```

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 4469 Introduced in Senate (IS)]

<DOC>

116th CONGRESS
  2d Session
                                S. 4469

        To ensure coverage of a COVID-19 vaccine and treatment.

_______________________________________________________________________

                   IN THE SENATE OF THE UNITED STATES

                             August 6, 2020

  Ms. Smith (for herself, Mr. Bennet, and Ms. Harris) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 A BILL

 
        To ensure coverage of a COVID-19 vaccine and treatment.

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

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``COVID-19 Treatment 
Coverage Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Coverage at no cost sharing of COVID-19 vaccine and treatment 
                            under Medicaid program.
Sec. 3. Coverage of treatment and vaccines at no cost sharing for the 
                            uninsured.
Sec. 4. Coverage of COVID-19 treatment at no cost sharing under 
                            Medicare program.
Sec. 5. Coverage of COVID-19 treatment at no cost sharing under 
                            Medicare Advantage program.
Sec. 6. Coverage of COVID-19 Drugs at no cost sharing under Medicare 
                            prescription drug plans.
Sec. 7. Coverage of COVID-19 treatment at no cost sharing under private 
                            health insurance.
Sec. 8. Coverage of COVID-19 treatment at no cost sharing for TRICARE 
                            recipients.
Sec. 9. Coverage of COVID-19 treatment at no cost sharing for veterans.
Sec. 10. Coverage of COVID-19 treatment at no cost sharing for Federal 
                            civilian employees.
Sec. 11. Coverage of COVID-19 treatment at no cost sharing under Indian 
                            Health Service.
Sec. 12. Sense of Congress related to surprise medical bills.
Sec. 13. Special enrollment period; outreach and enrollment activities.

SEC. 2. COVERAGE AT NO COST SHARING OF COVID-19 VACCINE AND TREATMENT 
              UNDER MEDICAID PROGRAM.

    (a) Medicaid.--
            (1) In general.--Section 1905(a)(4) of the Social Security 
        Act (42 U.S.C. 1396d(a)(4)) is amended--
                    (A) by striking ``and (D)'' and inserting ``(D)''; 
                and
                    (B) by striking the semicolon at the end and 
                inserting ``; (E) during the portion of the emergency 
                period described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of the COVID-19 
                Treatment Coverage Act, a COVID-19 vaccine licensed 
                under section 351 of the Public Health Service Act, or 
                approved or authorized under section 505 or 564 of the 
                Federal Food, Drug, and Cosmetic Act, and 
                administration of the vaccine; (F) during such portion 
                of the emergency period described in paragraph (1)(B) 
                of section 1135(g), items or services for the 
                prevention or treatment of COVID-19, including drugs 
                approved or authorized under such section 505 or such 
                section 564 or, without regard to the requirements of 
                section 1902(a)(10)(B) (relating to comparability), in 
                the case of an individual who is diagnosed with or 
                presumed to have COVID-19, during such portion of such 
                emergency period during which such individual is 
                infected (or presumed infected) with COVID-19, the 
                treatment of a condition that may complicate the 
                treatment of COVID-19;''.
            (2) Prohibition of cost sharing.--
                    (A) In general.--Subsections (a)(2) and (b)(2) of 
                section 1916 of the Social Security Act (42 U.S.C. 
                1396o) are each amended--
                            (i) in subparagraph (F), by striking ``or'' 
                        at the end;
                            (ii) in subparagraph (G), by striking ``; 
                        and'' and inserting ``, or''; and
                            (iii) by adding at the end the following 
                        subparagraphs:
                    ``(H) during the portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of this 
                subparagraph, a COVID-19 vaccine licensed under section 
                351 of the Public Health Service Act, or approved or 
                authorized under section 505 or 564 of the Federal 
                Food, Drug, and Cosmetic Act, and the administration of 
                such vaccine, or
                    ``(I) during such portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g), any 
                item or service furnished for the treatment of COVID-
                19, including drugs approved or authorized under such 
                section 505 or such section 564 or, in the case of an 
                individual who is diagnosed with or presumed to have 
                COVID-19, during the portion of such emergency period 
                during which such individual is infected (or presumed 
                infected) with COVID-19, the treatment of a condition 
                that may complicate the treatment of COVID-19; and''.
                    (B) Application to alternative cost sharing.--
                Section 1916A(b)(3)(B) of the Social Security Act (42 
                U.S.C. 1396o-1(b)(3)(B)) is amended--
                            (i) in clause (xi), by striking ``any 
                        visit'' and inserting ``any service''; and
                            (ii) by adding at the end the following 
                        clauses:
                            ``(xii) During the portion of the emergency 
                        period described in paragraph (1)(B) of section 
                        1135(g) beginning on the date of the enactment 
                        of this clause, a COVID-19 vaccine licensed 
                        under section 351 of the Public Health Service 
                        Act, or approved or authorized under section 
                        505 or 564 of the Federal Food, Drug, and 
                        Cosmetic Act, and the administration of such 
                        vaccine.
