Title: Medicare Crisis Program Act of 2020
Policy area: Health

Summary:
Medicare Crisis Program Act of 2020
This bill makes a series of changes to health insurance coverage and requirements during the public health emergency relating to COVID-19 (i.e., coronavirus disease 2019).
For example, the bill makes several changes to Medicare and Medicare Advantage (MA) during the public health emergency. Among other things, the bill
The bill also alters requirements under Medicaid and the Children's Health Insurance Program (CHIP) and for private health insurers during the emergency. Among other things, the bill

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6674 Introduced in House (IH)]

<DOC>






116th CONGRESS
  2d Session
                                H. R. 6674

To ensure access to affordable, comprehensive health insurance benefits 
for certain uninsured individuals during the COVID-19 emergency, and to 
ensure adequate coverage of treatments for COVID-19 under the Medicare 
    and Medicaid programs and under group health plans and group or 
     individual health insurance coverage, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                              May 1, 2020

 Ms. Jayapal (for herself, Mr. Kennedy, Mr. Blumenauer, Ms. Clarke of 
      New York, Mr. Cohen, Mrs. Dingell, Mr. Michael F. Doyle of 
Pennsylvania, Mr. Espaillat, Mr. Hastings, Mrs. Hayes, Ms. Jackson Lee, 
  Mr. Khanna, Ms. Lee of California, Mr. Lowenthal, Mr. McGovern, Ms. 
 Meng, Mrs. Napolitano, Mr. Neguse, Ms. Norton, Ms. Ocasio-Cortez, Ms. 
Omar, Ms. Pingree, Ms. Pressley, Mr. Raskin, Ms. Schakowsky, Mr. Soto, 
 Mr. Takano, Ms. Tlaib, Mr. Vargas, Mr. Welch, Ms. Gabbard, Mr. Engel, 
and Ms. Velazquez) introduced the following bill; which was referred to 
the Committee on Energy and Commerce, and in addition to the Committees 
   on Ways and Means, Education and Labor, and Armed Services, for a 
 period to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
To ensure access to affordable, comprehensive health insurance benefits 
for certain uninsured individuals during the COVID-19 emergency, and to 
ensure adequate coverage of treatments for COVID-19 under the Medicare 
    and Medicaid programs and under group health plans and group or 
     individual health insurance coverage, and for other purposes.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Medicare Crisis Program Act of 
2020''.

                           TITLE I--MEDICARE

SEC. 101. COVID-19 MEDICARE ENROLLMENT OPTION.

    (a) In General.--Title XVIII of the Social Security Act (42 U.S.C. 
1395c et seq.) is amended by adding at the end the following new 
section:

                 ``covid-19 medicare enrollment option

    ``Sec. 1899C.  (a) Option.--
            ``(1) Eligibility.--Every individual who meets the 
        requirements described in paragraph (2) shall be eligible to 
        enroll under this section.
            ``(2) Requirements.--For purposes of paragraph (1), the 
        requirements described in this paragraph are the following:
                    ``(A) The individual--
                            ``(i) experienced a loss of, or reduction 
                        in, employment during the specified period (as 
                        defined in subsection (h)) and was approved for 
                        unemployment benefits relating to such loss or 
                        reduction in the State in which such individual 
                        resides; or
                            ``(ii) is the spouse, child, or other 
                        dependent of an individual described in clause 
                        (i).
                    ``(B) The individual is not--
                            ``(i) otherwise entitled to benefits under 
                        part A or eligible to enroll under part A or 
                        part B;
                            ``(ii) enrolled under a Federal health care 
                        program (as defined in section 1128B(f)) or the 
                        program established under chapter 89 of title 
                        5, United States Code;
                            ``(iii) enrolled under an eligible 
                        employer-sponsored plan (as defined in section 
                        5000A(f)(2) of the Internal Revenue Code of 
                        1986), but only if such plan--
                                    ``(I) includes the essential health 
                                benefits package (as defined in section 
                                1302(a) of the Patient Protection and 
                                Affordable Care Act); and
                                    ``(II) the employee's required 
                                contribution (within the meaning of 
                                section 5000A(e)(1)(B) of such Code, 
                                except that such contribution shall be 
                                determined with respect to self-only or 
                                family coverage, as applicable to the 
                                employee) with respect to the plan does 
                                not exceed the percentage specified in 
                                section 36B(c)(2)(C)(i)(II) of such 
                                Code for the applicable year; or
                            ``(iv) enrolled under a qualified health 
                        plan (as defined in section 1301(a) of such 
                        Act).
            ``(3) Benefits.--An individual enrolled under this section 
        is entitled to the same benefits under this title as an 
        individual who is entitled to benefits under part A and 
        enrolled under part B and, at the option of the individual, 
        eligible for prescription drug benefits under part D.
    ``(b) Enrollment and Coverage Periods.--The Secretary shall 
establish enrollment and coverage periods for individuals who enroll 
under this section. A coverage period with respect to an individual 
enrolled under this section shall be retroactive to the date on which 
the individual experienced the loss or reduction described in 
subsection (a)(2)(A)(i).
    ``(c) Enrollment Premium.--
            ``(1) Amount of monthly premiums.--There shall be no 
        monthly premium for an individual enrolled under this section 
        except as provided in paragraph (2).
            ``(2) Premium for optional part d benefits.--In the case an 
        individual enrolled under this section elects to receive 
        coverage under a prescription drug plan under part D, there 
        shall be a monthly premium with respect to such individual in 
        an amount determined appropriate by the Secretary.
    ``(d) Payment of Premiums.--
            ``(1) Payment.--Premiums for enrollment under this section 
        shall be paid to the Secretary at such times, and in such 
        manner, as the Secretary determines appropriate.
            ``(2) Deposit.--Amounts collected by the Secretary under 
        this section shall be deposited in the Medicare COVID-19 Trust 
        Fund established under subsection (e).
    ``(e) Medicare COVID-19 Trust Fund.--
            ``(1) In general.--There is hereby created on the books of 
        the Treasury of the United States a trust fund to be known as 
        the `Medicare COVID-19 Trust Fund' (in this subsection referred 
        to as the `Trust Fund'). The Trust Fund shall consist of such 
        gifts and bequests as may be made and such amounts as may be 
        deposited in, or appropriated to, such fund as provided in this 
        title.
            ``(2) Premiums.--Premiums collected under subsection (d) 
        shall be transferred to the Trust Fund.
            ``(3) Incorporation of provisions.--Subsections (b) through 
        (i) of section 1841 shall apply with respect to the Trust Fund 
        and this title in the same manner as they apply with respect to 
        the Federal Supplementary Medical Insurance Trust Fund and part 
        B, respectively, except that in applying such section 1841, any 
        reference in such section to `this part' shall be construed to 
        be a reference to this section and any reference in section 
        1841(h) to section 1840(d) and in section 1841(i) to sections 
        1840(b)(1) and 1842(g) are deemed to be references to 
        comparable authority exercised under this section.
    ``(f) Termination of Coverage.--Coverage of an individual enrolled 
under this section shall terminate on the earliest of the following:
            ``(1) The date on which the individual becomes entitled to 
        benefits under part A or eligible to enroll under such part A 
        or part B (as determined without regard to this section).
            ``(2) The date on which the individual becomes enrolled in 
        coverage described in any of clauses (ii) through (iv) of 
        subsection (a)(2)(B) (as determined without regard to this 
        section).
            ``(3) The end of the specified period (as defined in 
        subsection (h)) with respect to such individual.
    ``(g) Enrollment Information.--
            ``(1) Guidance.--The Secretary of Labor shall publish 
        guidance for States with respect to information to be included 
        by States on unemployment portals for purposes of facilitating 
        enrollment of individuals under this section.
            ``(2) Provision of information to cms.--In the case of a 
        claim for unemployment benefits submitted to a State that 
        indicates that the individual may be eligible for enrollment 
        under this section, the State shall provide such information 
        regarding such individual as the Secretary may specify to the 
        Secretary.
            ``(3) Online enrollment.--The Secretary shall create an 
        online application form to facilitate enrollment under this 
        section.
    ``(h) Specified Period.--
            ``(1) In general.--In this section, the term `specific 
        period' means, with respect to an individual residing in a 
        State, the date beginning on the first day of the emergency 
        period (as described in section 1135(g)(1)(B)) and ending on 
        the date that is 3 months after the first day occurring on or 
        after the date of the enactment of this section that the 
        average unemployment rate for the 12-month period ending on 
        such first day--
                    ``(A) in such State is not more than 2 percentage 
                points higher that the average unemployment rate in 
                such State during the period consisting of October 1 
                through December 31 of 2019; and
                    ``(B) in the United States is not more than 2 
                percentage points higher than the average unemployment 
                rate in the United States during the period consisting 
                of October 1 through December 31 of 2019.
            ``(2) Notice.--In the case of an individual enrolled under 
        this section, if the specified period with respect to such 
        individual ends while such individual is so enrolled, the 
        Secretary shall provide notice to such individual of the end of 
        such period and an explanation that coverage under this section 
        shall terminate with respect to such individual not later than 
        the date that is 3 months after the end of such period.
    ``(i) Funding.--There is appropriated, out of any monies in the 
Treasury not otherwise obligated, to the Trust Fund described in 
subsection (e) such sums as may be necessary to carry out this section 
(including for the payment of part A and part B benefits for 
individuals enrolled under this section).''.
    (b) Medigap.--Section 1882 of the Social Security Act is amended by 
adding at the end the following new subsection:
    ``(aa) Development of New Standards for Certain Medicare 
Supplemental Policies Relating to COVID-19 Enrollment Option.--The 
Secretary shall request the National Association of Insurance 
Commissioners to review and revise the standards for benefit packages 
described in subsection (p)(1), to otherwise update standards to 
include requirements for each medicare supplemental policy that offers 
such a policy in a State, with respect to each year, to accept every 
individual in the State who is enrolled pursuant to section 1899C and 
who applies for such coverage for such year if the individual applies 
for enrollment in such policy during the 30-day period following the 
date of enrollment pursuant to section 1899C and to accept every such 
individual during a period of transition from enrollment pursuant to 
such section to enrollment under this title pursuant to eligibility 
other than under such section. Such revisions shall be made consistent 
with the rules applicable under subsection (p)(1)(E) with the reference 
to the `1991 NAIC Model Regulation' deemed a reference to the NAIC 
Model Regulation as published in the Federal Register on December 4, 
1998, and as subsequently updated by the National Association of 
Insurance Commissioners to reflect previous changes in law and the 
reference to `date of enactment of this subsection' deemed a reference 
to the date of enactment of this subsection (aa).''.

