,,ii  #aafth ,,congress  #b;d ,session  
,s4 #ddfi  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,august #f1    
#bjbj,ms4 ,smith 7for herself1 ,mr4     
,bennet1 and ,ms4 ,harris7 introduced   
the following bill2 which was read twice
 and referred to the ,committee on      
,health1 ,education1 ,labor1 and        
,pensions  ,a ,,bill  ,to ensure        
coverage of a ,,covid-#ai vaccine and   
treatment4  #a4 ,short title2 table of  
contents  7a7 ,short title ,this ,act   
may be cited as the ,,covid-#ai         
,treatment ,coverage ,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 at no cost sharing of     
,,covid-#ai vaccine and treatment under 
,medicaid program4,sec4 #c4 ,coverage of
 treatment and vaccines at no cost      
sharing for the uninsured4,sec4 #d4     
,coverage of ,,covid-#ai treatment at no
 cost sharing under ,medicare           
program4,sec4 #e4 ,coverage of          

,,covid-#ai treatment at no cost sharing
 under ,medicare ,advantage             
program4,sec4 #f4 ,coverage of          
,,covid-#ai ,drugs at no cost sharing   
under ,medicare prescription drug       
plans4,sec4 #g4 ,coverage of ,,covid-#ai
 treatment at no cost sharing under     
private health insurance4,sec4 #h4      
,coverage of ,,covid-#ai treatment at no
 cost sharing for ,,tricare             
recipients4,sec4 #i4 ,coverage of       
,,covid-#ai treatment at no cost sharing
 for veterans4,sec4 #aj4 ,coverage of   
,,covid-#ai treatment at no cost sharing
 for ,federal civilian employees4,sec4  
#aa4 ,coverage of ,,covid-#ai treatment 
at no cost sharing under ,indian ,health
 ,service4,sec4 #ab4 ,sense of ,congress
 related to surprise medical bills4,sec4
 #ac4 ,special enrollment period2       
outreach and enrollment activities4  #b4
 ,coverage at no cost sharing of        
,,covid-#ai vaccine and treatment under 
,medicaid program  7a7 ,medicaid  7#a7  
,in general ,section #aije7;a77#d7 of   

the ,social ,security ,act 7#db         
,u4,s4,c4 #acif;d7a77#d77 is amended--  
7,a7 by striking and 7,d7 and inserting 
7,d72 and  7,b7 by striking the         
semicolon at the end and inserting 2    
7,e7 during the portion of the emergency
 period described in paragraph 7#a77;,b7
 of section #aace7;g7 beginning on the  
date of the enactment of the ,,covid-#ai
 ,treatment ,coverage ,act1 a           
,,covid-#ai vaccine licensed under      
section #cea of the ,public ,health     
,service ,act1 or approved or authorized
 under section #eje or #efd of the      
,federal ,food1 ,drug1 and ,cosmetic    
,act1 and administration of the vaccine2
 7,f7 during such portion of the        
emergency period described in paragraph 
7#a77;,b7 of section #aace7;g71 items or
 services for the prevention or         
treatment of ,,covid-#ai1 including     
drugs approved or authorized under such 
section #eje or such section #efd or1   
without regard to the requirements of   
section #aijb7;a77#aj77;,b7 7relating to

 comparability71 in the case of an      
individual who is diagnosed with or     
presumed to have ,,covid-#ai1 during    
such portion of such emergency period   
during which such individual is infected
 7or presumed infected7 with            
,,covid-#ai1 the treatment of a         
condition that may complicate the       
treatment of ,,covid-#ai24  7#b7        
,prohibition of 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,f71 by striking or at the end2  7ii7  
in subparagraph 7,g71 by striking 2 and 
and inserting 1 or2 and  7iii7 by adding
 at the end the following subparagraphs3
  7,h7 during the portion of the        
emergency period described in paragraph 
7#a77;,b7 of section #aace7;g7 beginning
 on the date of the enactment of this   
subparagraph1 a ,,covid-#ai vaccine     
licensed under section #cea of the      
,public ,health ,service ,act1 or       

approved or authorized under section    
#eje or #efd of the ,federal ,food1     
,drug1 and ,cosmetic ,act1 and the      
administration of such vaccine1 or  7,i7
 during such portion of the emergency   
period described in paragraph 7#a77;,b7 
of section #aace7;g71 any item or       
service furnished for the treatment of  
,,covid-#ai1 including drugs approved or
 authorized under such section #eje or  
such section #efd or1 in the case of an 
individual who is diagnosed with or     
presumed to have ,,covid-#ai1 during the
 portion of such emergency period during
 which such individual is infected 7or  
presumed infected7 with ,,covid-#ai1 the
 treatment of a condition that may      
complicate the treatment of ,,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-- 7i7
 in clause 7xi71 by striking any visit  
and inserting any service2 and  7ii7 by 

