With the need for States to plan with some predictability and stability, the Department of Health and Human Services has provided a letter indicating their intent to treat all of 2021 as a public health emergency, and to give States at least 60 days advance notice of when they will declare the public health emergency is coming to a close.
- This means health plans should expect for the rest of the year to pay for COVID-19 tests (and other related services during such a visit) without cost sharing, in- or out-of-network.
- This also means non-grandfathered health plans should expect for the rest of the year to pay for vaccine administration without cost sharing, in- or out-of-network.
- Once the public health emergency is closed, then testing and vaccinations obtained out-of-network could apply cost-sharing, so long as in-network access is adequate.
IMA will continue to monitor regulator guidance and offer meaningful, practical, timely information.
This material should not be considered as a substitute for legal, tax and/or actuarial advice. Contact the appropriate professional counsel for such matters. These materials are not exhaustive and are subject to possible changes in applicable laws, rules, and regulations and their interpretations.