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.

Bill: 116-hr-6263
Sponsor: full_name: Rep. Sarbanes, John P. [D-MD-3]
Introduced: 2020-03-12
Policy area: Health
Subjects: Cardiovascular and respiratory health

Emergency medical services and trauma care

Health care coverage and access

Infectious and parasitic diseases

Medical tests and diagnostic methods

Medicare
Latest action: action_date: 2020-03-19
text: Referred to the Subcommittee on Health.

Summaries:
action_date: 2020-03-12
action_desc: Introduced in House
text: <p>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.</p>

tv_txt: I 116th CONGRESS 2d Session H. R. 6263 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.

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.