adding at the end the following clauses3
  7xii7 ,during the portion of the      
emergency period described in paragraph 
7#a77;,b7 of section #aace7;g7 beginning
 on the date of the enactment of this   
clause1 a ,,covid-#ai vaccine licensed  
under section #cea of the ,public       
,health ,service ,act1 or approved or   
authorized under section #eje or #efd of
 the ,federal ,food1 ,drug1 and         
,cosmetic ,act1 and the administration  
of such vaccine4  7xiii7 ,during such   
portion of the emergency period         
described in paragraph 7#a77;,b7 of     
section #aace7;g71 an item or service   
furnished for the treatment of          
,,covid-#ai1 including drugs approved or
 authorized under such section #eje or  
such section #efd or1 in the case of an 
individual who is diagnosed with or     
presumed to have ,,covid-#ai1 during    
such portion of such emergency period   
during which such individual is infected
 7or presumed infected7 with            
,,covid-#ai1 the treatment of a         

condition that may complicate the       
treatment of ,,covid-#ai4  4  7,c7      
,clarification ,the amendments made by  
this subsection 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  7b7 ,state pediatric  
vaccine distribution program ,section   
#aibh of the ,social ,security ,act 7#db
 ,u4,s4,c4 #acifs7 is amended-- 7#a7 in 
subsection 7a77#a7-- 7,a7 in            
subparagraph 7,a71 by striking 2 and and
 inserting a semicolon2  7,b7 in        
subparagraph 7,b71 by striking the      
period and inserting 2 and2 and  7,c7 by
 adding at the end the following        
subparagraph3  7,c7 during the portion  
of the emergency period described in    
paragraph 7#a77;,b7 of section #aace7;g7
 beginning on the date of the enactment 
of this subparagraph1 each              
vaccine-eligible child 7as defined in   
subsection 7b77 is entitled to receive a
 ,,covid-#ai vaccine from a             
program-registered provider 7as defined 

in subsection 7h77#g77 without charge   
for-- 7i7 the cost of such vaccine2 or  
7ii7 the administration of such vaccine4
  2  7#b7 in subsection 7c77#b7-- 7,a7  
in subparagraph 7,c77ii71 by inserting 1
 but1 during the portion of the         
emergency period described in paragraph 
7#a77;,b7 of section #aace7;g7 beginning
 on the date of the enactment of the    
,,covid-#ai ,treatment ,coverage ,act1  
may not impose a fee for the            
administration of a ,,covid-#ai vaccine 
before the period2 and  7,b7 by adding  
at the end the following subparagraph3  
7,d7 ,the provider will provide and     
administer an approved ,,covid-#ai      
vaccine to a vaccine-eligible child in  
accordance with the same requirements as
 apply under the preceding subparagraphs
 to the provision and administration of 
a qualified pediatric vaccine to such a 
child4  2 and  7#c7 in subsection       
7d77#a71 in the first sentence1 by      
inserting 1 including1 during the       
portion of the emergency period         

described in paragraph 7#a77;,b7 of     
section #aace7;g7 beginning on the date 
of the enactment of the ,,covid-#ai     
,treatment ,coverage ,act1 with respect 
to a ,,covid-#ai vaccine licensed under 
section #cea of the ,public ,health     
,service ,act1 or approved or authorized
 under section #eje or #efd of the      
,federal ,food1 ,drug1 and ,cosmetic    
,act before the period4  7c7 ,,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#aa7 ,coverage of          
,,covid-#ai vaccines and treatment      
,regardless of the type of coverage     
elected by a ,state under subsection    
7a71 child health assistance provided   
under such coverage for targeted        
low-income children and1 in the case    
that the ,state elects to provide       
pregnancy-related assistance under such 
coverage pursuant to section #baab1 such
 pregnancy-related assistance for       

targeted low-income pregnant women 7as  
defined in section #baab7;d77 shall     
include coverage1 during the portion of 
the emergency period described in       
paragraph 7#a77;,b7 of section #aace7;g7
 beginning on the date of the enactment 
of this paragraph1 of-- 7,a7 a          
,,covid-#ai vaccine licensed under      
section #cea of the ,public ,health     
,service ,act1 or approved or authorized
 under section #eje or #efd of the      
,federal ,food1 ,drug1 and ,cosmetic    
,act1 and the administration of such    
vaccine2 and  7,b7 any item or service  
furnished for the treatment of          
,,covid-#ai1 including drugs approved or
 authorized under such section #eje or  
such section #efd1 or1 in the case of an
 individual who is diagnosed with or    
presumed to have ,,covid-#ai1 during the
 portion of such emergency period during
 which such individual is infected 7or  
presumed infected7 with ,,covid-#ai1 the
 treatment of a condition that may      
complicate the treatment of ,,covid-#ai4

