Title: To amend title XVIII of the Social Security Act to waive cost sharing under the Medicare program for certain visits relating to testing for COVID-19.
Policy area: Health

Summary:
This bill requires Medicare to cover, without cost-sharing, visits to health care providers that relate to COVID-19 (i.e., coronavirus disease 2019) testing during the public health emergency declared on January 31, 2020.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6263 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 6263

 To amend title XVIII of the Social Security Act to waive cost sharing 
 under the Medicare program for certain visits relating to testing for 
                               COVID-19.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 12, 2020

  Mr. Sarbanes (for himself, Mr. Danny K. Davis of Illinois, and Mr. 
  Courtney) introduced the following bill; which was referred to the 
 Committee on Energy and Commerce, and in addition to the Committee on 
   Ways and Means, 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 amend title XVIII of the Social Security Act to waive cost sharing 
 under the Medicare program for certain visits relating to testing for 
                               COVID-19.

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

SECTION 1. WAIVING COST SHARING UNDER THE MEDICARE PROGRAM FOR CERTAIN 
              VISITS RELATING TO TESTING FOR COVID-19.

    (a) In General.--Section 1833 of the Social Security Act (42 U.S.C. 
1395l) is amended--
            (1) in subsection (a)(1)--
                    (A) by striking ``and'' before ``(CC)''; and
                    (B) by inserting before the period at the end the 
                following: ``, and (DD) with respect to a specified 
                COVID-19 testing-related service described in paragraph 
                (1) of subsection (cc) for which payment may be made 
                under a specified outpatient payment provision 
                described in paragraph (2) of such subsection, the 
                amounts paid shall be 100 percent of the payment amount 
                otherwise recognized under such respective specified 
                outpatient payment provision for such service,'';
            (2) in subsection (b), in the first sentence--
                    (A) by striking ``and'' before ``(10)''; and
                    (B) by inserting before the period at the end the 
                following: ``, and (11) such deductible shall not apply 
                with respect to any specified COVID-19 testing-related 
                service described in paragraph (1) of subsection (cc) 
                for which payment may be made under a specified 
                outpatient payment provision described in paragraph (2) 
                of such subsection''; and
            (3) by adding at the end the following new subsection:
    ``(cc) Specified COVID-19 Testing-Related Services.--For purposes 
of subsection (a)(1)(DD):
            ``(1) Description.--
                    ``(A) In general.--A specified COVID-19 testing-
                related service described in this paragraph is a 
                medical visit that--
                            ``(i) is in any of the categories of HCPCS 
                        evaluation and management service codes 
                        described in subparagraph (B);
                            ``(ii) is furnished during any portion of 
                        the emergency period defined in section 
                        1135(g)(1)(B) beginning on or after the date of 
                        the date of the enactment of this subsection; 
                        and
                            ``(iii) results in an order for or 
                        administration of an in vitro diagnostic 
                        product (as defined in section 809.3(a) of 
                        title 21, Code of Federal Regulations) 
                        administered during any portion of such 
                        emergency period beginning on or after the date 
                        of the enactment of this subsection for the 
                        detection of SARS-CoV-2 or the diagnosis of the 
                        virus that causes COVID-19 that is approved, 
                        cleared, or authorized under section 510(k), 
                        513, 515, or 564 of the Federal Food, Drug, and 
                        Cosmetic Act.
                    ``(B) Categories of hcpcs codes.--For purposes of 
                subparagraph (A), the categories of HCPCS evaluation 
                and management services codes are the following:
                            ``(i) Office and other outpatient services.
                            ``(ii) Hospital observation services.
                            ``(iii) Emergency department services.
                            ``(iv) Skilled nursing facility services.
                            ``(v) Domiciliary, rest home, or custodial 
                        care services.
                            ``(vi) Home services.
            ``(2) Specified outpatient payment provision.--A specified 
        outpatient payment provision described in this paragraph is any 
        of the following:
                    ``(A) The hospital outpatient prospective payment 
                system under subsection (t).
                    ``(B) The physician fee schedule under section 
                1848.
                    ``(C) The prospective payment system developed 
                under section 1834(o).
                    ``(D) Section 1834(g), with respect to an 
                outpatient critical access hospital service.
                    ``(E) The payment basis determined in regulations 
                pursuant to section 1833(a)(3) for rural health clinic 
                services.''.
    (b) Claims Modifier.--The Secretary of Health and Human Services 
shall provide for an appropriate modifier (or other identifier) to 
include on claims to identify, for purposes of subparagraph (DD) of 
section 1833(a)(1), as added by subsection (a), specified COVID-19 
testing-related services described in paragraph (1) of section 1833(cc) 
of the Social Security Act, as added by subsection (a), for which 
payment may be made under a specified outpatient payment provision 
described in paragraph (2) of such subsection.
    (c) Implementation.--Notwithstanding any other provision of law, 
the Secretary of Health and Human Services may implement the provisions 
of, including amendments made by, this section through program 
instruction or otherwise.
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