,,ii #aafth ,,congress #b;d ,session ,s4 #cdii ,,in ,,the ,,senate ,,of ,,the ,,united ,,states ,march #ab1 #bjbj,ms4 ,smith 7for herself1 ,mr4 ,peters1 ,mr4 ,schumer1 ,mrs4 ,murray1 ,mr4 ,wyden1 ,mr4 ,casey1 ,mr4 ,jones1 ,mr4 ,brown1 ,ms4 ,duckworth1 ,mr4 ,tester1 ,mr4 ,whitehouse1 ,mr4 ,sanders1 ,ms4 ,baldwin1 ,mr4 ,reed1 ,mr4 ,murphy1 ,ms4 ,klobuchar1 ,ms4 ,hirono1 ,mr4 ,schatz1 ,mr4 ,king1 ,mr4 ,coons1 ,ms4 ,stabenow1 ,mr4 ,booker1 ,mrs4 ,feinstein1 ,ms4 ,harris1 ,mr4 ,udall1 ,ms4 ,hassan1 ,mrs4 ,gillibrand1 ,mr4 ,heinrich1 ,ms4 ,rosen1 ,mrs4 ,shaheen1 ,mr4 ,kaine1 ,ms4 ,warren1 ,mr4 ,carper1 ,mr4 ,warner1 ,mr4 ,van ,hollen1 ,mr4 ,durbin1 ,mr4 ,markey1 ,mr4 ,blumenthal1 ,mr4 ,bennet1 and ,mr4 ,menendez7 introduced the following bill2 which was read twice and referred to the ,committee on ,health1 ,education1 ,labor1 and ,pensions ,a ,,bill ,to amend coverage requirements to ensure that no person incurs cost sharing when receiving a test to confirm a ,,covid-#ai infection4 #a4 ,short title2 table of contents 7a7 ,short title ,this ,act may be cited as the ,free ,,covid-#ai ,testing ,act4 7b7 ,table of contents ,the table of contents of this ,act is as follows3 ,sec4 #a4 ,short title2 table of contents4,sec4 #b4 ,coverage of testing for ,,covid-#ai4,sec4 #c4 ,waiving cost sharing under the ,medicare program for certain visits relating to testing for ,,covid-#ai4,sec4 #d4 ,coverage of testing for ,,covid-#ai at no cost sharing under the ,medicare ,advantage program4,sec4 #e4 ,coverage at no cost sharing of ,,covid-#ai testing under ,medicaid and ,,chip4,sec4 #f4 ,laboratory reimbursement for diagnostic testing for ,,covid-#ai in uninsured individuals4,sec4 #g4 ,application with respect to ,,tricare1 coverage for veterans1 and coverage for ,federal civilians4,sec4 #h4 ,coverage of testing for ,,covid-#ai at no cost sharing for ,indians receiving contract health services4 #b4 ,coverage of testing for ,,covid-#ai 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 requirements or prior authorization or other medical management 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 ,in vitro diagnostic products 7as defined in section #hji4c7;a7 of title #ba1 ,code of ,federal ,regulations7 for the detection of ,,sars-,co,v-#b or the diagnosis of the virus that causes ,,covid-#ai that are approved1 cleared1 or authorized under section #eaj7k71 #eac1 #eae1 or #efd of the ,federal ,food1 ,drug1 and ,cosmetic ,act1 and the administration of such in vitro diagnostic products4 7#b7 ,health care provider office visits1 urgent care center visits1 and emergency room visits that result in an order for or administration of an in vitro diagnostic product described in paragraph 7#a74 7b7 ,enforcement ,the provisions of subsection 7a7 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 7c7 ,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 7d7 ,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 #c4 ,waiving cost sharing under the ,medicare program for certain visits relating to testing for ,,covid-#ai 7a7 ,in general ,section #ahcc of the ,social ,security ,act 7#db ,u4,s4,c4 #aciel7 is amended-- 7#a7 in subsection 7a77#a7-- 7,a7 by striking and before 7,,cc72 and 7,b7 by inserting before the period at the end the following3 1 and 7,,dd7 with respect to a specified ,,covid-#ai testing-related service described in paragraph 7#a7 of subsection 7cc7 for which payment may be made under a specified outpatient payment provision described in paragraph 7#b7 of such subsection1 the amounts paid shall be #ajj percent of the payment amount otherwise recognized under such respective specified outpatient payment provision for such service12 7#b7 in subsection 7b71 in the first sentence-- 7,a7 by striking and before 7#aj72 and 7,b7 by inserting before the period at the end the following3 1 and 7#aa7 such deductible shall not apply with respect to any specified ,,covid-#ai testing-related service described in paragraph 7#a7 of