  4  7#b7 ,prohibition of cost sharing  
,section #bajc7;e77#b7 of the ,social   
,security ,act 7#db ,u4,s4,c4           
#acig;cc7e77#b771 as amended by section 
#fjjd7;b77#c7 of the ,families ,first   
,coronavirus ,response ,act1 is         
amended-- 7,a7 in the paragraph header1 
by inserting a ,,covid-#ai vaccine1     
,,covid-#ai treatment1 before or        
pregnancy-related assistance2 and  7,b7 
by striking visits described in section 
#aiaf7;a77#b77;,g71 or and inserting    
services described in section           
#aiaf7;a77#b77;,g71 vaccines described  
in section #aiaf7;a77#b77;,h7           
administered during the portion of the  
emergency period described in paragraph 
7#a77;,b7 of section #aace7;g7 beginning
 on the date of the enactment of the    
,,covid-#ai ,treatment ,coverage ,act1  
items or services described in section  
#aiaf7;a77#b77;,i7 furnished during such
 emergency period1 or4  7d7 ,conforming 
amendments ,section #aicg of the ,social
 ,security ,act 7#db ,u4,s4,c4          

#acifu-#g7 is amended-- 7#a7 in         
subsection 7a77#a77;,b71 by inserting 1 
under subclause 7,,xxiii7 of section    
#aijb7;a77#aj77;,a77ii71 after section  
#aijb7;a77#aj77;,a77i72 and  7#b7 in    
subsection 7b77#e71 by adding before the
 period the following3 1 and1 effective 
on the date of the enactment of the     
,,covid-#ai ,treatment ,coverage ,act1  
must comply with subparagraphs 7,f7     
through 7,i7 of subsections 7a77#b7 and 
7b77#b7 of section #aiaf and subsection 
7b77#c77;,b7 of section #aiaf;,a4  7e7  
,effective date ,the amendments made by 
this section shall take effect on the   
date of enactment of this ,act and shall
 apply with respect to a ,,covid-#ai    
vaccine beginning on the date that such 
vaccine is licensed under section #cea  
of the ,public ,health ,service ,act    
7#db ,u4,s4,c4 #bfb71 or approved or    
authorized under section #eje or #efd of
 the ,federal ,food1 ,drug1 and         
,cosmetic ,act4  #c4 ,coverage of       
treatment and vaccines at no cost       

sharing for the uninsured  7a7 ,in      
general ,section #aijb7;a77#aj7 of the  
,social ,security ,act 7#db ,u4,s4,c4   
#acif;a7a77#aj77 is amended1 in the     
matter following subparagraph 7,g71 by  
striking and any visit described in     
section #aiaf7;a77#b77;,g7 and inserting
 the following3 1 any ,,covid-#ai       
vaccine that is administered during any 
such portion 7and the administration of 
such vaccine71 any item or service that 
is furnished during any such portion for
 the treatment of ,,covid-#ai1 including
 drugs approved or authorized under     
section #eje or #efd of the ,federal    
,food1 ,drug1 and ,cosmetic ,act1 or1 in
 the case of an individual who is       
diagnosed with or presumed to have      
,,covid-#ai1 during the period such     
individual is infected 7or presumed     
infected7 with ,,covid-#ai1 the         
treatment of a condition that may       
complicate the treatment of ,,covid-#ai1
 the treatment of a ,,covid-#ai-related 
condition that follows the treatment of1

 or hospitalization with1 ,,covid-#ai1  
and any services described in section   
#aiaf7;a77#b77;,g74  7b7 ,definition of 
uninsured individual  7#a7 ,in general  
,subsection 7ss7 of section #aijb of the
 ,social ,security ,act 7#db ,u4,s4,c4  
#acif;a7 is amended to read as follows3 
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 not   
covered by minimum essential coverage   
7as defined in section #ejjj;,a7f77#a7  
of the ,internal ,revenue ,code of      
#aihf74  4  7#b7 ,effective date ,the   
amendment made by paragraph 7#a7 shall  
take effect and apply as if included in 
the enactment of the ,families ,first   
,coronavirus ,response ,act 7,public    
,law #aaf-abg74  7c7 ,clarification     
regarding emergency services for certain
 individuals ,for purposes of applying  
section #aijc7v77#b77;,a7 of the ,social
 ,security ,act 7#db ,u4,s4,c4          

