This bill requires Medicare to cover, without cost-sharing, visits to health care providers that relate to COVID-19 (i.e., coronavirus disease 2019) testing during the public health emergency declared on January 31, 2020.
[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[H.R. 6263 Introduced in House (IH)]
<DOC>
116th CONGRESS
2d Session
H. R. 6263
To amend title XVIII of the Social Security Act to waive cost sharing
under the Medicare program for certain visits relating to testing for
COVID-19.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 12, 2020
Mr. Sarbanes (for himself, Mr. Danny K. Davis of Illinois, and Mr.
Courtney) introduced the following bill; which was referred to the
Committee on Energy and Commerce, and in addition to the Committee on
Ways and Means, for a period to be subsequently determined by the
Speaker, in each case for consideration of such provisions as fall
within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To amend title XVIII of the Social Security Act to waive cost sharing
under the Medicare program for certain visits relating to testing for
COVID-19.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. WAIVING COST SHARING UNDER THE MEDICARE PROGRAM FOR CERTAIN
VISITS RELATING TO TESTING FOR COVID-19.
(a) In General.--Section 1833 of the Social Security Act (42 U.S.C.
1395l) is amended--
(1) in subsection (a)(1)--
(A) by striking ``and'' before ``(CC)''; and
(B) by inserting before the period at the end the
following: ``, and (DD) with respect to a specified
COVID-19 testing-related service described in paragraph
(1) of subsection (cc) for which payment may be made
under a specified outpatient payment provision
described in paragraph (2) of such subsection, the
amounts paid shall be 100 percent of the payment amount
otherwise recognized under such respective specified
outpatient payment provision for such service,'';
(2) in subsection (b), in the first sentence--
(A) by striking ``and'' before ``(10)''; and
(B) by inserting before the period at the end the
following: ``, and (11) such deductible shall not apply
with respect to any specified COVID-19 testing-related
service described in paragraph (1) of subsection (cc)
for which payment may be made under a specified
outpatient payment provision described in paragraph (2)
of such subsection''; and
(3) by adding at the end the following new subsection:
``(cc) Specified COVID-19 Testing-Related Services.--For purposes
of subsection (a)(1)(DD):
``(1) Description.--
``(A) In general.--A specified COVID-19 testing-
related service described in this paragraph is a
medical visit that--
``(i) is in any of the categories of HCPCS
evaluation and management service codes
described in subparagraph (B);
``(ii) is furnished during any portion of
the emergency period defined in section
1135(g)(1)(B) beginning on or after the date of
the date of the enactment of this subsection;
and
``(iii) results in an order for or
administration of an in vitro diagnostic
product (as defined in section 809.3(a) of
title 21, Code of Federal Regulations)
administered during any portion of such
emergency period beginning on or after the date
of the enactment of this subsection for the
detection of SARS-CoV-2 or the diagnosis of the
virus that causes COVID-19 that is approved,
cleared, or authorized under section 510(k),
513, 515, or 564 of the Federal Food, Drug, and
Cosmetic Act.
``(B) Categories of hcpcs codes.--For purposes of
subparagraph (A), the categories of HCPCS evaluation
and management services codes are the following:
``(i) Office and other outpatient services.
``(ii) Hospital observation services.
``(iii) Emergency department services.
``(iv) Skilled nursing facility services.
``(v) Domiciliary, rest home, or custodial
care services.
``(vi) Home services.
``(2) Specified outpatient payment provision.--A specified
outpatient payment provision described in this paragraph is any
of the following:
``(A) The hospital outpatient prospective payment
system under subsection (t).
``(B) The physician fee schedule under section
1848.
``(C) The prospective payment system developed
under section 1834(o).
``(D) Section 1834(g), with respect to an
outpatient critical access hospital service.
``(E) The payment basis determined in regulations
pursuant to section 1833(a)(3) for rural health clinic
services.''.
(b) Claims Modifier.--The Secretary of Health and Human Services
shall provide for an appropriate modifier (or other identifier) to
include on claims to identify, for purposes of subparagraph (DD) of
section 1833(a)(1), as added by subsection (a), specified COVID-19
testing-related services described in paragraph (1) of section 1833(cc)
of the Social Security Act, as added by subsection (a), for which
payment may be made under a specified outpatient payment provision
described in paragraph (2) of such subsection.
(c) Implementation.--Notwithstanding any other provision of law,
the Secretary of Health and Human Services may implement the provisions
of, including amendments made by, this section through program
instruction or otherwise.
<all>
Introduced in House
Introduced in House
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned.
Referred to the Subcommittee on Health.
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