SEC. 102. HOLDING MEDICARE BENEFICIARIES HARMLESS FOR SPECIFIED COVID-
              19 TREATMENT SERVICES FURNISHED UNDER PART A OR PART B OF 
              THE 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 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.) or enrolled under section 1899C of the 
Social Security Act 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;
            (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; and
            (3) no prior authorization or other utilization management 
        requirement is applied with respect to such service.
    (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--
            (1) relating to the treatment or diagnosis of COVID-19;
            (2) furnished to an individual in an emergency department 
        where such individual presents with COVID-19 symptoms; or
            (3) in the case of an individual furnished a test for 
        COVID-19 or diagnosed with COVID-19, furnished during the same 
        episode of care as such test or diagnosis, regardless of 
        setting.
    (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. 103. COVERAGE OF TREATMENTS FOR COVID-19 AT NO COST SHARING UNDER 
              THE 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 102(b) of the Medicare 
                        Crisis Program Act of 2020) 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) 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) Reimbursement of Medicare Advantage Plans for Elimination of 
Cost Sharing.--Section 1853 of the Social Security Act (42 U.S.C. 
1395w-23) is amended by adding at the end the following new subsection:
    ``(p) Additional Payment To Account for Cost Sharing Elimination 
for COVID-19 Treatment Services.--
            ``(1) In general.--A Medicare Advantage plan shall notify 
        the Secretary of the total dollar amount of cost sharing that, 
        but for the application of section 1852(a)(1)(B)(vii), would 
        have been required under such plan for specified COVID-19 
        treatment services (as defined in section 70202(b) of the Take 
        Responsibility for Workers and Families Act) furnished during a 
        plan year described in such section to individuals enrolled in 
        the plan. The Secretary shall make periodic and timely payments 
        in accordance with this subsection to such plan that, in the 
        aggregate, equal such total dollar amount.
            ``(2) Timing of payment.--Payments by the Secretary under 
        this subsection shall be made beginning March 1, 2021, for 
        amounts described in such paragraph that would have been 
        required under such plan for specified COVID-19 treatment 
        services furnished during plan year 2020. Payments by the 
        Secretary under this subsection for such amounts that would 
        have been so required under such plan for such services 
        furnished during a plan year subsequent to plan year 2020 shall 
        be made beginning March 1 of the plan year following such 
        subsequent plan year.
            ``(3) Non-application.--Section 1853(c)(7) shall not apply 
        with respect to the application of this subsection.
            ``(4) Appropriation.--There are transferred to the Centers 
        for Medicare & Medicaid Program Management Fund, out of any 
        monies in the Treasury not otherwise obligated, such sums as 
        may be necessary to the Secretary for purposes of making 
        payments under this subsection.''.
    (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. 104. GUARANTEED ISSUE OF CERTAIN MEDIGAP POLICIES.

    (a) Guaranteed Issue of Medigap Policies to All Medigap-Eligible 
Medicare Beneficiaries.--
            (1) In general.--Section 1882(s) of the Social Security Act 
        (42 U.S.C. 1395ss(s)) is amended--
                    (A) in paragraph (2)(A), by striking ``65 years of 
                age or older and is enrolled for benefits under part 
                B'' and inserting ``entitled to, or enrolled for, 
                benefits under part A and enrolled for benefits under 
                part B'';
                    (B) in paragraph (2)(D), by striking ``who is 65 
                years of age or older as of the date of issuance and'';
                    (C) in paragraph (3)(B)(ii), by striking ``is 65 
                years of age or older and''; and
                    (D) in paragraph (3)(B)(vi), by striking ``at age 
                65''.
            (2) Additional enrollment period for certain individuals.--
                    (A) One-time enrollment period.--
                            (i) In general.--In the case of a specified 
                        individual, the Secretary shall establish a 
                        one-time enrollment period described in clause 
                        (iii) during which such an individual may 
                        enroll in any medicare supplemental policy of 
                        the individual's choosing.
                            (ii) Application.--The provisions of--
                                    (I) paragraph (2) of section 
                                1882(s) of the Social Security Act (42 
                                U.S.C. 1395ss(s)) shall apply with 
                                respect to a specified individual who 
                                is described in subclause (I) of 
                                subparagraph (B)(iii) as if references 
                                in such paragraph (2) to the 6-month 
                                period described in subparagraph (A) of 
                                such paragraph were references to the 
                                one-time enrollment period established 
                                under clause (i); and
                                    (II) paragraph (3) of such section 
                                shall apply with respect to a specified 
                                individual who is described in 
                                subclause (II) of subparagraph (B)(iii) 
                                as if references in such paragraph (3) 
                                to the period specified in subparagraph 
                                (E) of such paragraph were references 
                                to the one-time enrollment period 
                                established under clause (i).
                            (iii) Period.--The enrollment period 
                        established under clause (i) shall be the 6-
                        month period beginning on January 1, 2024.
                    (B) Specified individual.--For purposes of this 
                paragraph, the term ``specified individual'' means an 
                individual who--
                            (i) is entitled to hospital insurance 
                        benefits under part A of title XVIII of the 
                        Social Security Act (42 U.S.C. 1395c et seq.) 
                        pursuant to section 226(b) or section 226A of 
                        such Act (42 U.S.C. 426(b); 426-1);
                            (ii) is enrolled for benefits under part B 
                        of such Act (42 U.S.C. 1395j et seq.); and
                            (iii)(I) would not, but for the amendments 
                        made by subparagraphs (A) and (B) of paragraph 
                        (1) and the provisions of this paragraph (if 
                        such provisions applied to such individual), be 
                        eligible for the guaranteed issue of a medicare 
                        supplemental policy under paragraph (2) of 
                        section 1882(s) of such Act (42 U.S.C. 
                        1395ss(s)); or
                            (II) would not, but for the amendments made 
                        by subparagraphs (C) and (D) of paragraph (1) 
                        and the provisions of this paragraph (if such 
                        provisions applied to such individual), be 
                        eligible for the guaranteed issue of a medicare 
                        supplemental policy under paragraph (3) of such 
                        section.
                    (C) Outreach plan.--
                            (i) In general.--The Secretary shall 
                        develop an outreach plan to notify specified 
                        individuals of the one-time enrollment period 
                        established under subparagraph (A).
                            (ii) Consultation.--In implementing the 
                        outreach plan developed under clause (i), the 
                        Secretary shall consult with consumer 
                        advocates, brokers, insurers, the National 
                        Association of Insurance Commissioners, and 
                        State Health Insurance Assistance Programs.
            (3) Effective date.--The amendments made by paragraph (1) 
        shall apply to medicare supplemental policies effective on or 
        after the date of the enactment of this Act.
    (b) Guaranteed Issue of Medigap Policies for Medicare Advantage 
Enrollees.--
            (1) In general.--Section 1882(s)(3) of the Social Security 
        Act (42 U.S.C. 1395ss(s)(3)), as amended by subsection (a), is 
        further amended--
                    (A) in subparagraph (B), by adding at the end the 
                following new clause:
            ``(vii) The individual--
                    ``(I) was enrolled in a Medicare Advantage plan 
                under part C for not less than 12 months;
                    ``(II) subsequently disenrolled from such plan;
                    ``(III) elects to receive benefits under this title 
                through the original Medicare fee-for-service program 
                under parts A and B; and
                    ``(IV) has not previously elected to receive 
                benefits under this title through the original Medicare 
                fee-for-service program pursuant to disenrollment from 
                a Medicare Advantage plan under part C.'';
                    (B) by striking subparagraph (C)(iii) and inserting 
                the following:
    ``(iii) Subject to subsection (v)(1), for purposes of an individual 
described in clause (vi) or (vii) of subparagraph (B), a medicare 
supplemental policy described in this subparagraph shall include any 
medicare supplemental policy.''; and
                    (C) in subparagraph (E)--
                            (i) in clause (iv), by striking ``and'' at 
                        the end;
                            (ii) in clause (v), by striking the period 
                        at the end and inserting ``; and''; and
                            (iii) by adding at the end the following 
                        new clause--
            ``(vi) in the case of an individual described in 
        subparagraph (B)(vii), the annual, coordinated election period 
        (as defined in section 1851(e)(3)(B)) or a continuous open 
        enrollment period (as defined in section 1851(e)(2)) during 
        which the individual disenrolls from a Medicare Advantage plan 
        under part C.''.
            (2) Effective date.--The amendments made by paragraph (1) 
        shall apply to medicare supplemental policies effective on or 
        after the date of the enactment of this Act.

