COVID-19 Emergency Declarations to End

On January 30, 2023, the Biden Administration announced that it intends to end both the public health emergency and national emergency declarations for COVID-19 on May 11, 2023.

Background

The public health emergency was first declared by the Secretary of Health and Human Services on January 31, 2020 and was periodically renewed until the Administration announced that it would end on May 11.  Several COVID-19 relief measures are tied to the public health emergency: (1) health plans must cover COVID-19 testing (including at-home tests) and related services without cost sharing; and (2) non-grandfathered health plans must cover COVID vaccinations, administered by both in-network and out-of-network providers, without cost sharing.

The national emergency was declared by President Trump in March 2020, during which time the federal government released the Timeline Extension Rule extending timelines for HIPAA special enrollment, COBRA election, and claims filing and appeals.  This extension ends for any applicable event on the earlier of (1) one year from the date that the relief was first available, or (2) the end of the Outbreak Period.  The Outbreak Period refers to the period from March 1, 2020 until 60 days after the announced end of the national emergency.

Effect on Health Plans

When the public health emergency ends, the testing coverage requirements will no longer apply.  The requirement to cover recommended COVID-19 immunizations without cost sharing will remain in effect for non-grandfathered plans, but these plans can limit coverage to in-network providers.  With the expiration of the national emergency, the Outbreak Period will end July 10, 2023.

ASR-administered plans do not require amending for this change, as the initial language is self-terminating, but because these changes are likely considered material reductions in benefits, ASR will provide plan administrators with a notice (Summary of Material Modifications) to plan members for distribution.

The Biden Administration will release more guidance 60 days before the public health emergency ends.  ASR will continue to monitor these legal developments and advise our clients accordingly.

Contact ASR Health Benefits at (616) 957-1751 or (800) 968-2449 for more information on this relief.