                            ``(xiii) During such portion of the 
                        emergency period described in paragraph (1)(B) 
                        of section 1135(g), an item or service 
                        furnished for the treatment of COVID-19, 
                        including drugs approved or authorized under 
                        such section 505 or such section 564 or, in the 
                        case of an individual who is diagnosed with or 
                        presumed to have COVID-19, during such portion 
                        of such emergency period during which such 
                        individual is infected (or presumed infected) 
                        with COVID-19, the treatment of a condition 
                        that may complicate the treatment of COVID-
                        19.''.
                    (C) Clarification.--The amendments made by this 
                subsection shall apply with respect to a State plan of 
                a territory in the same manner as a State plan of one 
                of the 50 States.
    (b) State Pediatric Vaccine Distribution Program.--Section 1928 of 
the Social Security Act (42 U.S.C. 1396s) is amended--
            (1) in subsection (a)(1)--
                    (A) in subparagraph (A), by striking ``; and'' and 
                inserting a semicolon;
                    (B) in subparagraph (B), by striking the period and 
                inserting ``; and''; and
                    (C) by adding at the end the following 
                subparagraph:
                    ``(C) during the portion of the emergency period 
                described in paragraph (1)(B) of section 1135(g) 
                beginning on the date of the enactment of this 
                subparagraph, each vaccine-eligible child (as defined 
                in subsection (b)) is entitled to receive a COVID-19 
                vaccine from a program-registered provider (as defined 
                in subsection (h)(7)) without charge for--
                            ``(i) the cost of such vaccine; or
                            ``(ii) the administration of such 
                        vaccine.'';
            (2) in subsection (c)(2)--
                    (A) in subparagraph (C)(ii), by inserting ``, but, 
                during the portion of the emergency period described in 
                paragraph (1)(B) of section 1135(g) beginning on the 
                date of the enactment of the COVID-19 Treatment 
                Coverage Act, may not impose a fee for the 
                administration of a COVID-19 vaccine'' before the 
                period; and
                    (B) by adding at the end the following 
                subparagraph:
                    ``(D) The provider will provide and administer an 
                approved COVID-19 vaccine to a vaccine-eligible child 
                in accordance with the same requirements as apply under 
                the preceding subparagraphs to the provision and 
                administration of a qualified pediatric vaccine to such 
                a child.''; and
            (3) in subsection (d)(1), in the first sentence, by 
        inserting ``, including, during the portion of the emergency 
        period described in paragraph (1)(B) of section 1135(g) 
        beginning on the date of the enactment of the COVID-19 
        Treatment Coverage Act, with respect to a COVID-19 vaccine 
        licensed under section 351 of the Public Health Service Act, or 
        approved or authorized under section 505 or 564 of the Federal 
        Food, Drug, and Cosmetic Act'' before the period.
    (c) CHIP.--
            (1) In general.--Section 2103(c) of the Social Security Act 
        (42 U.S.C. 1397cc(c)) is amended by adding at the end the 
        following paragraph:
            ``(11) Coverage of covid-19 vaccines and treatment.--
        Regardless of the type of coverage elected by a State under 
        subsection (a), child health assistance provided under such 
        coverage for targeted low-income children and, in the case that 
        the State elects to provide pregnancy-related assistance under 
        such coverage pursuant to section 2112, such pregnancy-related 
        assistance for targeted low-income pregnant women (as defined 
        in section 2112(d)) shall include coverage, during the portion 
        of the emergency period described in paragraph (1)(B) of 
        section 1135(g) beginning on the date of the enactment of this 
        paragraph, of--
                    ``(A) a COVID-19 vaccine licensed under section 351 
                of the Public Health Service Act, or approved or 
                authorized under section 505 or 564 of the Federal 
                Food, Drug, and Cosmetic Act, and the administration of 
                such vaccine; and
                    ``(B) any item or service furnished for the 
                treatment of COVID-19, including drugs approved or 
                authorized under such section 505 or such section 564, 
                or, in the case of an individual who is diagnosed with 
                or presumed to have COVID-19, during the portion of 
                such emergency period during which such individual is 
                infected (or presumed infected) with COVID-19, the 
                treatment of a condition that may complicate the 
                treatment of COVID-19.''.
            (2) Prohibition of cost sharing.--Section 2103(e)(2) of the 
        Social Security Act (42 U.S.C. 1397cc(e)(2)), as amended by 
        section 6004(b)(3) of the Families First Coronavirus Response 
        Act, is amended--
                    (A) in the paragraph header, by inserting ``a 
                covid-19 vaccine, covid-19 treatment,'' before ``or 
                pregnancy-related assistance''; and
                    (B) by striking ``visits described in section 
                1916(a)(2)(G), or'' and inserting ``services described 
                in section 1916(a)(2)(G), vaccines described in section 
                1916(a)(2)(H) administered during the portion of the 
                emergency period described in paragraph (1)(B) of 
                section 1135(g) beginning on the date of the enactment 
                of the COVID-19 Treatment Coverage Act, items or 
                services described in section 1916(a)(2)(I) furnished 
                during such emergency period, or''.