SEC. 105. REQUIRING COVERAGE UNDER MEDICARE PDPS AND MA-PD PLANS, 
              WITHOUT THE IMPOSITION OF COST SHARING OR UTILIZATION 
              MANAGEMENT REQUIREMENTS, OF DRUGS INTENDED TO TREAT 
              COVID-19 DURING CERTAIN EMERGENCIES.

    (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) LIS Eligibility.--Section 1860D-14(a)(3)(C)(i) of the Social 
Security Act (42 U.S.C. 1395w-114(a)(3)(C)(i)) is amended by inserting 
``and any amounts received from a State as unemployment benefits'' 
after ``furnished in kind''.
    (d) 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. 106. MEDICARE SPECIAL ENROLLMENT PERIOD FOR INDIVIDUALS RESIDING 
              IN COVID-19 EMERGENCY AREAS.

    (a) In General.--Section 1837(i) of the Social Security Act (42 
U.S.C. 1395p(i)) is amended by adding at the end the following new 
paragraph:
            ``(5)(A) In the case of an individual who--
                    ``(i) is eligible under section 1836 to enroll in 
                the medical insurance program established by this part;
                    ``(ii) has elected not to enroll (or to be deemed 
                enrolled) under such section during an enrollment 
                period; and
                    ``(iii) during the emergency period (as described 
                in section 1135(g)(1)(B)), is residing in an emergency 
                area (as described in such section),
                there shall be a special enrollment period described in 
                subparagraph (B).
                    ``(B) The special enrollment period referred to in 
                subparagraph (A) is, with respect to an individual 
                residing in a State, the period that begins on the date 
                of the enactment of this paragraph and ends on the date 
                that is 3 months after the first day occurring on or 
                after the date of the enactment of this paragraph that 
                the average unemployment rate for the 12-month period 
                ending on such first day--
                            ``(i) in such State is not more than 2 
                        percentage points higher that the average 
                        unemployment rate in such State during the 
                        period consisting of October 1 through December 
                        31 of 2019; and
                            ``(ii) in the United States is not more 
                        than 2 percentage points higher that the 
                        average unemployment rate in the United States 
                        during the period consisting of October 1 
                        through December 31 of 2019.''.
    (b) Coverage Period for Individuals Transitioning From Other 
Coverage.--Section 1838(e) of the Social Security Act (42 U.S.C. 
1395q(e)) is amended--
            (1) by striking ``pursuant to section 1837(i)(3) or 
        1837(i)(4)(B)--'' and inserting the following: ``pursuant to--
            ``(1) section 1837(i)(3) or 1837(i)(4)(B)--'';
            (2) by redesignating paragraphs (1) and (2) as 
        subparagraphs (A) and (B), respectively, and moving the 
        indentation of each such subparagraph 2 ems to the right;
            (3) by striking the period at the end of the subparagraph 
        (B), as so redesignated, and inserting ``; or''; and
            (4) by adding at the end the following new paragraph:
            ``(2) section 1837(i)(5), the coverage period shall begin 
        on the first day of the month following the month in which the 
        individual so enrolls.''.
    (c) No Increase in Premiums.--Section 1839(b) of such Act (42 
U.S.C. 1395r(b)) is amended in the first sentence, by inserting ``, 
(i)(5),'' after ``subsection (i)(4)''.

SEC. 107. SPECIAL MEDICARE RULES DURING THE COVID-19 EMERGENCY.

    (a) Premiums.--Notwithstanding any other provision of law, the 
Secretary shall provide that 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.) is not required to pay any premium under 
such part A or part B (if any would otherwise be applicable) for any 
month occurring during the emergency period described in section 
1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b-5(g)(1)(B)).
    (b) Cost-Sharing Requirements.--Notwithstanding any other provision 
of law, with respect to items and services furnished during a month 
occurring during the emergency period described in section 
1135(g)(1)(B) of the Social Security Act (42 U.S.C. 1320b-5(g)(1)(B)) 
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.), including an individual enrolled under section 1899C of such 
Act, the Secretary of Health and Human Services shall ensure that the 
aggregate amount of any cost-sharing requirements (including any 
deductibles, copayments, or coinsurance) applicable under such part A 
or part B (or, in the case of an individual enrolled under part C of 
such title, under such part C if such item or service would have been 
covered under such part A or B) to such individual with respect to such 
items and services furnished during such month does not exceed 5 
percent of such individual's income during such month. The Secretary 
shall pay to the entity furnishing such item or service the amount of 
any such requirement that would be payable to such entity but for 
application of the previous sentence.

