In late January 2020, The Department of Health and Human Services (HHS) issued a public health emergency declaration. Several payment policies and regulatory adjustments are attached to the public health emergency, including the Medicare inpatient 20% add-on payment, Medicaid matching rates, and requirements that insurers and health plans cover COVID-19 testing without cost-sharing, and waivers of telehealth restrictions. This extension also extends the requirements on how plans cover the COVID-19 vaccine. In particular, it extends the requirement that non-grandfathered plans cover the vaccine without cost-sharing whether it is provided in or out of network, and whether or not it is recommended for routine use. After the end of the public health emergency, vaccines must only be covered in-network and if recommended for routine use.

As a result of the continued Coronavirus pandemic, HHS has extended their declaration of a public health emergency several times since January. The declaration, which was set to expire on January 20th has been extended for an additional 90 days to April 20th.

The public health emergency should not be confused with the Stafford Act national emergency declaration declared by President Trump in March. The national emergency declaration is also still in effect and impacts health plans by extending certain time frames and deadlines for participant actions and relieves some plan administration compliance obligations during the COVID‑19 National Emergency.

Diversified Group will continue to keep you up to date on both declarations as they progress.

DG Compliance