    (d) Conforming Amendments.--Section 1937 of the Social Security Act 
(42 U.S.C. 1396u-7) is amended--
            (1) in subsection (a)(1)(B), by inserting ``, under 
        subclause (XXIII) of section 1902(a)(10)(A)(ii),'' after 
        ``section 1902(a)(10)(A)(i)''; and
            (2) in subsection (b)(5), by adding before the period the 
        following: ``, and, effective on the date of the enactment of 
        the COVID-19 Treatment Coverage Act, must comply with 
        subparagraphs (F) through (I) of subsections (a)(2) and (b)(2) 
        of section 1916 and subsection (b)(3)(B) of section 1916A''.
    (e) Effective Date.--The amendments made by this section shall take 
effect on the date of enactment of this Act and shall apply with 
respect to a COVID-19 vaccine beginning on the date that such vaccine 
is licensed under section 351 of the Public Health Service Act (42 
U.S.C. 262), or approved or authorized under section 505 or 564 of the 
Federal Food, Drug, and Cosmetic Act.

SEC. 3. COVERAGE OF TREATMENT AND VACCINES AT NO COST SHARING FOR THE 
              UNINSURED.

    (a) In General.--Section 1902(a)(10) of the Social Security Act (42 
U.S.C. 1396a(a)(10)) is amended, in the matter following subparagraph 
(G), by striking ``and any visit described in section 1916(a)(2)(G)'' 
and inserting the following: ``, any COVID-19 vaccine that is 
administered during any such portion (and the administration of such 
vaccine), any item or service that is furnished during any such portion 
for the treatment of COVID-19, including drugs approved or authorized 
under section 505 or 564 of the Federal Food, Drug, and Cosmetic Act, 
or, in the case of an individual who is diagnosed with or presumed to 
have COVID-19, during the period such individual is infected (or 
presumed infected) with COVID-19, the treatment of a condition that may 
complicate the treatment of COVID-19, the treatment of a COVID-19-
related condition that follows the treatment of, or hospitalization 
with, COVID-19, and any services described in section 1916(a)(2)(G)''.
    (b) Definition of Uninsured Individual.--
            (1) In general.--Subsection (ss) of section 1902 of the 
        Social Security Act (42 U.S.C. 1396a) is amended to read as 
        follows:
    ``(ss) Uninsured Individual Defined.--For purposes of this section, 
the term `uninsured individual' means, notwithstanding any other 
provision of this title, any individual who is not covered by minimum 
essential coverage (as defined in section 5000A(f)(1) of the Internal 
Revenue Code of 1986).''.
            (2) Effective date.--The amendment made by paragraph (1) 
        shall take effect and apply as if included in the enactment of 
        the Families First Coronavirus Response Act (Public Law 116-
        127).
    (c) Clarification Regarding Emergency Services for Certain 
Individuals.--For purposes of applying section 1903(v)(2)(A) of the 
Social Security Act (42 U.S.C. 1396b(v)(2)(A)), the care and services 
described in such section shall include the following:
            (1) In vitro diagnostic products (as defined in section 
        809.3(a) of title 21, Code of Federal Regulations), and the 
        administration of such products.
            (2) A COVID-19 vaccine (and the administration of such 
        vaccine).
            (3) Any item or service that is furnished for the treatment 
        of COVID-19 or a condition that may complicate the treatment of 
        COVID-19, the treatment of a COVID-19-related condition that 
        follows the treatment of, or hospitalization with, COVID-19, 
        and any services described in section 1916(a)(2)(G) of such Act 
        (42 U.S.C. 1396o(a)(2)(G)).
    (d) Emergency Medicaid for Individuals With Suspected COVID-19 
Infections.--For purposes of applying section 1903(v)(3) of the Social 
Security Act (42 U.S.C. 1396b(v)(3)), the term ``emergency medical 
condition'' (as defined in such section 1903(v)(3)) shall include, with 
respect to an individual, any concern that the individual may have 
contracted COVID-19.
    (e) Treatment of Assistance and Services Provided.--Beginning on 
the date of enactment of this Act--
            (1) the value of assistance or services provided to any 
        person under a program with respect to which a coronavirus 
        response law establishes or expands eligibility or benefits 
        shall not be considered income or resources; and
            (2)(A) any medical coverage or services provided to an 
        individual under subsection (v) of section 1903 of the Social 
        Security Act (42 U.S.C. 1396b) shall be considered treatment 
        for an emergency medical condition (as defined in subsection 
        (v)(3) of such section) for any purpose under any Federal, 
        State, or local law, including law relating to taxation, 
        welfare, and public assistance programs; and
            (B) a participating State or political subdivision of a 
        State shall not decrease any assistance otherwise provided to 
        an individual because of the receipt of benefits under the 
        Social Security Act (42 U.S.C. 301 et seq.).
