including, but not limited to, in and out-of-network hospitals, provider offices, urgent care centers, and pharmacies), and includes items and services furnished to an individual during such visits that result in an order for or administration of a SARS-COV-2 molecular test.
As such, effective immediately, carriers must comply with the following:
- treat any such test authorized pursuant to the NJDOH standing order as medically appropriate
- not impose cost-sharing for SARS-COV-2 molecular tests provided by in or out-of-network laboratories
- not require a prescription or prior authorization, or employ any other medical management, for any SARS-COV-2 molecular test administered pursuant to the NJDOH standing order
- notify, as expeditiously as possible, the carrier’s contracted providers that the carrier is waiving cost-sharing as described above