Ensuring Treatment for COVID Act

II 116TH CONGRESS 2D SESSION S. 3564 To amend title XIX of the Social Security Act to require States to provide medical assistance for COVID–19 treatment services for individuals who are diagnosed with COVID–19, and for other purposes. IN THE SENATE OF THE UNITED STATES MARCH 22, 2020 Mr. CASEY (for himself and Mr. BOOKER) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend title XIX of the Social Security Act to require States to provide medical assistance for COVID–19 treatment services for individuals who are diagnosed with COVID–19, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Ensuring Treatment 4 for COVID Act’’. 5 SEC. 2. MANDATORY COVERAGE OF COVID–19 TREATMENT. 6 (a) IN GENERAL.—Section 1902 of the Social Secu- 7 rity Act (42 U.S.C. 1396a), as amended by section 6004 8 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 2 •S 3564 IS of the Families First Coronavirus Response Act, is amend- 1 ed— 2 (1) in subsection (a)— 3 (A) subparagraph (A)— 4 (i) in clause (i)— 5 (I) in subclause (VIII), by strik- 6 ing ‘‘; or’’ and inserting a semicolon; 7 and 8 (II) by inserting after subclause 9 (IX) the following new subclauses: 10 ‘‘(X) during any portion of the 11 emergency period defined in para- 12 graph (1)(B) of section 1135(g) be- 13 ginning on or after the date of the en- 14 actment of this subclause, who are un- 15 insured individuals (as defined in sub- 16 section (ss)); or 17 ‘‘(XI) who are uninsured individ- 18 uals who reside in one of the 50 19 States or the District of Columbia and 20 have been diagnosed with COVID–19 21 or the virus that causes COVID–19;’’; 22 and 23 (ii) in clause (ii)— 24 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 3 •S 3564 IS (I) in subclause (XXI), by insert- 1 ing ‘‘or’’ at the end; 2 (II) in subclause (XXII), by 3 striking ‘‘or’’ at the end; and 4 (III) by striking subclause 5 (XXIII); and 6 (B) in the matter following subparagraph 7 (G)— 8 (i) by striking ‘‘and (XVIII)’’ and in- 9 serting ‘‘(XVIII)’’; 10 (ii) by striking ‘‘and (XVIII)’’ and in- 11 serting ‘‘(XVIII)’’; 12 (iii) by striking ‘‘who is eligible for 13 medical assistance only because of sub- 14 paragraph (A)(ii)(XXIII)’’ and inserting 15 ‘‘who is eligible for medical assistance only 16 because of subparagraph (A)(i)(X)’’; and 17 (iv) by striking ‘‘and any visit de- 18 scribed in section 1916(a)(2)(G) that is 19 furnished during any such portion’’ and in- 20 serting ‘‘and any service described in sec- 21 tion 1916(a)(2)(G) that is furnished dur- 22 ing any such portion, and (XIX) the med- 23 ical assistance made available to an indi- 24 vidual who is eligible for medical assistance 25 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 4 •S 3564 IS only because of subclause (XI) of subpara- 1 graph (A)(i) shall be limited to medical as- 2 sistance for services that are related to 3 treating COVID–19, and shall only be 4 made available to such individual during 5 the 1-year period following the date of 6 such individual’s enrollment under the 7 State plan or waiver (or for such longer 8 period as the State may elect if the indi- 9 vidual continues to require treatment for 10 COVID–19 after the end of such 1-year 11 period)’’; and 12 (2) in subsection (ss)— 13 (A) in paragraph (1), by inserting ‘‘sub- 14 clauses (I) through (IX) of’’ before ‘‘subsection 15 (a)(10)(A)(i)’’; and 16 (B) in paragraph (2), by inserting ‘‘(unless 17 such individual is only enrolled for medical as- 18 sistance under this title under subclause (X) of 19 subsection (a)(10)(A)(i))’’ after ‘‘1128B(f))’’. 20 (b) COVERAGE OF COVID–19 TREATMENT AS A 21 MANDATORY SERVICE.—Section 1905(a)(4) of the Social 22 Security Act (42 U.S.C. 1396d(a)(4)) is amended— 23 (1) by striking ‘‘and (D)’’ and inserting ‘‘(D)’’; 24 and 25 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 5 •S 3564 IS (2) by striking the semicolon at the end and in- 1 serting ‘‘; and (E) items and services furnished for 2 the treatment of COVID–19;’’. 3 (c) PROHIBITION OF COST SHARING.— 4 (1) IN GENERAL.—Subsections (a)(2) and 5 (b)(2) of section 1916 of the Social Security Act (42 6 U.S.C. 1396o), as amended by section 7 6004(a)(2)(A) of the Families First Coronavirus Re- 8 sponse Act, are each amended— 9 (A) in subparagraph (F), by striking ‘‘or’’ 10 at the end; 11 (B) in subparagraph (G), by striking ‘‘; 12 and’’ and inserting ‘‘, or’’; and 13 (C) by adding at the end the following sub- 14 paragraphs: 15 ‘‘(H) a COVID–19 vaccine licensed under 16 section 351 of the Public Health Service Act 17 and the administration of such vaccine, or 18 ‘‘(I) any item or service furnished for the 19 treatment of COVID–19; and’’. 20 (2) APPLICATION TO ALTERNATIVE COST SHAR- 21 ING.