Ensuring Treatment for COVID Act

To amend title XIX of the Social Security Act to require States to provide medical assistance for COVID–19 treatment services for individuals who are diagnosed with COVID–19, and for other purposes. 1. Short title This Act may be cited as the Ensuring Treatment for COVID Act 2. Mandatory coverage of COVID–19 treatment (a) In general Section 1902 of the Social Security Act ( 42 U.S.C. 1396a (1) in subsection (a)— (A) subparagraph (A)— (i) in clause (i)— (I) in subclause (VIII), by striking ; or (II) by inserting after subclause (IX) the following new subclauses: (X) during any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) beginning on or after the date of the enactment of this subclause, who are uninsured individuals (as defined in subsection (ss)); or (XI) who are uninsured individuals who reside in one of the 50 States or the District of Columbia and have been diagnosed with COVID–19 or the virus that causes COVID–19; ; and (ii) in clause (ii)— (I) in subclause (XXI), by inserting or (II) in subclause (XXII), by striking or (III) by striking subclause (XXIII); and (B) in the matter following subparagraph (G)— (i) by striking and (XVIII) (XVIII) (ii) by striking and (XVIII) (XVIII) (iii) by striking who is eligible for medical assistance only because of subparagraph (A)(ii)(XXIII) who is eligible for medical assistance only because of subparagraph (A)(i)(X) (iv) by striking and any visit described in section 1916(a)(2)(G) that is furnished during any such portion and any service described in section 1916(a)(2)(G) that is furnished during any such portion, and (XIX) the medical assistance made available to an individual who is eligible for medical assistance only because of subclause (XI) of subparagraph (A)(i) shall be limited to medical assistance for services that are related to treating COVID–19, and shall only be made available to such individual during the 1-year period following the date of such individual's enrollment under the State plan or waiver (or for such longer period as the State may elect if the individual continues to require treatment for COVID–19 after the end of such 1-year period) (2) in subsection (ss)— (A) in paragraph (1), by inserting subclauses (I) through (IX) of subsection (a)(10)(A)(i) (B) in paragraph (2), by inserting (unless such individual is only enrolled for medical assistance under this title under subclause (X) of subsection (a)(10)(A)(i)) 1128B(f)) (b) Coverage of COVID–19 treatment as a mandatory service Section 1905(a)(4) of the Social Security Act ( 42 U.S.C. 1396d(a)(4) (1) by striking and (D) (D) (2) by striking the semicolon at the end and inserting ; and (E) items and services furnished for the treatment of COVID–19; (c) Prohibition of cost sharing (1) In general Subsections (a)(2) and (b)(2) of section 1916 of the Social Security Act ( 42 U.S.C. 1396o (A) in subparagraph (F), by striking or (B) in subparagraph (G), by striking ; and , or (C) by adding at the end the following subparagraphs: (H) a COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine, or (I) any item or service furnished for the treatment of COVID–19; and . (2) Application to alternative cost sharing Section 1916A(b)(3)(B) of the Social Security Act ( 42 U.S.C. 1396o–1(b)(3)(B) (A) in clause (xi), by striking any visit any service (B) by adding at the end the following clauses: (xii) A COVID–19 vaccine licensed under section 351 of the Public Health Service Act and the administration of such vaccine. (xiii) An item or service furnished for the treatment of COVID–19. . (3) Clarification The amendments made 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. (d) Receipt and processing of applications at certain locations Section 1902(a)(55) of the Social Security Act ( 42 U.S.C. 1396a(a)(55) or (a)(10)(A)(ii)(XXIII) (a)(10)(A)(i)(X), or (a)(10)(A)(i)(XI) (e) Federal medical assistance percentage (1) In general Section 1905 of the Social Security Act ( 42 U.S.C. 1396d (A) in subsection (b), by striking and (ff) (ff), and (gg) (B) by adding at the end the following new subsection: (gg) Enhanced FMAP for medical assistance for COVID–19 treatment Notwithstanding subsection (b), the Federal medical assistance percentage for a State that is one of the 50 States or the District of Columbia, with respect to amounts expended by such State for medical assistance for individuals who are only eligible for such assistance because of section 1902(a)(10)(A)(i)(XI) shall be equal to 100 percent. . (2) Conforming amendment Section 1905(b) of the Social Security Act ( 42 U.S.C. 1396d(b) section 1902(a)(10)(A)(ii)(XXIII) section 1902(a)(10)(A)(i)(X) (f) Enhanced provider payments for services to treat COVID–19 Section 1902(a)(13) of the Social Security Act ( 42 U.S.C. 1396a(a)(13) (1) in subparagraph (B), by striking ; and (2) in subparagraph (C), by striking the semicolon at the end and inserting ; and (3) by adding at the end the following new subparagraph: (D) payment for services to treat COVID–19 at a rate not less than 125 percent of the payment rate that would apply to such services if they were provided under title XVIII; . (g) Nonapplication of certain requirements With respect to medical assistance that is available under a State plan under title XIX of the Social Security Act ( 42 U.S.C. 1396 42 U.S.C. 1396a(a)(10)(A)(i) (1) subsections (a)(1) and (d) of section 1137 of such Act ( 42 U.S.C. 1320b–7 (2) notwithstanding the last sentence of section 1902(a) of such Act ( 42 U.S.C. 1396a(a) (3) the limitations on payment imposed by subsection (f) of section 1903 of such Act ( 42 U.S.C. 1396b (h) State requirement To streamline applications During any portion of the emergency period defined in paragraph (1)(B) of section 1135(g) of the Social Security Act beginning on or after the date of enactment of this Act, each State shall permit an individual who is enrolled for medical assistance under the State plan under title XIX of such Act, or a waiver of such plan, under subclause (X) of section 1902(a)(10)(A)(i) of such Act to enroll for medical assistance under subclause (XI) of such section without requiring a new application from the individual. Nothing in the preceding sentence shall be construed as requiring that an individual first be enrolled under subclause of (X) of section 1902(a)(10)(A)(i) of the Social Security Act in order to enroll under subclause (XI) of such section.

Summary: Ensuring Treatment for COVID Act This bill requires state Medicaid programs to cover treatment for COVID-19 (i.e., coronavirus disease 2019). State Medicaid programs must also cover COVID-19 testing and treatment for uninsured individuals. (Currently, state Medicaid programs are required to cover COVID-19 testing for enrollees and have the option to cover testing for uninsured individuals.) Coverage must be provided with no cost-sharing. Additionally, state Medicaid programs may not impose cost-sharing for COVID-19 vaccines.