Title: To amend title XVIII of the Social Security Act to provide for coverage of testing for COVID-19 at no cost sharing under the Medicare Advantage program.
Policy area: Health

Summary:
This bill requires Medicare Advantage (MA) plans to cover COVID-19 (i.e., coronavirus disease 2019) testing and related visits without cost-sharing during the public health emergency declared on January 31, 2020. MA plans are also prohibited from instituting prior authorization or other utilization management requirements with respect to coverage of such services.

[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6214 Introduced in House (IH)]

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116th CONGRESS
  2d Session
                                H. R. 6214

To amend title XVIII of the Social Security Act to provide for coverage 
of testing for COVID-19 at no cost sharing under the Medicare Advantage 
                                program.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             March 12, 2020

 Mr. Kind (for himself, Mrs. Trahan, and Ms. Barragan) introduced the 
following bill; which was referred to the Committee on Ways and Means, 
 and in addition to the Committee on Energy and Commerce, 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 provide for coverage 
of testing for COVID-19 at no cost sharing under the Medicare Advantage 
                                program.

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

SECTION 1. COVERAGE OF TESTING 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--
            (1) in clause (iv)--
                    (A) by redesignating subclause (IV) as subclause 
                (VI); and
                    (B) by inserting after subclause (III) the 
                following new subclauses:
                                    ``(IV) In vitro diagnostic products 
                                (as defined in section 809.3(a) of 
                                title 21, Code of Federal Regulations) 
                                administered during any portion of the 
                                emergency period defined in paragraph 
                                (1)(B) of section 1135(g) beginning on 
                                or after the date of the enactment of 
                                clause (vi) for the detection of SARS-
                                CoV-2 or the diagnosis of the virus 
                                that causes COVID-19 that are approved, 
                                cleared, or authorized under section 
                                510(k), 513, 515 or 564 of the Federal 
                                Food, Drug, and Cosmetic Act, and the 
                                administration of such in vitro 
                                diagnostic products.
                                    ``(V) Specified COVID-19 testing-
                                related services (as described in 
                                section 1833(cc)(1)) for which payment 
                                would be payable under a specified 
                                outpatient payment provision described 
                                in section 1833(cc)(2).'';
            (2) in clause (v), by inserting ``, other than subclauses 
        (IV) and (V) of such clause,'' after ``clause (iv)''; and
            (3) by adding at the end the following new clause:
                            ``(vi) Prohibition of application of 
                        certain requirements for covid-19 testing.--In 
                        the case of a product or service described in 
                        subclause (IV) or (V), respectively, of clause 
                        (iv) that is administered or furnished during 
                        any portion of the emergency period described 
                        in such subclause beginning on or after the 
                        date of the enactment of this clause, an MA 
                        plan may not impose any prior authorization or 
                        other utilization management requirements with 
                        respect to the coverage of such a product or 
                        service under such plan.''.
    (b) Implementation.--The Secretary of Health and Human Services may 
implement the amendments made by this section by program instruction or 
otherwise.
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