SEC. 108. NATIONAL CLEARINGHOUSE FOR COVID-19 PERSONAL PROTECTIVE 
              EQUIPMENT AND OTHER MEDICAL SUPPLIES.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') shall establish a 
national clearinghouse for COVID-19 personal protective equipment and 
other medical supplies (in this section referred to as the 
``clearinghouse'') through which the Secretary shall provide for the 
purchase, in accordance with subsection (b), of personal protective 
equipment and other medical items necessary for the diagnosis or 
treatment of COVID-19 (including respirator masks, ventilators, gloves, 
bodysuits, safety glasses, eye protection, and isolation gowns) and the 
distribution of such equipment and items in accordance with subsection 
(c).
    (b) Purchase of Equipment and Items.--The Secretary shall provide 
for the purchase of equipment and items described in subsection (a) for 
the clearinghouse through direct negotiations with entities selling 
such equipment or items. Any such purchase shall be made at a rate not 
exceeding the amount payable for such equipment or items by the 
Secretary of Veterans Affairs.
    (c) Distribution.--The Secretary shall provide for the distribution 
of equipment and items purchased for the clearinghouse to health care 
providers enrolled under section 1866(j) of the Social Security Act (42 
U.S.C. 1395cc(j)) based on the demonstrated need of such providers for 
such equipment and items.
    (d) Report.--The Secretary shall submit to Congressional Oversight 
Commission established under section 4020 of division A of the CARES 
Act and publish on a public website a monthly report on expenditures 
under this section and distribution of equipment and items made through 
the clearinghouse. Such report shall include a breakdown of the 
geographic distribution of such equipment and items and a specification 
of the types of expenditures made under this section.

                      TITLE II--MEDICAID AND CHIP

SEC. 201. MEDICAID COVERAGE AT NO COST SHARING OF COVID-19 VACCINE AND 
              TREATMENT.

    (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) a COVID-19 vaccine licensed under 
                section 351 of the Public Health Service Act and the 
                administration of such vaccine; and (F) specified 
                COVID-19 treatment services (as defined in section 
                102(b) of the Medicare Crisis Program Act of 2020);''.
            (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) a COVID-19 vaccine licensed under section 351 
                of the Public Health Service Act and the administration 
                of such vaccine; or
                    ``(I) any specified COVID-19 treatment service (as 
                defined in section 102(b) of the Medicare Crisis 
                Program Act of 2020); 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) A COVID-19 vaccine licensed under 
                        section 351 of the Public Health Service Act 
                        and the administration of such vaccine.
                            ``(xiii) A specified COVID-19 treatment 
                        service (as defined in section 102(b) of the 
                        Medicare Crisis Program Act of 2020).''.
                    (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) 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)(8)) 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 
                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 with respect to a COVID-19 vaccine 
        licensed under section 351 of the Public Health Service Act'' 
        before the period.
    (c) CHIP.--
            (1) In general.--Section 2103(c) of the Social Security Act 
        (42 U.S.C. 1397cc(c)), as amended by section 6004(b)(1) of the 
        Families First Coronavirus Response Act, is amended by adding 
        at the end the following paragraph:
            ``(11) Coverage of covid-19 vaccines and treatment.--The 
        child health assistance provided to a targeted low-income child 
        shall include coverage of--
                    ``(A) any COVID-19 vaccine licensed under section 
                351 of the Public Health Service Act and the 
                administration of such vaccine; and
                    ``(B) a specified COVID-19 treatment service (as 
                defined in section 102(b) of the Medicare Crisis 
                Program Act of 2020).''.
            (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), items or services described in section 
                1916(a)(2)(I), 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 Medicare Crisis Program Act of 2020, must comply with 
        subparagraphs (F) through (I) of subsections (a)(2) and (b)(2) 
        of sections 1916 and 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).

SEC. 202. INCREASING THE TEMPORARY INCREASE OF MEDICAID FMAP DURING THE 
              COVID-19 EMERGENCY.

    (a) In General.--Section 6008(a) of the Families First Coronavirus 
Response Act (Public Law 116-127) is amended by striking ``6.2'' and 
inserting ``13''.
    (b) Extension of Period of Applicability.--Section 6008 of such Act 
is amended--
            (1) in subsection (a), by striking ``such emergency 
        period'' and inserting ``the specified period (as defined in 
        subsection (d))'';
            (2) in subsection (b)(3)--
                    (A) by striking ``the emergency period'' and 
                inserting ``the specified period (as defined in 
                subsection (d))''; and
                    (B) by striking ``such emergency period'' and 
                inserting ``such specified period''; and
            (3) by adding at the end the following new subsection:
    ``(d) Specified Period.--In this section, the term `specified 
period' means, with respect to a State, including the District of 
Columbia, American Samoa, Guam, the Commonwealth of the Northern 
Mariana Islands, Puerto Rico, and the United States Virgin Islands, the 
period beginning on the first day of the emergency period described in 
subsection (a) and ending on the date that is 3 months after the first 
day occurring on or after the date of the enactment of this section 
that the average unemployment rate for the 12-month period ending on 
such first day--
            ``(1) in such State is not more than 2 percentage points 
        higher that the average unemployment rate in such State during 
        the period consisting of October 1 through December 31 of 2019; 
        and
            ``(2) in the United States is not more than 2 percentage 
        points higher that the average unemployment rate in the United 
        States during the period consisting of October 1 through 
        December 31 of 2019.''.

SEC. 203. INCREASING FEDERAL SUPPORT TO STATE MEDICAID PROGRAMS DURING 
              ECONOMIC DOWNTURNS.

