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.

I 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 Advan- tage program. IN THE HOUSE OF REPRESENTATIVES MARCH 12, 2020 Mr. KIND (for himself, Mrs. TRAHAN, and Ms. BARRAGA´N) introduced the fol- lowing 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 consider- ation 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 Representa- 1 tives of the United States of America in Congress assembled, 2 VerDate Sep 11 2014 22:43 Mar 21, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\H6214.IH H6214 kjohnson on DSK79L0C42PROD with BILLS 2 •HR 6214 IH SECTION 1. COVERAGE OF TESTING FOR COVID–19 AT NO 1 COST SHARING UNDER THE MEDICARE AD- 2 VANTAGE PROGRAM. 3 (a) IN GENERAL.—Section 1852(a)(1)(B) of the So- 4 cial Security Act (42 U.S.C. 1395w–22(a)(1)(B)) is 5 amended— 6 (1) in clause (iv)— 7 (A) by redesignating subclause (IV) as 8 subclause (VI); and 9 (B) by inserting after subclause (III) the 10 following new subclauses: 11 ‘‘(IV) In vitro diagnostic prod- 12 ucts (as defined in section 809.3(a) of 13 title 21, Code of Federal Regulations) 14 administered during any portion of 15 the emergency period defined in para- 16 graph (1)(B) of section 1135(g) be- 17 ginning on or after the date of the en- 18 actment of clause (vi) for the detec- 19 tion of SARS–CoV–2 or the diagnosis 20 of the virus that causes COVID–19 21 that are approved, cleared, or author- 22 ized under section 510(k), 513, 515 23 or 564 of the Federal Food, Drug, 24 and Cosmetic Act, and the adminis- 25 VerDate Sep 11 2014 22:43 Mar 21, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H6214.IH H6214 kjohnson on DSK79L0C42PROD with BILLS 3 •HR 6214 IH tration of such in vitro diagnostic 1 products. 2 ‘‘(V) Specified COVID–19 test- 3 ing-related services (as described in 4 section 1833(cc)(1)) for which pay- 5 ment would be payable under a speci- 6 fied outpatient payment provision de- 7 scribed in section 1833(cc)(2).’’; 8 (2) in clause (v), by inserting ‘‘, other than sub- 9 clauses (IV) and (V) of such clause,’’ after ‘‘clause 10 (iv)’’; and 11 (3) by adding at the end the following new 12 clause: 13 ‘‘(vi) PROHIBITION OF APPLICATION 14 OF CERTAIN REQUIREMENTS FOR COVID–19 15 TESTING.—In the case of a product or 16 service described in subclause (IV) or (V), 17 respectively, of clause (iv) that is adminis- 18 tered or furnished during any portion of 19 the emergency period described in such 20 subclause beginning on or after the date of 21 the enactment of this clause, an MA plan 22 may not impose any prior authorization or 23 other utilization management requirements 24 VerDate Sep 11 2014 22:43 Mar 21, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\H6214.IH H6214 kjohnson on DSK79L0C42PROD with BILLS 4 •HR 6214 IH with respect to the coverage of such a 1 product or service under such plan.’’. 2 (b) IMPLEMENTATION.—The Secretary of Health and 3 Human Services may implement the amendments made by 4 this section by program instruction or otherwise. 5 Æ VerDate Sep 11 2014 22:43 Mar 21, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6301 E:\BILLS\H6214.IH H6214 kjohnson on DSK79L0C42PROD with BILLS