ance coverage shall waive any restriction (including 
any prior authorization requirement, limitation on 
filling or refilling prescription drugs, or other re-
strictions) on access to covered benefits required 
under this section, if the service is determined by a 
qualified health professional to be medically nec-
essary by the provider and the Secretary determines 
such restriction to be unduly burdensome in the con-
text of the applicable public health emergency. 
‘‘(2) TERM OF WAIVER.—Any waiver of restric-
tions pursuant to paragraph (1) shall apply only for 
the duration of the public health emergency, as de-
clared under section 319 of the Public Health Serv-
ice Act.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subpart B of part 7 of subtitle B 
of title I of the Employee Retirement Income 
Security Act of 1974 is amended by adding at 
the end the following: 
‘‘Sec. 715. Additional market reforms. 
‘‘Sec. 716. Coverage of prevention and treatment related to public health emer-
gencies.’’. 
(3) IRC.— 
(A) IN GENERAL.—Subchapter B of chap-
ter 100 of the Internal Revenue Code of 1986 
is amended by adding at the end the following 
new section: 
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‘‘SEC. 9816. COVERAGE OF PREVENTION AND TREATMENT 
RELATED TO PUBLIC HEALTH EMERGENCIES. 
‘‘(a) IN GENERAL.—A group health plan shall pro-
vide coverage for such services related to a disease or con-
dition relating to a public health emergency declared 
under section 319 of the Public Health Service Act, which, 
as applicable, shall include any services for the prevention 
or treatment, of the disease or condition. 
‘‘(b) SCOPE
OF BENEFITS.—The prevention and 
treatment measures for which coverage is required under 
subsection (a) shall— 
‘‘(1) be at the same level as benefits for the 
prevention or treatment of other similar or related 
diseases or conditions, if applicable, under the plan; 
and 
‘‘(2) include, with respect to the disease or con-
dition reasonably related to the public health emer-
gency, even if no diagnosis has been made and even 
if the enrollee ultimately is determined not to have 
the disease or condition, as applicable— 
‘‘(A) vaccines to prevent the disease or 
condition, if applicable; 
‘‘(B) testing for diagnosis of the disease or 
condition, if applicable; 
‘‘(C) care related to symptoms an enrollee 
may experience; and 
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‘‘(D) treatments for the disease or condi-
tion. 
‘‘(c) COST-SHARING.—Cost-sharing for services for 
which coverage is required under subsection (a) shall be 
comparable to similar such services that would be covered 
by the plan outside of a public health emergency. 
‘‘(d) WAIVER OF RESTRICTIONS.— 
‘‘(1) IN GENERAL.—A group health plan shall 
waive any restriction (including any prior authoriza-
tion requirement, limitation on filling or refilling 
prescription drugs, or other restrictions) on access to 
covered benefits required under this section, if the 
service is determined by a qualified health profes-
sional to be medically necessary by the provider and 
the Secretary determines such restriction to be un-
duly burdensome in the context of the applicable 
public health emergency. 
‘‘(2) TERM OF WAIVER.—Any waiver of restric-
tions pursuant to paragraph (1) shall apply only for 
the duration of the public health emergency, as de-
clared under section 319 of the Public Health Serv-
ice Act.’’. 
(B) CLERICAL AMENDMENT.—The table of 
sections for subchapter B of chapter 100 of 
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such Code is amended by adding at the end the 
following new item: 
‘‘Sec. 9816. Coverage of prevention and treatment related to public health 
emergencies.’’. 
SEC. 4. EFFECTIVE DATE; APPLICATION. 
The amendments made by this Act shall take effect 
on the date of enactment of this Act and shall apply with 
respect to plan years in effect on the date of enactment 
of this Act, and plan years beginning on or after such 
date. 
Æ 
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