subsection 7cc7 for which payment may be made under a specified outpatient payment provision described in paragraph 7#b7 of such subsection2 and 7#c7 by adding at the end the following new subsection3 7cc7 ,specified ,,covid-#ai testing-,related services ,for purposes of subsection 7a77#a77;,,dd73 7#a7 ,description 7,a7 ,in general ,a specified ,,covid-#ai testing-related service described in this paragraph is a medical visit that-- 7i7 is in any of the categories of ,,hcpcs evaluation and management service codes described in subparagraph 7,b72 7ii7 is furnished during any portion of the emergency period 7as defined in section #aace7;g77#a77;,b77 beginning on or after the date of the enactment of this subsection2 and 7iii7 results in an order for or administration of a diagnostic test described in section #aheb7;a77#a77;,b77iv77,,iv74 7,b7 ,categories of ,,hcpcs codes ,for purposes of subparagraph 7,a71 the categories of ,,hcpcs evaluation and management services codes are the following3 7i7 ,office and other outpatient services4 7ii7 ,hospital observation services4 7iii7 ,emergency department services4 7iv7 ,nursing facility services4 7v7 ,domiciliary1 rest home1 or custodial care services4 7vi7 ,home services4 7#b7 ,specified outpatient payment provision ,a specified outpatient payment provision described in this paragraph is any of the following3 7,a7 ,the hospital outpatient prospective payment system under subsection 7t74 7,b7 ,the physician fee schedule under section #ahdh4 7,c7 ,the prospective payment system developed under section #ahcd7o74 7,d7 ,section #ahcd7;g71 with respect to an outpatient critical access hospital service4 7,e7 ,the payment basis determined in regulations pursuant to section #ahcc7;a77#c7 for rural health clinic services4 4 7b7 ,claims modifier ,the ,secretary of ,health and ,human ,services shall provide for an appropriate modifier 7or other identifier7 to include on claims to identify1 for purposes of subparagraph 7,,dd7 of section #ahcc7;a77#a71 as added by subsection 7a71 specified ,,covid-#ai testing-related services described in paragraph 7#a7 of section #ahcc7;cc7 of the ,social ,security ,act1 as added by subsection 7a71 for which payment may be made under a specified outpatient payment provision described in paragraph 7#b7 of such subsection4 7c7 ,implementation ,notwithstanding any other provision of law1 the ,secretary of ,health and ,human ,services may implement the provisions of1 including amendments made by1 this section through program instruction or otherwise4 #d4 ,coverage of testing for ,,covid-#ai at no cost sharing under the ,medicare ,advantage program 7a7 ,in general ,section #aheb7;a77#a77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #aciew-#bb7;a77#a77;,b77 is amended-- 7#a7 in clause 7iv7-- 7,a7 by redesignating subclause 7,,iv7 as subclause 7,,vi72 and 7,b7 by inserting after subclause 7,,iii7 the following new subclauses3 7,,iv7 ,clinical diagnostic laboratory test administered during any portion of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 beginning on or after the date of the enactment of the ,free ,,covid-#ai ,testing ,act for the detection of ,,sars-,co,v-#b or the diagnosis of the virus that causes ,,covid-#ai and the administration of such test4 7,v7 ,specified ,,covid-#ai testing-related services 7as described in section #ahcc7;cc77#a77 for which payment would be payable under a specified outpatient payment provision described in section #ahcc7;cc77#b74 2 7#b7 in clause 7v71 by inserting 1 other than subclauses 7,,iv7 and 7,v7 of such clause1 after clause 7iv72 and 7#c7 by adding at the end the following new clause3 7vi7 ,prohibition of application of certain requirements for ,,covid-#ai testing ,in the case of a product or service described in subclause 7,,iv7 or 7,v71 respectively1 of clause 7iv7 that is administered or furnished during any portion of the emergency period described in such subclause beginning on or after