#acif;b7v77#b77;,a771 the care and      
services described in such section shall
 include the following3 7#a7 ,in vitro  
diagnostic products 7as defined in      
section #hji4c7;a7 of title #ba1 ,code  
of ,federal ,regulations71 and the      
administration of such products4  7#b7  
,a ,,covid-#ai vaccine 7and the         
administration of such vaccine74  7#c7  
,any item or service that is furnished  
for the treatment of ,,covid-#ai or a   
condition that may complicate the       
treatment of ,,covid-#ai1 the treatment 
of a ,,covid-#ai-related condition that 
follows the treatment of1 or            
hospitalization with1 ,,covid-#ai1 and  
any services described in section       
#aiaf7;a77#b77;,g7 of such ,act 7#db    
,u4,s4,c4 #acifo7a77#b77;,g774  7d7     
,emergency ,medicaid for individuals    
with suspected ,,covid-#ai infections   
,for purposes of applying section       
#aijc7v77#c7 of the ,social ,security   
,act 7#db ,u4,s4,c4 #acif;b7v77#c771 the
 term emergency medical condition 7as   

defined in such section #aijc7v77#c77   
shall include1 with respect to an       
individual1 any concern that the        
individual may have contracted          
,,covid-#ai4  7e7 ,treatment of         
assistance and services provided        
,beginning on the date of enactment of  
this ,act-- 7#a7 the value of assistance
 or services provided to any person     
under a program with respect to which a 
coronavirus response law establishes or 
expands eligibility or benefits shall   
not be considered income or resources2  
and  7#b7 7,a7 any medical coverage or  
services provided to an individual under
 subsection 7v7 of section #aijc of the 
,social ,security ,act 7#db ,u4,s4,c4   
#acif;b7 shall be considered treatment  
for an emergency medical condition 7as  
defined in subsection 7v77#c7 of such   
section7 for any purpose under any      
,federal1 ,state1 or local law1         
including law relating to taxation1     
welfare1 and public assistance programs2
 and  7,b7 a participating ,state or    

political subdivision of a ,state shall 
not decrease any assistance otherwise   
provided to an individual because of the
 receipt of benefits under the ,social  
,security ,act 7#db ,u4,s4,c4 #cja et   
seq474  7f7 ,other definitions ,in this 
section3 7#a7 ,coronavirus public health
 emergency ,the term coronavirus public 
health emergency means-- 7,a7 an        
emergency involving ,federal primary    
responsibility determined to exist by   
the ,president under section #eja7;b7 of
 the ,robert ,t4 ,stafford ,disaster    
,relief and ,emergency ,assistance ,act 
7#db ,u4,s4,c4 #eaia7;b77 with respect  
to ,,covid-#ai or any other coronavirus 
with pandemic potential2  7,b7 an       
emergency declared by a ,federal        
official with respect to coronavirus 7as
 defined in section #ejf of the         
,coronavirus ,preparedness and ,response
 ,supplemental ,appropriations ,act1    
#bjbj 7,public ,law #aaf-abc772  7,c7 a 
national emergency declared by the      
,president under the ,national          

,emergencies ,act 7#ej ,u4,s4,c4 #afja  
et seq47 with respect to ,,covid-#ai or 
any other coronavirus with pandemic     
potential2 and  7,d7 a public health    
emergency declared by the ,secretary of 
,health and ,human ,services pursuant to
 section #cai of the ,public ,health    
,service ,act 7#db ,u4,s4,c4 #bdg7;d77  
with respect to ,,covid-#ai or any other
 coronavirus with pandemic potential4   
7#b7 ,coronavirus response law ,the term
 coronavirus response law means-- 7,a7  
the ,coronavirus ,preparedness and      
,response ,supplemental ,appropriations 
,act1 #bjbj 7,public ,law #aaf-abc72    
7,b7 the ,families ,first ,coronavirus  
,response ,act 7,public ,law #aaf-abg72 
7,c7 the ,coronavirus ,aid1 ,relief1 and
 ,economic ,security ,act 7,public ,law 
#aaf-acf72 and  7,d7 any subsequent law 
that appropriates or otherwise makes    
available funds1 establishes1 amends1 or
 expands a program1 or authorizes       
activities or assistance for a purpose  
that is expressly related to responding 

