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October 29, 2021

Health Law Weekly

CMS Details Medicaid, CHIP Coverage Requirements for COVID-19-Related Treatment

  • October 29, 2021

The Centers for Medicare & Medicaid Services (CMS) issued October 22 guidance instructing states that their Medicaid and Children Health Insurance Programs (CHIP) must cover COVID-19 related treatment without cost-sharing.

Beginning March 11, the American Rescue Plan required states to cover COVID-19 treatments, including preventative therapies and specialized equipment, CMS noted. The coverage requirement, which includes treatments for post-COVID conditions known as long COVID, generally extends until over a year after the COVID-19 public health emergency ends.

States also must cover drugs that have been approved or authorized by the Food and Drug Administration to treat or prevent COVID-19, CMS said.

Along with the guidance to states, CMS also encouraged private health insurers to continue to waive cost-sharing for COVID-19 treatment, including for long COVID.

“The American Rescue Plan expanded coverage for COVID-19 care. The pandemic has exacerbated the inequities that underlie our health care system, and we must continue to work on both the federal and state levels to improve access to and quality of care for everyone,” said CMS Administrator Chiquita Brooks-LaSure.

  • Coronavirus Pandemic Hub