the date of the enactment of this clause1 an ,,ma plan may not impose any prior authorization or other utilization management requirements with respect to the coverage of such a product or service under such plan4 4 7b7 ,implementation ,notwithstanding any other provision of law1 the ,secretary of ,health and ,human ,services may implement the amendments made by this section by program instruction or otherwise4 #e4 ,coverage at no cost sharing of ,,covid-#ai testing under ,medicaid and ,,chip 7a7 ,medicaid 7#a7 ,in general ,section #aije7;a77#c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7a77#c77 is amended-- 7,a7 by striking other laboratory and inserting 7,a7 other laboratory2 7,b7 by inserting and after the semicolon2 and 7,c7 by adding at the end the following new subparagraph3 7,b7 in vitro diagnostic products 7as defined in section #hji4c7;a7 of title #ba1 ,code of ,federal ,regulations7 administered during any portion of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 beginning on or after the date of the enactment of this subparagraph for the detection of ,,sars-,co,v-#b or the diagnosis of the virus that causes ,,covid-#ai that are approved1 cleared1 or authorized under section #eaj7k71 #eac1 #eae1 or #efd of the ,federal ,food1 ,drug1 and ,cosmetic ,act1 and the administration of such in vitro diagnostic products2 4 7#b7 ,no cost sharing 7,a7 ,in general ,subsections 7a77#b7 and 7b77#b7 of section #aiaf of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo7 are each amended-- 7i7 in subparagraph 7,d71 by striking or at the end2 7ii7 in subparagraph 7,e71 by striking 2 and and inserting a comma2 and 7iii7 by adding at the end the following new subparagraphs3 7,f7 any in vitro diagnostic product described in section #aije7;a77#c77;,b7 that is administered during any portion of the emergency period described in such section beginning on or after the date of the enactment of this subparagraph 7and the administration of such product71 or 7,g7 any medical visit for which payment may be made under the ,state plan1 that is furnished during any such portion of such emergency period1 and that relates to testing for ,,covid-#ai2 and 4 7,b7 ,application to alternative cost sharing ,section #aiaf;,a7b77#c77;,b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acifo-#a7;b77#c77;,b77 is amended by adding at the end the following new clause3 7xi7 ,any in vitro diagnostic product described in section #aije7;a77#c77;,b7 that is administered during any portion of the emergency period described in such section beginning on or after the date of the enactment of this clause 7and the administration of such product7 and any visit described in section #aiaf7;a77#b77;,g7 that is furnished during any such portion4 4 7,c7 ,clarification ,the amendments made this paragraph shall apply with respect to a ,state plan of a territory in the same manner as a ,state plan of one of the #ej ,states4 7#c7 ,state option to provide coverage for uninsured individuals 7,a7 ,in general ,section #aijb7;a77#aj7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#aj77 is amended-- 7i7 in subparagraph 7,a77ii7-- 7,i7 in subclause 7,,xxi71 by striking or at the end2 7,,ii7 in subclause 7,,xxii71 by adding or at the end2 and 7,,iii7 by adding at the end the following new subclause3 7,,xxiii7 during any portion of the emergency period defined in paragraph 7#a77;,b7 of section #aace7;g7 beginning on or after the date of the enactment of this subclause1 who are uninsured individuals 7as defined in subsection 7ss772 2 and 7ii7 in the matter following subparagraph 7,g7-- 7,i7 by striking and 7,,xvii7 and inserting 1 7,,xvii72 and 7,,ii7 by inserting after instead of through subclause 7,,viii7 the following3 1 and 7,,xviii7 the medical assistance made available to an uninsured individual 7as defined in subsection 7ss77 who is eligible for medical assistance only because of subparagraph 7,a77ii77,,xxiii7 shall be limited to medical