The Centers for Medicare & Medicaid Services (CMS) announced that CMS is now requiring states to cover COVID-19 vaccine counseling visits in which health care providers talk to families about the importance of kids’ vaccination. CMS will now consider certain COVID-19 vaccine counseling visits for children and youth to be COVID-19 vaccine administration, for which state expenditures can be federally matched at 100% through the last day of the first quarter that begins one year after the end of the COVID-19 public health emergency, under the American Rescue Plan (ARP). CMS will match COVID-19 vaccine counseling-only visits at the ARP 100% federal match rate only when they are provided to children and youth under age 21 as part of the Medicaid Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit.
In addition, to expand access to and affordability of at-home COVID-19 tests, the Department of Health and Human Services together with the Departments of Labor and the Treasury will issue guidance by January 15 to clarify that individuals who purchase over-the-counter COVID-19 diagnostic tests will be able to seek reimbursement from their group health plan or health insurance issuer and have insurance cover the cost during the COVID-19 public health emergency.
Finally, CMS issued a news alert encouraging those with Medicare who are fully vaccinated to get a booster dose of the COVID-19 vaccine. People with Medicare pay nothing when they get the COVID-19 vaccine and booster and there is no applicable copayment, coinsurance or deductible.
A press release is attached and available at: https://www.cms.gov/newsroom/press-releases/biden-harris-administration-makes-100-federal-medicaid-matching-funds-available-state-expenditures.
A news alert regarding the Medicare Booster is attached and available at: https://www.cms.gov/newsroom/news-alert/cms-encourages-people-medicare-get-covid-19-vaccine-booster-shot.
To view the announcement regarding at-home COVID-19 tests, please visit: https://www.whitehouse.gov/briefing-room/statements-releases/2021/12/02/fact-sheet-president-biden-announces-new-actions-to-protect-americans-against-the-delta-and-omicron-variants-as-we-battle-covid-19-this-winter/.
If you have any questions, please contact the CMS Office of Legislation. Thank you.