    (f) Other Definitions.--In this section:
            (1) Coronavirus public health emergency.--The term 
        ``coronavirus public health emergency'' means--
                    (A) an emergency involving Federal primary 
                responsibility determined to exist by the President 
                under section 501(b) of the Robert T. Stafford Disaster 
                Relief and Emergency Assistance Act (42 U.S.C. 5191(b)) 
                with respect to COVID-19 or any other coronavirus with 
                pandemic potential;
                    (B) an emergency declared by a Federal official 
                with respect to coronavirus (as defined in section 506 
                of the Coronavirus Preparedness and Response 
                Supplemental Appropriations Act, 2020 (Public Law 116-
                123));
                    (C) a national emergency declared by the President 
                under the National Emergencies Act (50 U.S.C. 1601 et 
                seq.) with respect to COVID-19 or any other coronavirus 
                with pandemic potential; and
                    (D) a public health emergency declared by the 
                Secretary of Health and Human Services pursuant to 
                section 319 of the Public Health Service Act (42 U.S.C. 
                247(d)) with respect to COVID-19 or any other 
                coronavirus with pandemic potential.
            (2) Coronavirus response law.--The term ``coronavirus 
        response law'' means--
                    (A) the Coronavirus Preparedness and Response 
                Supplemental Appropriations Act, 2020 (Public Law 116-
                123);
                    (B) the Families First Coronavirus Response Act 
                (Public Law 116-127);
                    (C) the Coronavirus Aid, Relief, and Economic 
                Security Act (Public Law 116-136); and
                    (D) any subsequent law that appropriates or 
                otherwise makes available funds, establishes, amends, 
                or expands a program, or authorizes activities or 
                assistance for a purpose that is expressly related to 
                responding to, or mitigating the effects of, a 
                coronavirus public health emergency.
    (g) Reimbursement for Additional Health Services Relating to 
Coronavirus.--Title V of division A of the Families First Coronavirus 
Response Act (Public Law 116-127) is amended under the heading 
``Department of Health and Human Services--Office of the Secretary--
Public Health and Social Services Emergency Fund'' by inserting ``, or 
treatment related to SARS-CoV-2 or COVID-19 for uninsured individuals'' 
after ``or visits described in paragraph (2) of such section for 
uninsured individuals''.
    (h) Rule of Construction.--Nothing in this section shall be 
construed to limit--
            (1) the types of care and services that are necessary for 
        the treatment of an emergency condition for purposes of section 
        1903(v) of the Social Security Act (42 U.S.C. 1396b(v)); or
            (2) the types of medical conditions that are ``emergency 
        medical conditions'' for purposes of such section.

SEC. 4. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING UNDER 
              MEDICARE PROGRAM.

    (a) In General.--Notwithstanding any other provision of law, in the 
case of a specified COVID-19 treatment service (as defined in 
subsection (b)) furnished during any portion of the emergency period 
described 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 to an individual entitled to benefits under part 
A or enrolled under part B of title XVIII of the Social Security Act 
(42 U.S.C. 1395 et seq.) for which payment is made under such part A or 
such part B, the Secretary of Health and Human Services (in this 
section referred to as the ``Secretary'') shall provide that--
            (1) any cost sharing required (including any deductible, 
        copayment, or coinsurance) applicable to such individual under 
        such part A or such part B with respect to such item or service 
        is paid by the Secretary; and
            (2) the provider of services or supplier (as defined in 
        section 1861 of the Social Security Act (42 U.S.C. 1395x)) does 
        not hold such individual liable for such requirement.
    (b) Definition of Specified COVID-19 Treatment Services.--For 
purposes of this section, the term ``specified COVID-19 treatment 
service'' means any item or service furnished to an individual for 
which payment may be made under part A or part B of title XVIII of the 
Social Security Act (42 U.S.C. 1395 et seq.) if such item or service is 
included in a claim with an ICD-10-CM code relating to COVID-19 (as 
described in the document entitled ``ICD-10-CM Official Coding 
Guidelines--Supplement Coding encounters related to COVID-19 
Coronavirus Outbreak'' published on February 20, 2020, or as otherwise 
specified by the Secretary).
    (c) Recovery of Cost-Sharing Amounts Paid by the Secretary in the 
Case of Supplemental Insurance Coverage.--
            (1) In general.--In the case of any amount paid by the 
        Secretary pursuant to subsection (a)(1) that the Secretary 
        determines would otherwise have been paid by a group health 
        plan or health insurance issuer (as such terms are defined in 
        section 2791 of the Public Health Service Act (42 U.S.C. 300gg-
        91)), a private entity offering a medicare supplemental policy 
        under section 1882 of the Social Security Act (42 U.S.C. 
        1395ss), any other health plan offering supplemental coverage, 
        a State plan under title XIX of the Social Security Act, or the 
        Secretary of Defense under the TRICARE program, such plan, 
        issuer, private entity, other health plan, State plan, or 
        Secretary of Defense, as applicable, shall pay to the 
        Secretary, not later than 1 year after such plan, issuer, 
        private entity, other health plan, State plan, or Secretary of 
        Defense receives a notice under paragraph (3), such amount in 
        accordance with this subsection.
            (2) Required information.--Not later than 9 months after 
        the date of the enactment of this Act, each group health plan, 
        health insurance issuer, private entity, other health plan, 
        State plan, and Secretary of Defense described in paragraph (1) 
        shall submit to the Secretary such information as the Secretary 
        determines necessary for purposes of carrying out this 
        subsection. Such information so submitted shall be updated by 
        such plan, issuer, private entity, other health plan, State 
        plan, or Secretary of Defense, as applicable, at such time and 
        in such manner as specified by the Secretary.