assistance for any in vitro diagnostic product described in section #aije7;a77#c77;,b7 that is administered during any portion of the emergency period described in such section beginning on or after the date of the enactment of this subclause 7and the administration of such product7 and any visit described in section #aiaf7;a77#b77;,g7 that is furnished during any such portion4 7,b7 ,receipt and initial processing of applications at certain locations ,section #aijb7;a77#ee7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7a77#ee77 is amended1 in the matter preceding subparagraph 7,a71 by striking or 7a77#aj77;,a77ii77,,ix7 and inserting 7a77#aj77;,a77ii77,,ix71 or 7a77#aj77;,a77ii77,,xxiii74 7,c7 ,uninsured individual defined ,section #aijb of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;a7 is amended by adding at the end the following new subsection3 7ss7 ,uninsured individual defined ,for purposes of this section1 the term uninsured individual means1 notwithstanding any other provision of this title1 any individual who is-- 7#a7 not described in subsection 7a77#aj77;,a77i72 and 7#b7 not enrolled in a ,federal health care program 7as defined in section #aabh;,b7f771 a group health plan1 group or individual health insurance coverage offered by a health insurance issuer 7as such terms are defined in section #bgia of the ,public ,health ,service ,act71 or a health plan offered under chapter #hi of title #e1 ,united ,states ,code4 4 7,d7 ,federal medical assistance percentage ,section #aije7;b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acif;d7b77 is amended by adding at the end the following new sentence3 ,notwithstanding the first sentence of this subsection1 the ,federal medical assistance percentage shall be #ajj per centum with respect to 7and1 notwithstanding any other provision of this title1 available for7 medical assistance provided to uninsured individuals 7as defined in section #aijb7ss77 who are eligible for such assistance only on the basis of section #aijb7;a77#aj77;,a77ii77,,xxiii7 and with respect to expenditures described in section #aijc7;a77#g7 that a ,state demonstrates to the satisfaction of the ,secretary are attributable to administrative costs related to providing for such medical assistance to such individuals under the ,state plan44 7b7 ,,chip 7#a7 ,in general ,section #bajc7;c7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7c77 is amended by adding at the end the following paragraph3 7#i7 ,certain in vitro diagnostic products for ,,covid-#ai testing ,the child health assistance provided to a targeted low-income child shall include coverage of any in vitro diagnostic product described in section #aije7;a77#c77;,b7 that is administered during any portion of the emergency period described in such section beginning on or after the date of the enactment of this subparagraph 7and the administration of such product74 4 7#b7 ,coverage for targeted low-income pregnant women ,section #baab7;b77#d7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acigll7b77#d77 is amended by inserting under section #bajc7;c7 after same requirements4 7#c7 ,prohibition of cost sharing ,section #bajc7;e77#b7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acig;cc7e77#b77 is amended-- 7,a7 in the paragraph header1 by inserting 1 ,,covid-#ai testing1 before or pregnancy-related assistance2 and 7,b7 by striking category of services described in subsection 7c77#a77;,d7 or and inserting categories of services described in subsection 7c77#a77;,d71 in vitro diagnostic products described in subsection 7c77#i7 7and administration of such products71 visits described in section #aiaf7;a77#b77;,g71 or4 #f4 ,laboratory reimbursement for diagnostic testing for ,,covid-#ai in uninsured individuals 7a7 ,reimbursement ,through the ,national ,disaster ,medical ,system under section #bhab of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;hh-#aa71 and in coordination with the ,administrator of