to1 or mitigating the effects of1 a     
coronavirus public health emergency4    
7g7 ,reimbursement for additional health
 services relating to coronavirus ,title
 ,v of division ,a of the ,families     
,first ,coronavirus ,response ,act      
7,public ,law #aaf-abg7 is amended under
 the heading ,department of ,health and 
,human ,services--,office of the        
,secretary--,public ,health and ,social 
,services ,emergency ,fund by inserting 
1 or treatment related to               
,,sars-,co,v-#b or ,,covid-#ai for      
uninsured individuals after or visits   
described in paragraph 7#b7 of such     
section for uninsured individuals4  7h7 
,rule of construction ,nothing in this  
section shall be construed to limit--   
7#a7 the types of care and services that
 are necessary for the treatment of an  
emergency condition for purposes of     
section #aijc7v7 of the ,social         
,security ,act 7#db ,u4,s4,c4           
#acif;b7v772 or  7#b7 the types of      
medical conditions that are emergency   

medical conditions for purposes of such 
section4  #d4 ,coverage of ,,covid-#ai  
treatment at no cost sharing under      
,medicare program  7a7 ,in general      
,notwithstanding any other provision of 
law1 in the case of a specified         
,,covid-#ai treatment service 7as       
defined in subsection 7b77 furnished    
during any portion of the emergency     
period described 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 ,act  
to an individual entitled to benefits   
under part ,a or enrolled under part ,b 
of title ,,xviii of the ,social         
,security ,act 7#db ,u4,s4,c4 #acie et  
seq47 for which payment is made under   
such part ,a or such part ,b1 the       
,secretary of ,health and ,human        
,services 7in this section referred to  
as the ,secretary7 shall provide that-- 
7#a7 any cost sharing required          
7including any deductible1 copayment1 or

 coinsurance7 applicable to such        
individual under such part ,a or such   
part ,b with respect to such item or    
service is paid by the ,secretary2 and  
7#b7 the provider of services or        
supplier 7as defined in section #ahfa of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #aciex77 does not hold such   
individual liable for such requirement4 
7b7 ,definition of specified ,,covid-#ai
 treatment services ,for purposes of    
this section1 the term specified        
,,covid-#ai treatment service means any 
item or service furnished to an         
individual for which payment may be made
 under part ,a or part ,b of title      
,,xviii of the ,social ,security ,act   
7#db ,u4,s4,c4 #acie et seq47 if such   
item or service is included in a claim  
with an ,,icd-#aj-;,,cm code relating to
 ,,covid-#ai 7as described in the       
document entitled ,,icd-#aj-;,,cm       
,official ,coding                       
,guidelines--,supplement ,coding        
encounters related to ,,covid-#ai       

,coronavirus ,outbreak published on     
,february #bj1 #bjbj1 or as otherwise   
specified by the ,secretary74  7c7      
,recovery of cost-,sharing amounts paid 
by the ,secretary in the case of        
supplemental insurance coverage  7#a7   
,in general ,in the case of any amount  
paid by the ,secretary pursuant to      
subsection 7a77#a7 that the ,secretary  
determines would otherwise have been    
paid by a group health plan or health   
insurance issuer 7as such terms are     
defined in section #bgia of the ,public 
,health ,service ,act 7#db ,u4,s4,c4    
#cjj;gg-#ia771 a private entity offering
 a medicare supplemental policy under   
section #ahhb of the ,social ,security  
,act 7#db ,u4,s4,c4 #aciess71 any other 
health plan offering supplemental       
coverage1 a ,state plan under title     
,,xix of the ,social ,security ,act1 or 
the ,secretary of ,defense under the    
,,tricare program1 such plan1 issuer1   
private entity1 other health plan1      
,state plan1 or ,secretary of ,defense1 

as applicable1 shall pay to the         
,secretary1 not later than #a year after
 such plan1 issuer1 private entity1     
other health plan1 ,state plan1 or      
,secretary of ,defense receives a notice
 under paragraph 7#c71 such amount in   
accordance with this subsection4  7#b7  
,required information ,not later than #i
 months after the date of the enactment 
of this ,act1 each group health plan1   
health insurance issuer1 private entity1
 other health plan1 ,state plan1 and    
,secretary of ,defense described in     
paragraph 7#a7 shall submit to the      
,secretary such information as the      
,secretary determines necessary for     
purposes of carrying out this           
subsection4 ,such information so        
submitted shall be updated by such plan1
 issuer1 private entity1 other health   
plan1 ,state plan1 or ,secretary of     
,defense1 as applicable1 at such time   
and in such manner as specified by the  
,secretary4  7#c7 ,review of claims and 
notification ,the ,secretary shall      