    (a) In General.--Section 1905 of the Social Security Act (42 U.S.C. 
1396d) is amended--
            (1) in subsection (b), by striking ``and (ff)'' and 
        inserting ``(ff), and (gg)''; and
            (2) by adding at the end the following new subsection:
    ``(gg) Increased FMAP During Economic Downturns.--
            ``(1) In general.--Notwithstanding subsection (b), (y), or 
        (z)(2), if a fiscal quarter that begins on or after January 1, 
        2020, is an economic downturn quarter (as defined in paragraph 
        (2)) with respect to a State, then the Federal medical 
        assistance percentage applicable to amounts expended by the 
        State for medical assistance for services furnished during such 
        quarter shall be increased in accordance with paragraphs (3) 
        and (4).
            ``(2) Economic downturn quarter.--
                    ``(A) In general.--
                            ``(i) In general.--In this subsection, the 
                        term `economic downturn quarter' means, with 
                        respect to a State, a fiscal quarter during 
                        which the State's unemployment rate for the 
                        quarter exceeds the percentage determined for 
                        the State and quarter under clause (ii).
                            ``(ii) Threshold percentage.--The 
                        percentage determined under this clause for a 
                        State and fiscal quarter is the percentage 
                        equal to the lower of--
                                    ``(I) the State unemployment rate 
                                at the 20th percentile of the 
                                distribution of the State's quarterly 
                                unemployment rates for the 60-quarter 
                                period preceding the quarter involved, 
                                increased by 1 percentage point; and
                                    ``(II) the State's average 
                                quarterly unemployment rate for the 12-
                                quarter period preceding the quarter 
                                involved, increased by 1 percentage 
                                point.
                    ``(B) Unemployment data.--
                            ``(i) In general.--Except as provided in 
                        clause (ii), for purposes of determining 
                        unemployment rates for a State and a quarter 
                        under this paragraph, the Secretary shall use 
                        data from the Local Area Unemployment 
                        Statistics from the Bureau of Labor Statistics.
                            ``(ii) Application to certain 
                        territories.--In the case of the Virgin 
                        Islands, Guam, the Northern Mariana Islands, or 
                        American Samoa, the Secretary shall use data 
                        from the U-6 unemployment measure of the Bureau 
                        of Labor Statistics to make any necessary 
                        determinations under subparagraph (A).
            ``(3) FMAP increase during economic downturn quarter.--
                    ``(A) In general.--During a fiscal quarter that is 
                an economic downturn quarter with respect to a State, 
                the Federal medical assistance percentage otherwise 
                determined for the State and quarter under subsection 
                (b) and, if applicable, the Federal medical assistance 
                percentage applicable under subsection (y), (z)(2), or 
                (ff) with respect to medical assistance furnished by 
                the State during such quarter to individuals described 
                in either such subsection shall be increased by the 
                number of percentage points (rounded to the nearest 
                tenth of a percentage point) equal to the product of--
                            ``(i) the number of percentage points 
                        (rounded to the nearest tenth of a percentage 
                        point) by which the unemployment rate for the 
                        State and quarter exceeds the percentage 
                        determined for the State and quarter under 
                        paragraph (2)(A)(ii); and
                            ``(ii) 4.8.
                    ``(B) Application of covid-19 fmap increase.--Any 
                increase applicable to the Federal medical assistance 
                percentage of a State for a fiscal quarter under 
                subparagraph (A) shall be in addition to any increase 
                to such percentage for such quarter made pursuant to 
                section 6008(a) of the Families First Coronavirus 
                Response Act.
                    ``(C) Limitation.--In no case shall an increase to 
                the Federal medical assistance percentage of a State 
                under this paragraph result in a Federal medical 
                assistance percentage that exceeds 95 percent.
                    ``(D) Scope of application.--Any increase to the 
                Federal medical assistance percentage of a State for a 
                fiscal quarter under this paragraph shall only apply 
                with respect to payments for amounts expended by the 
                State for medical assistance for services furnished 
                during such quarter and shall not apply with respect 
                to--
                            ``(i) disproportionate share hospital 
                        payments described in section 1923;
                            ``(ii) payments under title IV or XXI;
                            ``(iii) any payments under this title that 
                        are based on the enhanced FMAP described in 
                        section 2105(b); or
                            ``(iv) any payments under this title that 
                        are based on a Federal medical assistance 
                        percentage determined for a State under 
                        subsection (aa) (but only to the extent that 
                        such Federal medical assistance percentage is 
                        higher than the economic recovery FMAP).
            ``(4) Advance payment; retrospective adjustment.--
                    ``(A) In general.--Prior to the beginning of each 
                fiscal quarter that begins on or after July 1, 2020, 
                the Secretary shall, with respect to each State--
                            ``(i) determine the increase (if any) that 
                        is expected to apply to the Federal medical 
                        assistance percentage of such State for such 
                        quarter under this subsection based on the 
                        projections made for the State and quarter 
                        under subparagraph (B); and
                            ``(ii) shall apply such increase to the 
                        Federal medical assistance percentage of the 
                        State for purposes of making payments to the 
                        State for amounts expended during such quarter 
                        as medical assistance under the State plan.
                    ``(B) Projection of state unemployment rates.--
                Prior to the beginning of each fiscal quarter that 
                begins on or after July 1, 2020, the Secretary, acting 
                through the Chief Actuary of the Centers for Medicare & 
                Medicaid Services, shall, using the most recently 
                available data described in paragraph (2)(B), make 
                projections with respect to--
                            ``(i) the unemployment rates for each State 
                        for such quarter;
                            ``(ii) the threshold percentages described 
                        in paragraph (2)(A)(ii) for each State for such 
                        quarter; and
                            ``(iii) the national unemployment rate for 
                        such quarter.
                    ``(C) Retrospective adjustment.--As soon as 
                practicable after final unemployment data becomes 
                available for a fiscal quarter that begins on or after 
                July 1, 2020, the Secretary shall, with respect to each 
                State--
                            ``(i) make a final determination of the 
                        increase (if any) applicable to the Federal 
                        medical assistance percentage of the State for 
