,i  #aafth ,,congress  #b;d ,session    
,h4 ,r4 #fefh  ,,in ,,the ,,house ,,of  
,,representatives  ,april #ba1 #bjbj,ms4
 ,blunt ,rochester 7for herself1 ,mrs4  
,trahan1 and ,mr4 ,pascrell7 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 require group health     
plans and health insurance issuers      
offering group or individual health     
insurance coverage to provide coverage  
without imposing any cost sharing       
requirements for certain items and      
services furnished during any portion of
 the ,,covid-#ai emergency period1 and  
for other purposes4  #a4 ,short title   
,this ,act may be cited as the ,coverage
 for ,,covid-#ai ,treatment ,act of     

#bjbj4  #b4 ,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 instruction 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