Sec. 103. Coverage of treatments for COVID–19 at no cost sharing under the Medicare Advantage program

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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: 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— any cost-sharing requirement (including a deductible, copayment, or coinsurance requirement); and 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). . Section 1853 of the Social Security Act ( 42 U.S.C. 1395w–23 ) is amended by adding at the end the following new subsection: 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. 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.

Section 1853(c)(7) shall not apply with respect to the application of this subsection. 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. . 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.

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42 USC 1395w–22(a)(1)(B)
42 USC 1395w–23

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Sec. 103

Coverage of treatments for COVID–19 at no cost sharing under the Medicare Advantage program

Cite42 USC 1395w–22(a)(1)(B)

Cite42 USC 1395w–23

Cites 2Cited by 0 across 0 sources