            (3) Review of claims and notification.--The Secretary shall 
        establish a process under which claims for items and services 
        for which the Secretary has paid an amount pursuant to 
        subsection (a)(1) are reviewed for purposes of identifying if 
        such amount would otherwise have been paid by a plan, issuer, 
        private entity, other health plan, State plan, or Secretary of 
        Defense described in paragraph (1). In the case such a claim is 
        so identified, the Secretary shall determine the amount that 
        would have been otherwise payable by such plan, issuer, private 
        entity, other health plan, State plan, or Secretary of Defense 
        and notify such plan, issuer, private entity, other health 
        plan, State plan, or Secretary of Defense of such amount.
            (4) Enforcement.--The Secretary may impose a civil monetary 
        penalty in an amount determined appropriate by the Secretary in 
        the case of a plan, issuer, private entity, other health plan, 
        or State plan that fails to comply with a provision of this 
        section. The provisions of section 1128A of the Social Security 
        Act shall apply to a civil monetary penalty imposed under the 
        previous sentence in the same manner as such provisions apply 
        to a penalty or proceeding under subsection (a) or (b) of such 
        section.
    (d) Funding.--The Secretary shall provide for the transfer to the 
Centers for Medicare & Medicaid Program Management Account from the 
Federal Hospital Insurance Trust Fund and the Federal Supplementary 
Trust Fund (in such portions as the Secretary determines appropriate) 
$100,000,000 for purposes of carrying out this section.
    (e) Report.--Not later than 3 years after the date of the enactment 
of this Act, the Inspector General of the Department of Health and 
Human Services shall submit to Congress a report containing an analysis 
of amounts paid pursuant to subsection (a)(1) compared to amounts paid 
to the Secretary pursuant to subsection (c).
    (f) Implementation.--Notwithstanding any other provision of law, 
the Secretary may implement the provisions of this section by program 
instruction or otherwise.

SEC. 5. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING UNDER 
              MEDICARE ADVANTAGE PROGRAM.

    (a) In General.--Section 1852(a)(1)(B) of the Social Security Act 
(42 U.S.C. 1395w-22(a)(1)(B)) is amended by adding at the end the 
following new clause:
                            ``(vii) Special coverage rules for 
                        specified covid-19 treatment services.--
                        Notwithstanding clause (i), in the case of a 
                        specified COVID-19 treatment service (as 
                        defined in section 4(b) of the COVID-19 
                        Treatment Coverage Act) that is furnished 
                        during a plan year occurring during any portion 
                        of the emergency period defined in section 
                        1135(g)(1)(B) beginning on or after the date of 
                        the enactment of this clause, a Medicare 
                        Advantage plan may not, with respect to such 
                        service, impose--
                                    ``(I) any cost-sharing requirement 
                                (including a deductible, copayment, or 
                                coinsurance requirement); and
                                    ``(II) in the case such service is 
                                a critical specified COVID-19 treatment 
                                service (including ventilator services 
                                and intensive care unit services), any 
                                prior authorization or other 
                                utilization management requirement.
                        A Medicare Advantage plan may not take the 
                        application of this clause into account for 
                        purposes of a bid amount submitted by such plan 
                        under section 1854(a)(6).''.
    (b) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 6. COVERAGE OF COVID-19 DRUGS AT NO COST SHARING UNDER MEDICARE 
              PRESCRIPTION DRUG PLANS.

    (a) Coverage Requirement.--
            (1) In general.--Section 1860D-4(b)(3) of the Social 
        Security Act (42 U.S.C. 1395w-104(b)(3)) is amended by adding 
        at the end the following new subparagraph:
                    ``(I) Required inclusion of drugs intended to treat 
                covid-19.--
                            ``(i) In general.--Notwithstanding any 
                        other provision of law, a PDP sponsor offering 
                        a prescription drug plan shall, with respect to 
                        a plan year, any portion of which occurs during 
                        the period described in clause (ii), be 
                        required to--
                                    ``(I) include in any formulary--
                                            ``(aa) all covered part D 
                                        drugs with a medically accepted 
                                        indication (as defined in 
                                        section 1860D-2(e)(4)) to treat 
                                        COVID-19 that are marketed in 
                                        the United States; and
                                            ``(bb) all drugs authorized 
                                        under section 564 or 564A of 
                                        the Federal Food, Drug, and 
                                        Cosmetic Act to treat COVID-19; 
                                        and
                                    ``(II) not impose any prior 
                                authorization or other utilization 
                                management requirement with respect to 
                                such drugs described in item (aa) or 
                                (bb) of subclause (I) (other than such 
                                a requirement that limits the quantity 
                                of drugs due to safety).