establish a process under which claims  
for items and services for which the    
,secretary has paid an amount pursuant  
to subsection 7a77#a7 are reviewed for  
purposes of identifying if such amount  
would otherwise have been paid by a     
plan1 issuer1 private entity1 other     
health plan1 ,state plan1 or ,secretary 
of ,defense described in paragraph 7#a74
 ,in the case such a claim is so        
identified1 the ,secretary shall        
determine the amount that would have    
been otherwise payable by such plan1    
issuer1 private entity1 other health    
plan1 ,state plan1 or ,secretary of     
,defense and notify such plan1 issuer1  
private entity1 other health plan1      
,state plan1 or ,secretary of ,defense  
of such amount4  7#d7 ,enforcement ,the 
,secretary may impose a civil monetary  
penalty in an amount determined         
appropriate by the ,secretary in the    
case of a plan1 issuer1 private entity1 
other health plan1 or ,state plan that  
fails to comply with a provision of this

 section4 ,the provisions of section    
#aabh;,a of the ,social ,security ,act  
shall apply to a civil monetary penalty 
imposed under the previous sentence in  
the same manner as such provisions apply
 to a penalty or proceeding under       
subsection 7a7 or 7b7 of such section4  
7d7 ,funding ,the ,secretary shall      
provide for the transfer to the ,centers
 for ,medicare  ,medicaid ,program      
,management ,account from the ,federal  
,hospital ,insurance ,trust ,fund and   
the ,federal ,supplementary ,trust ,fund
 7in such portions as the ,secretary    
determines appropriate7 #ajj1jjj1jjj for
 purposes of carrying out this section4 
7e7 ,report ,not later than #c years    
after the date of the enactment of this 
,act1 the ,inspector ,general of the    
,department of ,health and ,human       
,services shall submit to ,congress a   
report containing an analysis of amounts
 paid pursuant to subsection 7a77#a7    
compared to amounts paid to the         
,secretary pursuant to subsection 7c74  

7f7 ,implementation ,notwithstanding any
 other provision of law1 the ,secretary 
may implement the provisions of this    
section by program instruction or       
otherwise4  #e4 ,coverage of ,,covid-#ai
 treatment at no cost sharing under     
,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 by adding at the end the        
following new clause3  7vii7 ,special   
coverage rules for specified ,,covid-#ai
 treatment services ,notwithstanding    
clause 7i71 in the case of a specified  
,,covid-#ai treatment service 7as       
defined in section #d7;b7 of the        
,,covid-#ai ,treatment ,coverage ,act7  
that is furnished during a plan year    
occurring during any portion of the     
emergency period defined in section     
#aace7;g77#a77;,b7 beginning on or after
 the date of the enactment of this      
clause1 a ,medicare ,advantage plan may 
not1 with respect to such service1      

impose-- 7,i7 any cost-sharing          
requirement 7including a deductible1    
copayment1 or coinsurance requirement72 
and  7,,ii7 in the case such service is 
a critical specified ,,covid-#ai        
treatment service 7including ventilator 
services and intensive care unit        
services71 any prior authorization or   
other utilization management            
requirement4  ,a ,medicare ,advantage   
plan may not take the application of    
this clause into account for purposes of
 a bid amount submitted by such plan    
under section #ahed7;a77#f74  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  #f4 ,coverage of ,,covid-#ai
 ,drugs at no cost sharing under        
,medicare prescription drug plans  7a7  
,coverage requirement  7#a7 ,in general 
,section #ahfj;,d-#d7;b77#c7 of the     
,social ,security ,act 7#db ,u4,s4,c4   

#aciew-#ajd7;b77#c77 is amended by      
adding at the end the following new     
subparagraph3  7,i7 ,required inclusion 
of drugs intended to treat ,,covid-#ai  
7i7 ,in general ,notwithstanding any    
other provision of law1 a ,,pdp sponsor 
offering a prescription drug plan shall1
 with respect to a plan year1 any       
portion of which occurs during the      
period described in clause 7ii71 be     
required to-- 7,i7 include in any       
formulary-- 7aa7 all covered part ,d    
drugs with a medically accepted         
indication 7as defined in section       
#ahfj;,d-#b7;e77#d77 to treat           
,,covid-#ai that are marketed in the    
,united ,states2 and  7bb7 all drugs    
authorized under section #efd or #efd;,a
 of the ,federal ,food1 ,drug1 and      
,cosmetic ,act to treat ,,covid-#ai2 and
  7,,ii7 not impose any prior           
authorization or other utilization      
management requirement with respect to  
such drugs described in item 7aa7 or    
7bb7 of subclause 7,i7 7other than such 

