Page 137 - Washington Nationals 2023 Benefits Guide -10.26.22_Neat

MLB League-Wide Insurance Program
Plan and Summary Plan Description

Preventative Services Task Force.
• Immunizations for routine use in children, adolescents, or adults recommended by the
Advisory Committee on Immunization Practices of the Centers for Disease Control and
Prevention.
• Evidence-informed preventative care and screening provided for in the comprehensive
guidelines support by the Health Resource and Services Administration (“HRSA”) for
infants, children, and adolescents.
• Other evidence-informed preventative care and screening provided for in comprehensive
guidelines supported by HRSA for women.

For more information contact the Plan Administrator or visit
http://www.healthcare.gov/news/factsheets/2010/07/preventive-services-
list.html#CoveredPreventiveServicesforAdults.

CARES Act Preventive Services. Effective March 27, 2020, all medical benefit options
provided under the Plan shall provide “qualifying coronavirus preventive services” without
cost sharing (including deductibles, copayments, and coinsurance) as required under the
Coronavirus Aid, Relief, and Economic Security Act (“CARES Act”). For this purpose,
“qualifying coronavirus preventive services” have been defined to mean items, services, or
immunizations that are intended to prevent or mitigate COVID-19 and that are:

• Evidence-based items or services that have in effect a rating of “A” or “B” in the current
recommendations of the United States Preventive Services Task Force; or
• Immunizations that has in effect a recommendation from the Advisory Committee on
Immunization Practices of the Centers for Disease Control and Prevention with respect to
the individual involved.

Any such qualifying coronavirus preventive service shall be provided as of the date that is 15
business days after the date on which a recommendation is made by the United States
Preventive Services Task Force or the Advisory Committee on Immunization Practices of the
Centers for Disease Control and Prevention relating to the qualifying coronavirus preventive
service.

COVID-19 Testing Services. Effective March 18, 2020, all medical benefit options available
under the Plan will provide the following services without imposing any cost-sharing
(including deductibles, co-payments, and coinsurance), prior authorization, or other medical
management requirements, regardless of whether the items or services are furnished by an in-
network or out-of-network health care provider:

• A test for the detection of SARS-CoV-2 or the diagnosis of the virus that causes COVID-
19 that is (i) approved, cleared, or authorized under the Federal Food, Drug, and Cosmetic
Act, (ii) allowed pursuant to an emergency use authorization under section 564 of the
Federal Food, Drug and Cosmetic Act, (iii) being developed and used in States who have
notified the U.S. Department of Health and Human Services, and (iv) any other test allowed
by Secretary of Health and Human Services and the administration of any such test;
• Items and services furnished to an individual during a health care provider visit (including

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