                        the quarter under this subsection; and
                            ``(ii) in accordance with subsection (d)(2) 
                        of section 1903, reduce or increase the amount 
                        payable to the State under subsection (a) of 
                        such section for a subsequent fiscal quarter to 
                        the extent of any overpayment or underpayment 
                        which the Secretary determines was made as a 
                        result of a miscalculation of the increase 
                        applicable to the Federal medical assistance 
                        percentage of the State for such prior fiscal 
                        quarter under this subsection.
            ``(5) Retrospective application of over-the-limit fmap 
        increases.--
                    ``(A) In general.--If a State has excess percentage 
                points with respect to an economic downturn quarter and 
                an applicable FMAP (as determined under subparagraph 
                (B)), the State may elect to apply such excess 
                percentage points to increase such applicable FMAP for 
                one or more quarters during the look-back period for 
                the State and economic downturn quarter in accordance 
                with this paragraph.
                    ``(B) Excess percentage points.--For purposes of 
                this paragraph, the number of excess percentage points 
                for a State, economic downturn quarter, and an 
                applicable FMAP shall be equal to the number of 
                percentage points by which--
                            ``(i) the applicable FMAP for the State and 
                        quarter (after application of paragraph (3) but 
                        without regard to subparagraph (C) of such 
                        paragraph); exceeds
                            ``(ii) 95 percent.
                    ``(C) Effect of application of excess percentage 
                points.--If a State elects to apply excess percentage 
                points to an applicable FMAP to a quarter during a 
                look-back period under this paragraph, the Secretary 
                shall determine the additional amount of payment under 
                section 1903(a) to which the State would have been 
                entitled for such quarter if the applicable FMAP (as so 
                increased) had been in effect for such quarter, and 
                shall treat such additional amount as an underpayment 
                for such quarter.
                    ``(D) Distribution of excess percentage points.--A 
                State that has excess percentage points with respect to 
                an economic downturn quarter and applicable FMAP may 
                elect to divide such points among more than 1 quarter 
                during the look-back period for such State and quarter 
                provided that no excess percentage point (or fraction 
                of an excess percentage point) is applied to the 
                applicable FMAP of more than 1 quarter.
                    ``(E) Limitations.--
                            ``(i) No increases over 100 percent.--A 
                        State may not increase an applicable FMAP for 
                        any quarter during a look-back period under 
                        this paragraph if such increase would result in 
                        the applicable FMAP for such quarter exceeding 
                        100 percent.
                            ``(ii) Scope of application.--Any increase 
                        to an applicable FMAP of a State for a fiscal 
                        quarter under this paragraph--
                                    ``(I) shall only apply with respect 
                                to payments for amounts expended by the 
                                State for medical assistance for 
                                services furnished during such quarter 
                                to which such applicable FMAP is 
                                applicable; and
                                    ``(II) shall not apply with respect 
                                to payments described in paragraph 
                                (3)(D).
                    ``(F) Definitions.--In this paragraph:
                            ``(i) Applicable fmap.--The term 
                        `applicable FMAP' means, with respect to a 
                        State and fiscal quarter--
                                    ``(I) the Federal medical 
                                assistance percentage determined for 
                                the State and quarter under subsection 
                                (b);
                                    ``(II) the Federal medical 
                                assistance percentage applicable under 
                                subsection (y);
                                    ``(III) the Federal medical 
                                assistance percentage applicable under 
                                subsection (z)(2); or
                                    ``(IV) the Federal medical 
                                assistance percentage determined for 
                                the State and quarter under subsection 
                                (ff).
                            ``(ii) Look-back period.--The term `look-
                        back period' means, with respect to a State and 
                        a fiscal quarter that is an economic downturn 
                        quarter for the State, the period of 4 fiscal 
                        quarters that ends with the fourth quarter 
                        which precedes the most recent fiscal quarters 
                        that was not an economic downturn quarter for 
                        the State.
            ``(6) Requirement for all states.--A State may not receive 
        an increase in the Federal medical assistance percentage for 
        such State under this subsection, with respect to a fiscal 
        quarter, if--
                    ``(A) eligibility standards, methodologies, or 
                procedures under the State plan or a waiver of such 
                plan are more restrictive during such quarter than the 
                eligibility standards, methodologies, or procedures, 
                respectively, under such plan (or waiver) as in effect 
                on the last day of the most recent fiscal quarter that 
                was not an economic downturn quarter for the State;
                    ``(B) the amount of any premium imposed by the 
                State pursuant to section 1916 or 1916A during such 
                quarter, with respect to an individual enrolled under 
                such plan (or waiver), exceeds the amount of such 
                premium as of the date described in subparagraph (A); 
                or
                    ``(C) the State fails to provide that an individual 
                who is enrolled for benefits under such plan (or 
                waiver) as of the date described in subparagraph (A) or 
                enrolls for benefits under such plan (or waiver) during 
                the period beginning with such date and ending with the 
                day before the first day of the next quarter that is 
                not an economic downturn quarter for the State shall be 
                treated as eligible for such benefits for not less than 
                12 months (or, if such period is less than 12 months, 
                throughout such period) unless the individual requests 
                a voluntary termination of eligibility or the 
                individual ceases to be a resident of the State.''.
    (b) Exclusion of Economic Downturn FMAP Increases From Territorial 
Caps.--Section 1108 of the Social Security Act (42 U.S.C. 1308) is 
amended--
            (1) in subsection (f), in the matter preceding paragraph 
        (1), by striking ``subsection (g) and section 1935(e)(1)(B)'' 
        and inserting ``subsections (g) and (h) and section 
        1935(e)(1)(B)''; and
            (2) by adding at the end the following:
    ``(h) Exclusion From Caps of Amounts Attributable to Economic 
Downturn FMAP.--The portion of any payment made to a territory for a 
fiscal year that is attributable to an increase in the Federal medical 
assistance percentage for a fiscal quarter during such year under 
section 1905(gg) shall not be taken into account for purposes of 
applying payment limits under subsections (f) and (g).''.