                            ``(ii) Period described.--For purposes of 
                        clause (i), the period described in this clause 
                        is the period during which there exists the 
                        public health emergency declared by the 
                        Secretary pursuant to section 319 of the Public 
                        Health Service Act on January 31, 2020, 
                        entitled `Determination that a Public Health 
                        Emergency Exists Nationwide as the Result of 
                        the 2019 Novel Coronavirus' (including any 
                        renewal of such declaration pursuant to such 
                        section).''.
    (b) Elimination of Cost Sharing.--
            (1) Elimination of cost sharing for drugs intended to treat 
        covid-19 under standard and alternative prescription drug 
        coverage.--Section 1860D-2 of the Social Security Act (42 
        U.S.C. 1395w-102) is amended--
                    (A) in subsection (b)--
                            (i) in paragraph (1)(A), by striking ``The 
                        coverage'' and inserting ``Subject to paragraph 
                        (8), the coverage'';
                            (ii) in paragraph (2)--
                                    (I) in subparagraph (A), by 
                                inserting after ``Subject to 
                                subparagraphs (C) and (D)'' the 
                                following: ``and paragraph (8)'';
                                    (II) in subparagraph (C)(i), by 
                                striking ``paragraph (4)'' and 
                                inserting ``paragraphs (4) and (8)''; 
                                and
                                    (III) in subparagraph (D)(i), by 
                                striking ``paragraph (4)'' and 
                                inserting ``paragraphs (4) and (8)'';
                            (iii) in paragraph (4)(A)(i), by striking 
                        ``The coverage'' and inserting ``Subject to 
                        paragraph (8), the coverage''; and
                            (iv) by adding at the end the following new 
                        paragraph:
            ``(8) Elimination of cost-sharing for drugs intended to 
        treat covid-19.--The coverage does not impose any deductible, 
        copayment, coinsurance, or other cost-sharing requirement for 
        drugs described in section 1860D-4(b)(3)(I)(i)(I) with respect 
        to a plan year, any portion of which occurs during the period 
        during which there exists the public health emergency declared 
        by the Secretary pursuant to section 319 of the Public Health 
        Service Act on January 31, 2020, entitled `Determination that a 
        Public Health Emergency Exists Nationwide as the Result of the 
        2019 Novel Coronavirus' (including any renewal of such 
        declaration pursuant to such section).''; and
                    (B) in subsection (c), by adding at the end the 
                following new paragraph:
            ``(4) Same elimination of cost-sharing for drugs intended 
        to treat covid-19.--The coverage is in accordance with 
        subsection (b)(8).''.
            (2) Elimination of cost sharing for drugs intended to treat 
        covid-19 dispensed to individuals who are subsidy eligible 
        individuals.--Section 1860D-14(a) of the Social Security Act 
        (42 U.S.C. 1395w-114(a)) is amended--
                    (A) in paragraph (1)--
                            (i) in subparagraph (D)--
                                    (I) in clause (ii), by striking 
                                ``In the case of'' and inserting 
                                ``Subject to subparagraph (F), in the 
                                case of''; and
                                    (II) in clause (iii), by striking 
                                ``In the case of'' and inserting 
                                ``Subject to subparagraph (F), in the 
                                case of''; and
                            (ii) by adding at the end the following new 
                        subparagraph:
                    ``(F) Elimination of cost-sharing for drugs 
                intended to treat covid-19.--Coverage that is in 
                accordance with section 1860D-2(b)(8).''; and
                    (B) in paragraph (2)--
                            (i) in subparagraph (B), by striking ``A 
                        reduction'' and inserting ``Subject to 
                        subparagraph (F), a reduction'';
                            (ii) in subparagraph (D), by striking ``The 
                        substitution'' and inserting ``Subject to 
                        subparagraph (F), the substitution'';
                            (iii) in subparagraph (E), by inserting 
                        after ``Subject to'' the following: 
                        ``subparagraph (F) and''; and
                            (iv) by adding at the end the following new 
                        subparagraph:
                    ``(F) Elimination of cost-sharing for drugs 
                intended to treat covid-19.--Coverage that is in 
                accordance with section 1860D-2(b)(8).''.
    (c) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the amendments 
made by this section by program instruction or otherwise.

SEC. 7. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING UNDER PRIVATE 
              HEALTH INSURANCE.

    (a) In General.--A group health plan and a health insurance issuer 
offering group or individual health insurance coverage (including a 
grandfathered health plan (as defined in section 1251(e) of the Patient 
Protection and Affordable Care Act)) shall provide coverage, and shall 
not impose any cost sharing (including deductibles, copayments, and 
coinsurance) requirements, for the following items and services 
furnished during 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:
            (1) Medically necessary items and services (including in-
        person or telehealth visits in which such items and services 
        are furnished) that are furnished to an individual who has been 
        diagnosed with (or after provision of the items and services is 
        diagnosed with) COVID-19 to treat or mitigate the effects of 
        COVID-19.
            (2) Medically necessary items and services (including in-
        person or telehealth visits in which such items and services 
        are furnished) that are furnished to an individual who is 
        presumed to have COVID-19 but is never diagnosed as such, if 
        the following conditions are met:
                    (A) Such items and services are furnished to the 
                individual to treat or mitigate the effects of COVID-19 
                or to mitigate the impact of COVID-19 on society.
