,i #aafth ,,congress #b;d ,session ,h4 ,r4 #fdhf ,,in ,,the ,,house ,,of ,,representatives ,april #aj1 #bjbj,mr4 ,ruiz 7for himself and ,ms4 ,underwood7 introduced the following bill2 which was referred to the ,committee on ,energy and ,commerce1 and in addition to the ,committees on ,ways and ,means1 and ,education and ,labor1 for a period to be subsequently determined by the ,speaker1 in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned ,a ,,bill ,to amend the ,patient ,protection and ,affordable ,care ,act to require the ,secretary of ,health and ,human ,services to establish a special enrollment period during the ,,covid-#ai emergency period1 to require the ,secretary to carry out outreach and educational activities for such special enrollment period1 to require group health plans and health insurance issuers offering group or individual health insurance coverage to provide coverage without any cost sharing for certain items and services furnished during any portion of such emergency period1 and for other purposes4 #a4 ,short title ,this ,act may be cited as the ,care for ,,covid-#ai ,act #b4j4 #b4 ,special enrollment period through ,exchanges2 ,federal ,exchange outreach and educational activities 7a7 ,special enrollment period through ,exchanges ,section #acaa7;c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjca7;c77 is amended-- 7#a7 in paragraph 7#f7-- 7,a7 in subparagraph 7,c71 by striking at the end and2 7,b7 in subparagraph 7,d71 by striking at the end the period and inserting 2 and2 and 7,c7 by adding at the end the following new subparagraph3 7,e7 subject to subparagraph 7,b7 of paragraph 7#h71 the special enrollment period described in subparagraph 7,a7 of such paragraph4 2 and 7#b7 by adding at the end the following new paragraph3 7#h7 ,special enrollment period for certain public health emergency 7,a7 ,in general ,the ,secretary shall1 subject to subparagraph 7,b71 require an ,exchange to provide-- 7i7 for a special enrollment period during the emergency period described in section #aace7;g77#a77;,b7 of the ,social ,security ,act-- 7,i7 which shall begin on the date that is one week after the date of the enactment of this paragraph and which1 in the case of an ,exchange established or operated by the ,secretary within a ,state pursuant to section #acba7;c71 shall be an #h-week period2 and 7,,ii7 during which any individual who is otherwise eligible to enroll in a qualified health plan through the ,exchange may enroll in such a qualified health plan2 and 7ii7 that1 in the case of an individual who enrolls in a qualified health plan through the ,exchange during such enrollment period1 the coverage period under such plan shall begin1 at the option of the individual1 on ,april #a1 #bjbj1 or on the first day of the month following the day the individual selects a plan through such special enrollment period4 7,b7 ,exception ,the requirement of subparagraph 7,a7 shall not apply to a ,state-operated or ,state-established ,exchange if such ,exchange1 prior to the date of the enactment of this paragraph1 established or otherwise provided for a special enrollment period to address access to coverage under qualified health plans offered through such ,exchange during the emergency period described in section #aace7;g77#a77;,b7 of the ,social ,security ,act4 4 7b7 ,federal ,exchange outreach and educational activities ,section #acba7;c7 of the ,patient ,protection and ,affordable ,care ,act 7#db ,u4,s4,c4 #ahjda7;c77 is amended by adding at the end the following new paragraph3 7#c7 ,outreach and educational activities 7,a7 ,in general ,in the case of an ,exchange established or operated by the ,secretary within a ,state pursuant to this subsection1 the ,secretary shall carry out outreach and educational activities for purposes of informing potential enrollees in qualified health plans offered through the ,exchange of the availability of coverage under such plans and financial assistance for coverage under such plans4 ,such outreach and educational activities shall be provided in a manner that is culturally and linguistically appropriate to the needs of the populations being served by the ,exchange 7including hard-to-reach populations1 such as racial and sexual minorities1 limited ,english proficient populations1 and young adults74 7,b7 ,limitation on use of funds ,no funds appropriated under this paragraph shall be used for expenditures for promoting non-,,aca compliant health insurance coverage4 7,c7 ,non-,,aca compliant health insurance coverage ,for purposes of subparagraph 7,b73 7i7 ,the term non-,,aca compliant health insurance coverage means health insurance coverage1 or a group health plan1 that is not a qualified health plan4 7ii7 ,such term includes the following3 7,i7 ,an association health plan4 7,,ii7 ,short-term limited duration insurance4 7,d7 ,funding ,out of any funds in the ,treasury not otherwise appropriated1 there are hereby appropriated #be1jjj1jjj to carry out this paragraph4 ,funds appropriated under this subparagraph shall remain available until expended4 4 7c7 ,implementation ,the ,secretary of ,health and ,human ,services may implement the provisions of 7including amendments made by7 this section through subregulatory guidance1 program instruction1 or otherwise4 #c4 ,coverage of ,,covid-#ai related treatment at no cost sharing 7a7 ,in general ,a group health plan and a health insurance issuer offering group or individual health insurance coverage 7including a grandfathered health plan 7as defined in section #abea7;e7 of the ,patient ,protection and ,affordable ,care ,act77 shall provide coverage1 and shall not impose any cost sharing 7including deductibles1 copayments1 and coinsurance7 requirements1 for