the ,centers for ,medicare ,medicaid ,services1 the ,secretary of ,health and ,human ,services shall1 subject to the availability of appropriations under subsection 7c71 pay the claims of laboratories for reimbursement1 as described in subsection 7a77#c77;,d7 of such section #bhab1 for health services consisting of diagnostic testing to detect or diagnose ,,covid-#ai in uninsured individuals4 ,the amount that will be paid shall be equal to the amount that would have been paid to a physician or laboratory under ,clinical ,laboratory ,fee ,schedule under section #ahcc7;h77#h7 of the ,social ,security ,act4 7b7 ,definition ,in this section1 the term uninsured individual means an individual who is not enrolled in-- 7#a7 a ,federal health care program 7as defined under section #aabh;,b7f7 of the ,social ,security ,act 7#db ,u4,s4,c4 #acbj;a-#g;b7f7772 or 7#b7 a group health plan or health insurance coverage offered by a health insurance issuer in the group or individual market 7as such terms are defined in section #bgia of the ,public ,health ,service ,act 7#db ,u4,s4,c4 #cjj;gg-#ia77 or a health plan offered under chapter #hi of title #e1 ,united ,states ,code4 7c7 ,funding ,to carry out this section1 there is authorized to be appropriated1 and there is hereby appropriated1 out of amounts in the ,treasury not otherwise obligated1 #a1jjj1jjj1jjj1 to remain available until expended4 #g4 ,application with respect to ,,tricare1 coverage for veterans1 and coverage for ,federal civilians 7a7 ,,tricare ,the ,secretary of ,defense may not require any copayment or other cost sharing under chapter #ee of title #aj1 ,united ,states ,code1 for in vitro diagnostic products described in paragraph 7#a7 of section #b7;a7 7or the administration of such products7 or visits described in paragraph 7#b7 of such section 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 ,act4 7b7 ,veterans ,the ,secretary of ,veterans ,affairs may not require any copayment or other cost sharing under chapter #ag of title #ch1 ,united ,states ,code1 for in vitro diagnostic products described in paragraph 7#a7 of section #b7;a7 7or the adminsitration of such products7 or visits described in paragraph 7#b7 of such section 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 ,act4 7c7 ,federal civilians ,no copayment or other cost sharing may be required for any individual occupying a position in the civil service 7as that term is defined in section #baja7a7 of title #e1 ,united ,states ,code7 enrolled in a health benefits plan1 including any plan under chapter #hi of title #e1 ,united ,states ,code1 or for any other individual currently enrolled in any plan under chapter #hi of title #e for diagnostic tests0 after 8including any plan under chapter #hi of title #e1 ,united ,states ,code71 for in vitro diagnostic products described in paragraph 7#a7 of section #b7;a7 7or the administration of such products7 or visits described in paragraph 7#b7 of such section 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 ,act4 #h4 ,coverage of testing for ,,covid-#ai at no cost sharing for ,indians receiving contract health services ,the ,secretary of ,health and ,human ,services shall cover1 without the imposition of any cost sharing requirements1 the cost of providing any ,,covid-#ai related items and services as described in paragraph 7#a7 of section #b7;a7 7or the administration of such products7 or visits described in paragraph 7#b7 of such section 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 #cbj;b-#e7;g77 beginning on or after the date of the enactment of this ,act to ,indians 7as defined in section #d of the ,indian ,health ,care ,improvement ,act 7#be ,u4,s4,c4 #afjc77 receiving health services through the ,indian ,health ,service1 regardless of whether such items or services have been authorized under the contract health services system funded by the ,indian ,health ,service or is covered as a health service of the ,indian ,health ,service4