                    (B) Health care providers have taken appropriate 
                steps under the circumstances to make a diagnosis, or 
                confirm whether a diagnosis was made, with respect to 
                such individual, for COVID-19, if possible.
    (b) Items and Services Related to COVID-19.--For purposes of this 
section--
            (1) not later than one week after the date of the enactment 
        of this section, the Secretary of Health and Human Services, 
        the Secretary of Labor, and the Secretary of the Treasury shall 
        jointly issue guidance specifying applicable diagnoses and 
        medically necessary items and services related to COVID-19; and
            (2) such items and services shall include all items or 
        services that are relevant to the treatment or mitigation of 
        COVID-19, regardless of whether such items or services are 
        ordinarily covered under the terms of a group health plan or 
        group or individual health insurance coverage offered by a 
        health insurance issuer.
    (c) Enforcement.--
            (1) Application with respect to phsa, erisa, and irc.--The 
        provisions of this section shall be applied by the Secretary of 
        Health and Human Services, the Secretary of Labor, and the 
        Secretary of the Treasury to group health plans and health 
        insurance issuers offering group or individual health insurance 
        coverage as if included in the provisions of part A of title 
        XXVII of the Public Health Service Act (42 U.S.C. 300gg et 
        seq.), part 7 of subtitle B of title I of the Employee 
        Retirement Income Security Act of 1974 (29 U.S.C. 1181 et 
        seq.), and subchapter B of chapter 100 of the Internal Revenue 
        Code of 1986, as applicable.
            (2) Private right of action.--An individual with respect to 
        whom an action is taken by a group health plan or health 
        insurance issuer offering group or individual health insurance 
        coverage in violation of subsection (a) may commence a civil 
        action against the plan or issuer for appropriate relief. The 
        previous sentence shall not be construed as limiting any 
        enforcement mechanism otherwise applicable pursuant to 
        paragraph (1).
    (d) Implementation.--The Secretary of Health and Human Services, 
the Secretary of Labor, and the Secretary of the Treasury may implement 
the provisions of this section through sub-regulatory guidance, program 
instruction or otherwise.
    (e) Terms.--The terms ``group health plan'', ``health insurance 
issuer'', ``group health insurance coverage'', and ``individual health 
insurance coverage'' have the meanings given such terms in section 2791 
of the Public Health Service Act (42 U.S.C. 300gg-91), section 733 of 
the Employee Retirement Income Security Act of 1974 (29 U.S.C. 1191b), 
and section 9832 of the Internal Revenue Code of 1986, as applicable.

SEC. 8. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING FOR TRICARE 
              RECIPIENTS.

    (a) In General.--Section 6006(a) of the Families First Coronavirus 
Response Act (Public Law 116-127; 38 U.S.C. 1074 note) is amended by 
striking ``or visits described in paragraph (2) of such section'' and 
inserting ``, visits described in paragraph (2) of such section, or 
medical care to treat COVID-19''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to medical care furnished on or after the date of 
the enactment of this Act.

SEC. 9. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING FOR VETERANS.

    (a) In General.--Section 6006(b) of the Families First Coronavirus 
Response Act (Public Law 116-127; 38 U.S.C. 1701 note) is amended by 
striking ``or visits described in paragraph (2) of such section'' and 
inserting ``, visits described in paragraph (2) of such section, or 
hospital care or medical services to treat COVID-19''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to hospital care and medical services furnished on 
or after the date of the enactment of this Act.

SEC. 10. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING FOR FEDERAL 
              CIVILIAN EMPLOYEES.

    (a) In General.--Section 6006(c) of the Families First Coronavirus 
Response Act (Public Law 116-127; 5 U.S.C. 8904 note) is amended by 
striking ``or visits described in paragraph (2) of such section'' and 
inserting ``, visits described in paragraph (2) of such section, or 
hospital care or medical services to treat COVID-19''.
    (b) Effective Date.--The amendment made by subsection (a) shall 
apply with respect to hospital care and medical services furnished on 
or after the date of the enactment of this Act.

SEC. 11. COVERAGE OF COVID-19 TREATMENT AT NO COST SHARING UNDER INDIAN 
              HEALTH SERVICE.

    The Secretary of Health and Human Services shall cover, without the 
imposition of any cost sharing requirements, the cost of the following 
on or after the date of the enactment of this Act to Indians (as 
defined in section 4 of the Indian Health Care Improvement Act (25 
U.S.C. 1603)) receiving health services through the Indian Health 
Service, regardless of whether such items or services are authorized 
under the Contract Health Services program funded by the Indian Health 
Service and operated by the Indian Health Service or operated by an 
Indian tribe or tribal organization under a contract or compact with 
the Indian Health Service under the Indian Self-Determination and 
Education Assistance Act (25 U.S.C. 5301 et seq.), or are provided as a 
health service of the Indian Health Service:
            (1) A COVID-19 vaccine licensed under section 351 of the 
        Public Health Service Act, or approved or authorized under 
        section 505 or 564 of the Federal Food, Drug, and Cosmetic Act, 
        and the administration of such vaccine.