SEC. 204. 100 PERCENT FMAP FOR INDIVIDUALS ENROLLING UNDER MEDICAID 
              DURING THE COVID-19 EMERGENCY.

    (a) In General.--Notwithstanding any other provision of law, the 
Federal medical assistance percentage otherwise determined under 
section 1905(b) of the Social Security Act (42 U.S.C. 1396d(b)) with 
respect to medical assistance furnished during a specified period to a 
specified individual under a State plan (or waiver of such plan) under 
title XIX of such Act shall be 100 percent.
    (b) Definitions.--In this section:
            (1) Specified individual.--The term ``specified 
        individual'' means an individual who enrolls under the State 
        plan (or waiver of such plan) under title XIX of the Social 
        Security Act (42 U.S.C. 1396 et seq.) during the emergency 
        period described in section 1135(g)(1)(B) of such Act (42 
        U.S.C. 1320b-5(g)(1)(B)).
            (2) Specified period.--The term ``specified period'' means, 
        with respect to a State, including the District of Columbia, 
        American Samoa, Guam, the Commonwealth of the Northern Mariana 
        Islands, Puerto Rico, and the United States Virgin Islands, the 
        period beginning on the first day of the emergency period 
        described in subsection (a) and ending on the date that is 3 
        months after the first day occurring on or after the date of 
        the enactment of this section that the average unemployment 
        rate for the 12-month period ending on such first day--
                    (A) in such State is not more than 2 percentage 
                points higher that the average unemployment rate in 
                such State during the period consisting of October 1 
                through December 31 of 2019; and
                    (B) in the United States is not more than 2 
                percentage points higher that the average unemployment 
                rate in the United States during the period consisting 
                of October 1 through December 31 of 2019.

SEC. 205. MANDATORY APPROVAL OF WAIVERS TO COVER CERTAIN INDIVIDUALS 
              UNDER MEDICAID DURING THE COVID-19 EMERGENCY.

    Section 1115(d) of the Social Security Act (42 U.S.C. 1315(d)) is 
amended by adding at the end the following new paragraph:
    ``(4) Notwithstanding any other provision of this section, the 
Secretary shall approve an application for a demonstration project 
under this section to the extent that such project allows an individual 
whose income (as determined under section 1902(e)(14)) does not exceed 
300 percent of the poverty line (as defined in section 2110(c)(5)) 
applicable to a family of the size involved, to enroll under the State 
plan (or waiver of such plan) under title XIX of the State submitting 
such application.''.

                        TITLE III--MISCELLANEOUS

SEC. 301. GROUP HEALTH PLAN AND HEALTH INSURANCE ISSUER COVERAGE OF 
              COVID-19 RELATED TREATMENT AT NO COST SHARING.

    (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 specified COVID-19 treatment services 
(as defined in section 102(b)) 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.
    (b) Reimbursement to Plans and Coverage for Waiving Cost Sharing.--
            (1) In general.--A group health plan or 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)) 
        that does not impose cost sharing requirements as described in 
        subsection (a) shall notify the Secretary of Health and Human 
        Services, Secretary of Labor, and Secretary of the Treasury 
        (through a joint process established jointly by the 
        Secretaries) of the total dollar amount of cost sharing that, 
        but for the application of subsection (a), would have been 
        required under such plans and coverage for items and services 
        related to COVID-19 furnished during the period to which 
        subsection (a) applies to enrollees, participants, and 
        beneficiaries in the plan or coverage to whom such subsection 
        applies, but which was not imposed for such items and services 
        so furnished pursuant to such subsection and the Secretary of 
        Health and Human Services, in coordination with the Secretary 
        of Labor and the Secretary of the Treasury, shall make payments 
        in accordance with this subsection to the plan or issuer equal 
        to such total dollar amount.
            (2) Methodology for payments.--The Secretary of Health and 
        Human Services, in coordination with the Secretary of Labor and 
        the Secretary of the Treasury shall establish a payment system 
        for making payments under this subsection. Any such system 
        shall make payment for the value of cost sharing not imposed by 
        the plan or issuer involved.
            (3) Timing of payments.--Payments made under paragraph (1) 
        shall be made no later than May 1, 2021, for amounts of cost 
        sharing waivers with respect to 2020. Payments under this 
        subsection with respect to such waivers with respect to a year 
        subsequent to 2020 that begins during the period to which 
        subsection (a) applies shall be made no later than May of the 
        year following such subsequent year.
            (4) Appropriations.--There is authorized to be 
        appropriated, and there is appropriated, out of any monies in 
        the Treasury not otherwise appropriated, such funds as are 
        necessary to carry out this subsection.
    (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, Secretary of Labor, and 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, part 7 of the Employee Retirement 
        Income Security Act of 1974, 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, 
Secretary of Labor, and Secretary of the Treasury may implement the 
provisions of this section through sub-regulatory guidance, program 
instruction, or otherwise.
    (e) Terms.--In this section, 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. 302. PAYMENT FOR SPECIFIED COVID-19 TREATMENT SERVICES FURNISHED 
              TO THE UNINSURED.

    (a) In General.--The Secretary of Health and Human Services shall 
pay to a health care provider that furnishes a specified COVID-19 
treatment service (as defined in section 102) to an uninsured 
individual (as defined in subsection (b)) an amount equal to the amount 
that would have been payable (including any cost-sharing requirement) 
under title XVIII of the Social Security Act (42 U.S.C. 1395 et seq.) 
had such service been furnished to an individual entitled to benefits 
under part A and enrolled under part B of such title.
    (b) Uninsured Individual.--For purposes of this section, the term 
``uninsured individual'' means an individual who--
            (1) is not enrolled in a group health plan or in group or 
        individual health insurance coverage (as defined in section 
        2791 of the Public Health Service Act (42 U.S.C. 300gg-91)); 
        and
            (2) is not enrolled in a Federal health care program (as 
        defined in section 1128B(f) of the Social Security Act (42 
        U.S.C. 1320a-7b(f))) or under the program established under 
        chapter 89 of title 5, United States Code.
    (c) Holding Uninsured Individual Harmless for Specified COVID-19 
Treatment Services.--
            (1) In general.--A health care provider receiving payment 
        under subsection (a) for a specified COVID-19 treatment service 
        furnished to an individual may not hold such individual liable 
        for any amount for such service.
            (2) Enforcement.--A health care provider who violates 
        subsection (a) shall be subject to a civil monetary penalty 
        determined appropriate by the Secretary of Health and Human 
        Services. The provision of section 1128A of the Social Security 
        Act (42 U.S.C. 1320a-7a) (other than subsections (a) and (b)) 
        shall apply with respect to a civil monetary penalty imposed 
        under the previous sentence in the same manner as such 
        provisions apply with respect to a penalty or proceeding under 
        subsection (a) of such section.
                                 <all>