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Law360 (November 3, 2020, 7:19 PM EST ) The Trump administration issued regulations Monday that implement several aspects of a coronavirus relief law passed this spring, attempting to make coronavirus treatment and prevention efforts more affordable and accessible.
The regulations require most health care plans to fully cover a COVID-19 vaccine within 15 business days of it clinching a Centers for Disease Control and Prevention recommendation and call for providers who charge for COVID-19 tests to publicize the prices.
The regulations also, among other things, try to ease Medicare patients' access to coronavirus drugs that gain Food and Drug Administration approval by increasing federal payments to hospitals caring for COVID-19-stricken Medicare patients.
"We believe that as drugs and biological products become available and are authorized or approved by FDA for the treatment of COVID-19 in the inpatient setting, it is appropriate to … mitigate any potential financial disincentives for hospitals to provide new COVID-19 treatments," the regulations say.
The administration published the 243-page regulations, titled "Additional Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency," on Monday afternoon.
The regulations implement aspects of this spring's Coronavirus Aid, Relief, and Economic Security Act, a $2.2 trillion stimulus bill signed into law March 27 to address the impact of the COVID-19 pandemic.
The vast majority of the dictates go into effect immediately, but a few components, including a temporary increase in Medicaid funding, become effective Jan. 1.
The requirement for health plans to cover COVID-19 vaccines applies to all non-grandfathered health plans, whether they're provided by a person's job or obtained through the health insurance marketplace. Those plans must fully cover the vaccine even if the medical provider who administers it is out-of-network, the regulations stipulate.
"To help ensure full access to and the widespread use of qualifying coronavirus preventive services ... it is critical that individuals be able to receive such services from any provider authorized to provide the service," the regulations state.
Grandfathered plans, which are exempt from certain Affordable Care Act requirements because they were established before the law passed, are relatively rare. Just 16% of American workers received health care through a grandfathered health plan in 2018, according to the Kaiser Family Foundation.
--Editing by Jack Karp.
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