a requirement that limits the quantity  
of drugs due to safety74  7ii7 ,period  
described ,for purposes of clause 7i71  
the period described in this clause is  
the period during which there exists the
 public health emergency declared by the
 ,secretary pursuant to section #cai of 
the ,public ,health ,service ,act on    
,january #ca1 #bjbj1 entitled           
,determination that a ,public ,health   
,emergency ,exists ,nationwide as the   
,result of the #bjai ,novel ,coronavirus
 7including any renewal of such         
declaration pursuant to such section74  
4  7b7 ,elimination of cost sharing     
7#a7 ,elimination of cost sharing for   
drugs intended to treat ,,covid-#ai     
under standard and alternative          
prescription drug coverage ,section     
#ahfj;,d-#b of the ,social ,security    
,act 7#db ,u4,s4,c4 #aciew-#ajb7 is     
amended-- 7,a7 in subsection 7b7-- 7i7  
in paragraph 7#a77;,a71 by striking ,the
 coverage and inserting ,subject to     
paragraph 7#h71 the coverage2  7ii7 in  

paragraph 7#b7-- 7,i7 in subparagraph   
7,a71 by inserting after ,subject to    
subparagraphs 7,c7 and 7,d7 the         
following3 and paragraph 7#h72  7,,ii7  
in subparagraph 7,c77i71 by striking    
paragraph 7#d7 and inserting paragraphs 
7#d7 and 7#h72 and  7,,iii7 in          
subparagraph 7,d77i71 by striking       
paragraph 7#d7 and inserting paragraphs 
7#d7 and 7#h72  7iii7 in paragraph      
7#d77;,a77i71 by striking ,the coverage 
and inserting ,subject to paragraph     
7#h71 the coverage2 and  7iv7 by adding 
at the end the following new paragraph3 
7#h7 ,elimination of cost-sharing for   
drugs intended to treat ,,covid-#ai ,the
 coverage does not impose any           
deductible1 copayment1 coinsurance1 or  
other cost-sharing requirement for drugs
 described in section                   
#ahfj;,d-#d7;b77#c77;,i77i77,i7 with    
respect to a plan year1 any portion of  
which occurs during the period during   
which there exists the public health    
emergency declared by the ,secretary    

pursuant to section #cai of the ,public 
,health ,service ,act on ,january #ca1  
#bjbj1 entitled ,determination that a   
,public ,health ,emergency ,exists      
,nationwide as the ,result of the #bjai 
,novel ,coronavirus 7including any      
renewal of such declaration pursuant to 
such section74  2 and  7,b7 in          
subsection 7c71 by adding at the end the
 following new paragraph3  7#d7 ,same   
elimination of cost-sharing for drugs   
intended to treat ,,covid-#ai ,the      
coverage is in accordance with          
subsection 7b77#h74  4  7#b7            
,elimination of cost sharing for drugs  
intended to treat ,,covid-#ai dispensed 
to individuals who are subsidy eligible 
individuals ,section #ahfj;,d-#ad7;a7 of
 the ,social ,security ,act 7#db        
,u4,s4,c4 #aciew-#aad7;a77 is amended-- 
7,a7 in paragraph 7#a7-- 7i7 in         
subparagraph 7,d7-- 7,i7 in clause 7ii71
 by striking ,in the case of and        
inserting ,subject to subparagraph 7,f71
 in the case of2 and  7,,ii7 in clause  

7iii71 by striking ,in the case of and  
inserting ,subject to subparagraph 7,f71
 in the case of2 and  7ii7 by adding at 
the end the following new subparagraph3 
7,f7 ,elimination of cost-sharing for   
drugs intended to treat ,,covid-#ai     
,coverage that is in accordance with    
section #ahfj;,d-#b7;b77#h74  2 and     
7,b7 in paragraph 7#b7-- 7i7 in         
subparagraph 7,b71 by striking ,a       
reduction and inserting ,subject to     
subparagraph 7,f71 a reduction2  7ii7 in
 subparagraph 7,d71 by striking ,the    
substitution and inserting ,subject to  
subparagraph 7,f71 the substitution2    
7iii7 in subparagraph 7,e71 by inserting
 after ,subject to the following3       
subparagraph 7,f7 and2 and  7iv7 by     
adding at the end the following new     
subparagraph3  7,f7 ,elimination of     
cost-sharing for drugs intended to treat
 ,,covid-#ai ,coverage that is in       
accordance with section                 
#ahfj;,d-#b7;b77#h74  4  7c7            
,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  #g4 ,coverage of ,,covid-#ai
 treatment at no cost sharing under     
private health insurance  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 the ,secretary of ,labor1 and
 the ,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 ,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 the ,secretary of ,labor1 and

 the ,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 
,act 7#db ,u4,s4,c4 #cjj;gg et seq471   
part #g of subtitle ,b of title ,i of   
the ,employee ,retirement ,income       
,security ,act of #aigd 7#bi ,u4,s4,c4  
#aaha et seq471 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  7d7 ,implementation    

