Some of the federal requirements will change, but that does not mean COVID is going away anytime soon. Pay attention to COVID conditions in your state. Currently nationwide, 652 people a day are dying from COVID-19. For Michigan, all but two counties are considered to be "Low Risk" for the virus. One good source of information is the COVID Dashboard at BridgeMichigan.com.
These excerpts refer to Medicare and Medicaid requirements and waivers that gave flexibility in administering federally-funded programs. See the Fact sheet for a more complete picture of all that will be affected by the expiration of the Public Health Emergency. (Most adults with developmental disabilities qualify for Medicaid based on their low income and disability. Many adults also qualify for Medicare when a parent retires or dies or when the disabled adult retires from employment.)
Excerpts from the FACT SHEET:
"The emergency declarations, legislative actions by Congress, and regulatory actions across government, including by the Centers for Medicare & Medicaid Services (CMS), allowed for changes to many aspects of health care delivery during the COVID-19 PHE. Health care providers received maximum flexibility to streamline delivery and allow access to care during the PHE [Public Health Emergency]. While some of these changes will be permanent or extended due to Congressional action, some waivers and flexibilities will expire, as they were intended to respond to the rapidly evolving pandemic, not to permanently replace standing rules."
"...For more information on what changes and does not change across the Department, visit https://www.hhs.gov/about/news/2023/02/09/fact-sheet-covid-19-public-health-emergency-transition-roadmap.html "
Medicare
"Vaccines: People with Medicare coverage will continue to have access to COVID-19 vaccinations without cost sharing after the end of the PHE.
"Testing: Additionally, people with traditional Medicare can continue to receive COVID-19 PCR and antigen tests with no cost sharing when the test is ordered by a physician [or other healthcare professional]..
"Treatments: There is no change in Medicare coverage of treatments for those exposed to COVID-19 once the PHE ends, and in cases where cost sharing and deductibles apply now, they will continue to apply. Generally, the end of the COVID-19 PHE does not change access to oral antivirals, such as Paxlovid and Lagevrio."
Medicaid and CHIP(Children's Health Insurance)
"Vaccines, Testing, and Treatment: As a result of the American Rescue Plan Act of 2021 (ARPA), states must provide Medicaid and CHIP coverage without cost sharing for COVID-19 vaccinations, testing, and treatments through the last day of the first calendar quarter that begins one year after the last day of the COVID-19 PHE. If the COVID-19 PHE ends as expected on May 11, 2023, this coverage requirement will end on September 30, 2024.
"After that date, many Medicaid and CHIP enrollees will continue to have coverage for COVID-19 vaccinations. After the ARPA coverage requirements expire, Medicaid and CHIP coverage of COVID-19 treatments and testing may vary by state.
"Additionally, 18 states and U.S. territories have opted to provide Medicaid coverage to uninsured individuals for COVID-19 vaccinations, testing, and treatment. Under federal law, Medicaid coverage of COVID-19 vaccinations, testing, and treatment for this group will end when the PHE ends."
Private Health Insurance [See the Fact Sheet for details]
Access to Telehealth Services
...“'Telehealth' includes services provided through telecommunications systems (for example, computers and phones) and allows health care providers to give care to patients remotely in place of an in-person office visit."
"The Consolidated Appropriations Act, 2023, extended many telehealth flexibilities through December 31, 2024, such as:
• People with Medicare can access telehealth services in any geographic area in the United States, rather than only those in rural areas.
• People with Medicare can stay in their homes for telehealth visits that Medicare pays for rather than traveling to a health care facility.
• Certain telehealth visits can be delivered audio-only (such as a telephone) if someone is unable to use both audio and video, such as a smartphone or computer."
Medicaid, CHIP, and Telehealth
"For Medicaid and CHIP, telehealth flexibilities are not tied to the end of the PHE and have been offered by many state Medicaid programs long before the pandemic. Coverage will ultimately vary by state. CMS encourages states to continue to cover Medicaid and CHIP services when they are delivered via telehealth."
COVID-19 Waivers and Administrative Flexibilities: How Health Care Providers and Suppliers are Affected [See the Fact Sheet] This includes Hospital at Home, Nurse Aide Training for Nursing Homes, Virtual Supervision, Scope of Practice, and Health and Safety Requirements,
Medicaid Continuous Enrollment Condition
"As part of the Consolidated Appropriations Act, 2023, the continuous enrollment condition will end on March 31, 2023. The temporary FMAP increase will be gradually reduced and phased down beginning April 1, 2023 (and will end on December 31, 2023). For more information, visit Medicaid.gov/unwinding."
From the Kaiser Family Foundation (KFF)
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