—Section 1916A(b)(3)(B) of the Social Security 22 Act (42 U.S.C. 1396o–1(b)(3)(B)), as amended by 23 section 6004(a)(2)(B) of the Families First 24 Coronavirus Response Act, is amended— 25 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 6 •S 3564 IS (A) in clause (xi), by striking ‘‘any visit’’ 1 and inserting ‘‘any service’’; and 2 (B) by adding at the end the following 3 clauses: 4 ‘‘(xii) A COVID–19 vaccine licensed 5 under section 351 of the Public Health 6 Service Act and the administration of such 7 vaccine. 8 ‘‘(xiii) An item or service furnished 9 for the treatment of COVID–19.’’. 10 (3) CLARIFICATION.—The amendments made 11 this subsection shall apply with respect to a State 12 plan of a territory in the same manner as a State 13 plan of one of the 50 States. 14 (d) RECEIPT AND PROCESSING OF APPLICATIONS AT 15 CERTAIN LOCATIONS.—Section 1902(a)(55) of the Social 16 Security Act (42 U.S.C. 1396a(a)(55)), as amended by 17 section 6004 of the Families First Coronavirus Response 18 Act, is amended by striking ‘‘or (a)(10)(A)(ii)(XXIII)’’ 19 and inserting ‘‘(a)(10)(A)(i)(X), or (a)(10)(A)(i)(XI)’’. 20 (e) FEDERAL MEDICAL ASSISTANCE PERCENT- 21 AGE.— 22 (1) IN GENERAL.—Section 1905 of the Social 23 Security Act (42 U.S.C. 1396d) is amended— 24 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 7 •S 3564 IS (A) in subsection (b), by striking ‘‘and 1 (ff)’’ and inserting ‘‘(ff), and (gg)’’; and 2 (B) by adding at the end the following new 3 subsection: 4 ‘‘(gg) ENHANCED FMAP FOR MEDICAL ASSISTANCE 5 FOR COVID–19 TREATMENT.—Notwithstanding sub- 6 section (b), the Federal medical assistance percentage for 7 a State that is one of the 50 States or the District of 8 Columbia, with respect to amounts expended by such 9 State for medical assistance for individuals who are only 10 eligible for such assistance because of section 11 1902(a)(10)(A)(i)(XI) shall be equal to 100 percent.’’. 12 (2) CONFORMING AMENDMENT.—Section 13 1905(b) of the Social Security Act (42 U.S.C. 14 1396d(b)), as amended by 6004(a)(3)(D) of the 15 Families First Coronavirus Response Act, is amend- 16 ed by striking ‘‘section 1902(a)(10)(A)(ii)(XXIII)’’ 17 and inserting ‘‘section 1902(a)(10)(A)(i)(X)’’. 18 (f) ENHANCED PROVIDER PAYMENTS FOR SERVICES 19 TO TREAT COVID–19.—Section 1902(a)(13) of the Social 20 Security Act (42 U.S.C. 1396a(a)(13)) is amended— 21 (1) in subparagraph (B), by striking ‘‘; and’’ 22 and inserting a semicolon; 23 (2) in subparagraph (C), by striking the semi- 24 colon at the end and inserting ‘‘; and’’; and 25 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 8 •S 3564 IS (3) by adding at the end the following new sub- 1 paragraph: 2 ‘‘(D) payment for services to treat 3 COVID–19 at a rate not less than 125 percent 4 of the payment rate that would apply to such 5 services if they were provided under title 6 XVIII;’’. 7 (g) NONAPPLICATION OF CERTAIN REQUIRE- 8 MENTS.—With respect to medical assistance that is avail- 9 able under a State plan under title XIX of the Social Secu- 10 rity Act (42 U.S.C. 1396 et seq.) or a waiver of such a 11 plan pursuant to subclause (X) or (XI) of section 12 1902(a)(10)(A)(i) of such Act (42 U.S.C. 13 1396a(a)(10)(A)(i))— 14 (1) subsections (a)(1) and (d) of section 1137 15 of such Act (42 U.S.C. 1320b–7) shall not apply to 16 individuals seeking medical assistance under either 17 such subclause; 18 (2) notwithstanding the last sentence of section 19 1902(a) of such Act (42 U.S.C. 1396a(a)) or any 20 other provision of law, payment may be made to the 21 State for expenditures for medical assistance fur- 22 nished to an individual who is enrolled for medical 23 assistance pursuant to either such subclause without 24 VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S3564.IS S3564 9 •S 3564 IS regard to whether such individual is lawfully residing 1 in the United States; and 2 (3) the limitations on payment imposed by sub- 3 section (f) of section 1903 of such Act (42 U.S.C. 4 1396b) shall not apply with respect amounts ex- 5 pended by the State for medical assistance furnished 6 to an individual who is enrolled under either such 7 subclause. 8 (h) STATE REQUIREMENT TO STREAMLINE APPLICA- 9 TIONS.—During any portion of the emergency period de- 10 fined in paragraph (1)(B) of section 1135(g) of the Social 11 Security Act beginning on or after the date of enactment 12 of this Act, each State shall permit an individual who is 13 enrolled for medical assistance under the State plan under 14 title XIX of such Act, or a waiver of such plan, under 15 subclause (X) of section 1902(a)(10)(A)(i) of such Act to 16 enroll for medical assistance under subclause (XI) of such 17 section without requiring a new application from the indi- 18 vidual. Nothing in the preceding sentence shall be con- 19 strued as requiring that an individual first be enrolled 20 under subclause of (X) of section 1902(a)(10)(A)(i) of the 21 Social Security Act in order to enroll under subclause (XI) 22 of such section. 23 Æ VerDate Sep 11 2014 00:23 Apr 04, 2020 Jkt 099200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\S3564.IS S3564