,the ,secretary of ,health and ,human   
,services1 the ,secretary of ,labor1 and
 the ,secretary of the ,treasury may    
implement the provisions of this section
 through sub-regulatory guidance1       
program instruction or otherwise4  7e7  
,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  #h4     
,coverage of ,,covid-#ai treatment at no
 cost sharing for ,,tricare recipients  
7a7 ,in general ,section #fjjf7;a7 of   
the ,families ,first ,coronavirus       
,response ,act 7,public ,law #aaf-abg2  
#ch ,u4,s4,c4 #ajgd note7 is amended by 
striking or visits described in         

paragraph 7#b7 of such section and      
inserting 1 visits described in         
paragraph 7#b7 of such section1 or      
medical care to treat ,,covid-#ai4  7b7 
,effective date ,the amendment made by  
subsection 7a7 shall apply with respect 
to medical care furnished on or after   
the date of the enactment of this ,act4 
#i4 ,coverage of ,,covid-#ai treatment  
at no cost sharing for veterans  7a7 ,in
 general ,section #fjjf7;b7 of the      
,families ,first ,coronavirus ,response 
,act 7,public ,law #aaf-abg2 #ch        
,u4,s4,c4 #agja note7 is amended by     
striking or visits described in         
paragraph 7#b7 of such section and      
inserting 1 visits described in         
paragraph 7#b7 of such section1 or      
hospital care or medical services to    
treat ,,covid-#ai4  7b7 ,effective date 
,the amendment made by subsection 7a7   
shall apply with respect to hospital    
care and medical services furnished on  
or after the date of the enactment of   
this ,act4  #aj4 ,coverage of           

,,covid-#ai treatment at no cost sharing
 for ,federal civilian employees  7a7   
,in general ,section #fjjf7;c7 of the   
,families ,first ,coronavirus ,response 
,act 7,public ,law #aaf-abg2 #e         
,u4,s4,c4 #hijd note7 is amended by     
striking or visits described in         
paragraph 7#b7 of such section and      
inserting 1 visits described in         
paragraph 7#b7 of such section1 or      
hospital care or medical services to    
treat ,,covid-#ai4  7b7 ,effective date 
,the amendment made by subsection 7a7   
shall apply with respect to hospital    
care and medical services furnished on  
or after the date of the enactment of   
this ,act4  #aa4 ,coverage of           
,,covid-#ai treatment at no cost sharing
 under ,indian ,health ,service ,the    
,secretary of ,health and ,human        
,services shall cover1 without the      
imposition of any cost sharing          
requirements1 the cost of the following 
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 are      
authorized under the ,contract ,health  
,services program funded by the ,indian 
,health ,service and operated by the    
,indian ,health ,service or operated by 
an ,indian tribe or tribal organization 
under a contract or compact with the    
,indian ,health ,service under the      
,indian ,self-,determination and        
,education ,assistance ,act 7#be        
,u4,s4,c4 #ecja et seq471 or are        
provided as a health service of the     
,indian ,health ,service3 7#a7 ,a       
,,covid-#ai vaccine licensed under      
section #cea of the ,public ,health     
,service ,act1 or approved or authorized
 under section #eje or #efd of the      
,federal ,food1 ,drug1 and ,cosmetic    
,act1 and the administration of such    
vaccine4  7#b7 ,any item or service     
furnished for the treatment of          

,,covid-#ai1 including drugs approved or
 authorized under such section #eje or  
such section #efd1 or1 in the case of an
 individual who is diagnosed with or    
presumed to have ,,covid-#ai1 during the
 portion of such emergency period during
 which such individual is infected 7or  
presumed infected7 with ,,covid-#ai1 the
 treatment of a condition that may      
complicate the treatment of ,,covid-#ai4
  #ab4 ,sense of ,congress related to   
surprise medical bills ,it is the sense 
of ,congress that no individual should  
receive a medical bill1 including a     
balance bill1 for the cost of           
,,covid-#ai treatment1 office visits    
related to ,,covid-#ai treatment1       
,,covid-#ai vaccines1 or the            
administration of those vaccines4  #ac4 
,special enrollment period2 outreach and
 enrollment 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 ,there are appropriated1  
out of any funds in the ,treasury not   
otherwise appropriated1 #be1jjj1jjj1 to 
remain available until expended-- 7i7 to
 carry out this paragraph2 and  7ii7 at 
the discretion of the ,secretary1 to    

carry out section #acaa7;i71 with       
respect to an ,exchange established or  
operated by the ,secretary within a     
,state pursuant to this subsection4  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