the following items and services furnished during any portion of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;b-#e7;g77 beginning on or after the date of the enactment of this ,act3 7#a7 ,medically necessary items and services 7including in-person or telehealth visits in which such items and services are furnished7 that are furnished to an individual who has been diagnosed with 7or after provision of the items and services is diagnosed with7 ,,covid-#ai to treat or mitigate the effects of ,,covid-#ai4 7#b7 ,medically necessary items and services 7including in-person or telehealth visits in which such items and services are furnished7 that are furnished to an individual who is presumed to have ,,covid-#ai but is never diagnosed as such1 if the following conditions are met3 7,a7 ,such items and services are furnished to the individual to treat or mitigate the effects of ,,covid-#ai or to mitigate the impact of ,,covid-#ai on society4 7,b7 ,health care providers have taken appropriate steps under the circumstances to make a diagnosis1 or confirm whether a diagnosis was made1 with respect to such individual1 for ,,covid-#ai1 if possible4 7b7 ,items and services related to ,,covid-#ai ,for purposes of this section-- 7#a7 not later than one week after the date of the enactment of this section1 the ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 and ,secretary of the ,treasury shall jointly issue guidance specifying applicable diagnoses and medically necessary items and services related to ,,covid-#ai2 and 7#b7 such items and services shall include all items or services that are relevant to the treatment or mitigation of ,,covid-#ai1 regardless of whether such items or services are ordinarily covered under the terms of a group health plan or group or individual health insurance coverage offered by a health insurance issuer4 7c7 ,reimbursement to plans and coverage for waiving cost sharing 7#a7 ,in general ,a group health plan or a health insurance issuer offering group or individual health insurance coverage 7including a grandfathered health plan 7as defined in section #abea7;e7 of the ,patient ,protection and ,affordable ,care ,act77 that does not impose cost sharing requirements as described in subsection 7a7 shall notify the ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 and ,secretary of the ,treasury 7through a joint process established jointly by the ,secretaries7 of the total dollar amount of cost sharing that1 but for the application of subsection 7a71 would have been required under such plans and coverage for items and services related to ,,covid-#ai furnished during the period to which subsection 7a7 applies to enrollees1 participants1 and beneficiaries in the plan or coverage to whom such subsection applies1 but which was not imposed for such items and services so furnished pursuant to such subsection and the ,secretary of ,health and ,human ,services1 in coordination with the ,secretary of ,labor and the ,secretary of the ,treasury1 shall make payments in accordance with this subsection to the plan or issuer equal to such total dollar amount4 7#b7 ,methodology for payments ,the ,secretary of ,health and ,human ,services1 in coordination with the ,secretary of ,labor and the ,secretary of the ,treasury shall establish a payment system for making payments under this subsection4 ,any such system shall make payment for the value of cost sharing not imposed by the plan or issuer involved4 7#c7 ,timing of payments ,payments made under paragraph 7#a7 shall be made no later than ,may #a1 #bjba1 for amounts of cost sharing waivers with respect to #bjbj4 ,payments under this subsection with respect to such waivers with respect to a year subsequent to #bjbj that begins during the period to which subsection 7a7 applies shall be made no later than ,may of the year following such subsequent year4 7#d7 ,appropriations ,there is authorized to be appropriated1 and there is appropriated1 out of any monies in the ,treasury not otherwise appropriated1 such funds as are necessary to carry out this subsection4 7d7 ,enforcement 7#a7 ,application with respect to ,,phsa1 ,,erisa1 and ,,irc ,the provisions of this section shall be applied by the ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 and ,secretary of the ,treasury to group health plans and health insurance issuers offering group or individual health insurance coverage as if included in the provisions of part ,a of title ,,xxvii of the ,public ,health ,service ,act1 part #g of the ,employee ,retirement ,income ,security ,act of #aigd1 and subchapter ,b of chapter #ajj of the ,internal ,revenue ,code of #aihf1 as applicable4 7#b7 ,private right of action ,an individual with respect to whom an action is taken by a group health plan or health insurance issuer offering group or individual health insurance coverage in violation of subsection 7a7 may commence a civil action against the plan or issuer for appropriate relief4 ,the previous sentence shall not be construed as limiting any enforcement mechanism otherwise applicable pursuant to paragraph 7#a74 7e7 ,implementation ,the ,secretary of ,health and ,human ,services1 ,secretary of ,labor1 and ,secretary of the ,treasury may implement the provisions of this section through sub-regulatory guidance1 program instruction1 or otherwise4 7f7 ,terms ,the terms group health plan1 health insurance issuer1 group health insurance coverage1 and individual health insurance coverage have the meanings given such terms in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia71 section #gcc of the ,employee ,retirement ,income ,security ,act of #aigd 7#bi ,u4,s4,c4 #aaia;b71 and section #ihcb of the ,internal ,revenue ,code of #aihf1 as applicable4