            (2) Any item or service furnished for the treatment of 
        COVID-19, including drugs approved or authorized under such 
        section 505 or such section 564, or, in the case of an 
        individual who is diagnosed with or presumed to have COVID-19, 
        during the portion of such emergency period during which such 
        individual is infected (or presumed infected) with COVID-19, 
        the treatment of a condition that may complicate the treatment 
        of COVID-19.

SEC. 12. SENSE OF CONGRESS RELATED TO SURPRISE MEDICAL BILLS.

    It is the sense of Congress that no individual should receive a 
medical bill, including a balance bill, for the cost of COVID-19 
treatment, office visits related to COVID-19 treatment, COVID-19 
vaccines, or the administration of those vaccines.

SEC. 13. SPECIAL ENROLLMENT PERIOD; OUTREACH AND ENROLLMENT ACTIVITIES.

    (a) Special Enrollment Period Through Exchanges.--Section 1311(c) 
of the Patient Protection and Affordable Care Act (42 U.S.C. 18031(c)) 
is amended--
            (1) in paragraph (6)--
                    (A) in subparagraph (C), by striking at the end 
                ``and'';
                    (B) in subparagraph (D), by striking at the end the 
                period and inserting ``; and''; and
                    (C) by adding at the end the following new 
                subparagraph:
                    ``(E) subject to subparagraph (B) of paragraph (8), 
                the special enrollment period described in subparagraph 
                (A) of such paragraph.''; and
            (2) by adding at the end the following new paragraph:
            ``(8) Special enrollment period for certain public health 
        emergency.--
                    ``(A) In general.--The Secretary shall, subject to 
                subparagraph (B), require an Exchange to provide--
                            ``(i) for a special enrollment period 
                        during the emergency period described in 
                        section 1135(g)(1)(B) of the Social Security 
                        Act--
                                    ``(I) which shall begin on the date 
                                that is one week after the date of the 
                                enactment of this paragraph and which, 
                                in the case of an Exchange established 
                                or operated by the Secretary within a 
                                State pursuant to section 1321(c), 
                                shall be an 8-week period; and
                                    ``(II) during which any individual 
                                who is otherwise eligible to enroll in 
                                a qualified health plan through the 
                                Exchange may enroll in such a qualified 
                                health plan; and
                            ``(ii) that, in the case of an individual 
                        who enrolls in a qualified health plan through 
                        the Exchange during such enrollment period, the 
                        coverage period under such plan shall begin, at 
                        the option of the individual, on April 1, 2020, 
                        or on the first day of the month following the 
                        day the individual selects a plan through such 
                        special enrollment period.
                    ``(B) Exception.--The requirement of subparagraph 
                (A) shall not apply to a State-operated or State-
                established Exchange if such Exchange, prior to the 
                date of the enactment of this paragraph, established or 
                otherwise provided for a special enrollment period to 
                address access to coverage under qualified health plans 
                offered through such Exchange during the emergency 
                period described in section 1135(g)(1)(B) of the Social 
                Security Act.''.
    (b) Federal Exchange Outreach and Educational Activities.--Section 
1321(c) of the Patient Protection and Affordable Care Act (42 U.S.C. 
18041(c)) is amended by adding at the end the following new paragraph:
            ``(3) Outreach and educational activities.--
                    ``(A) In general.--In the case of an Exchange 
                established or operated by the Secretary within a State 
                pursuant to this subsection, the Secretary shall carry 
                out outreach and educational activities for purposes of 
                informing potential enrollees in qualified health plans 
                offered through the Exchange of the availability of 
                coverage under such plans and financial assistance for 
                coverage under such plans. Such outreach and 
                educational activities shall be provided in a manner 
                that is culturally and linguistically appropriate to 
                the needs of the populations being served by the 
                Exchange (including hard-to-reach populations, such as 
                racial and sexual minorities, limited English 
                proficient populations, and young adults).
                    ``(B) Limitation on use of funds.--No funds 
                appropriated under this paragraph shall be used for 
                expenditures for promoting non-ACA compliant health 
                insurance coverage.
                    ``(C) Non-ACA compliant health insurance 
                coverage.--For purposes of subparagraph (B):
                            ``(i) The term `non-ACA compliant health 
                        insurance coverage' means health insurance 
                        coverage, or a group health plan, that is not a 
                        qualified health plan.
                            ``(ii) Such term includes the following:
                                    ``(I) An association health plan.
                                    ``(II) Short-term limited duration 
                                insurance.
                    ``(D) Funding.--There are appropriated, out of any 
                funds in the Treasury not otherwise appropriated, 
                $25,000,000, to remain available until expended--
                            ``(i) to carry out this paragraph; and
                            ``(ii) at the discretion of the Secretary, 
                        to carry out section 1311(i), with respect to 
                        an Exchange established or operated by the 
                        Secretary within a State pursuant to this 
                        subsection.''.
    (c) Implementation.--The Secretary of Health and Human Services may 
implement the provisions of (including amendments made by) this section 
through subregulatory guidance, program instruction, or otherwise.
                                 <all>
```