The Centers for Medicare & Medicaid Services (CMS) released guidance requiring states to cover COVID-19 treatment with no cost-sharing for Medicaid and Children’s Health Insurance Program beneficiaries.
The American Rescue Plan (APR) required states to cover COVID-19 treatments without cost-sharing, including preventive therapies and specialized equipment, effective March 11, 2021. This coverage also includes treatments for prolonged COVID-19 conditions, or “long COVID.”
Further, states must cover without cost-sharing treatments for conditions that might seriously complicate the treatment of COVID-19 if the care is otherwise covered under the state plan when a beneficiary has, or is assumed to have, COVID-19. Examples of these conditions include, but are not limited to, cardiovascular diseases, chronic lung diseases, diabetes, cancer, obesity, Down syndrome, and receiving a transplant with immunosuppressive therapy. Whether a beneficiary has a condition the could seriously complicate the treatment of COVID-19 will be determined on a case-by-case basis.
Contact Senior Director of Policy Erin O’Malley at eomalley@essentialhospitals.org or 202.585.0127 with questions.
