Plans are moving forward at the US Department of Health and Human Services to prepare for the end of the country’s Covid-19 public health emergency declaration in May.
On Thursday, HHS Secretary Xavier Becerra sent a letter and backgrounder to state governors detailing exactly what the end of the emergency declaration will mean for jurisdictions and their residents.
“Fighting COVID-19 remains an important public health priority for the administration, and over the next few months we will transform our COVID-19 policies, as well as the current flexibilities allowed by COVID-19 emergency declarations. 19, improving standards of patient care. We will work closely with partners, including state, local, tribal and territorial agencies, industry and advocates, to ensure an orderly transition,” Becerra wrote in a draft of the letter obtained by CNN.
“In the coming days, the Centers for Medicare & Medicaid Services (CMS) will also provide additional information, including on the waivers that many states and health systems have adopted and how they will be affected by the end of the COVID-19 PHE” , he wrote. “I will share this resource with your team when it becomes available.”
Declaring a public health emergency in the United States means that certain actions, access to funds, grants, waivers, and data — among other steps — may occur more quickly in response to the crisis for the duration of the emergency. ’emergency. A statement lasts 90 days — unless terminated by HHS — and may be renewed.
On January 30, the White House announced its intention to end the national and public health emergencies of Covid-19 on May 11, signaling that the administration considers the nation to be out of the emergency response phase.
Becerra had agreed to give governors 60 days’ notice to prepare for the end of the emergency. Thursday’s letter was sent 90 days before the emergency was due to end.
“We have ongoing conversations about what else we need to do over the next 90 days to ensure a smooth transition. I can tell you that each of our agencies has been working hard on this plan,” an HHS official told CNN. “We are going to have a series of additional documents that will be released, as well as a series of conversations over the coming days and weeks.”
The end of the public health emergency will affect certain Medicare and state Medicaid flexibilities provided for the duration of the emergency. This includes waivers such as requiring a three-day hospital stay before Medicare covers care in a skilled nursing facility.
“We have worked closely with governors on the public health emergency. It’s a combination of the two federal flexibilities that we allow, and the states are often the ones using those flexibilities,” the HHS official said.
“Pretty much every aspect of the pandemic response, I would say, has been in partnership with our state partners. And so, I think those are, frankly for months now, the ones we’ve been heading towards and the ones we’ve publicly committed to advance notification of changes to the public health emergency declaration.
But the end of the emergency will not impact authorizations for Covid-19 devices, including tests, vaccines and treatments that have been authorized for emergency use by the US Food and Drug Administration. UNITED STATES.
During the Covid-19 pandemic, the FDA has issued about 15 times more emergency use authorizations than for all other previous public health emergencies, Commissioner Dr. Robert Califf said Wednesday during a briefing. a joint hearing of the House Oversight and Investigations and Health subcommittees. .
“Today we issued EUAs or provided traditional marketing authorizations to more than 2,800 medical devices for Covid-19, which is 15 times more EUAs than all other previous emergencies combined,” said Caliph. He added that the effects of ending the emergency declaration will be “modest” because the “EUAs are independent of the public health emergency, so we can maintain them for as long as needed.”
The emergency is scheduled to end on May 11. “What happens on May 12? On May 12, you can still walk into a pharmacy and get your bivalent vaccine,” wrote Dr. Ashish Jha, White House coronavirus response coordinator. Twitter last week.
He said that at some point, likely in the summer or early fall, the Biden administration will shift from federal distribution of Covid-19 vaccines and treatments to purchasing through the mainstream health care system — but that won’t happen. not happen yet.
Overall, there are additional Medicaid waivers and other flexibilities that states and territories have received as part of the public health emergency. Some of them will be terminated. But state Medicaid programs will have to continue covering Covid-19 testing, treatment and vaccinations without cost sharing until Sept. 30, 2024.
The end of the public health emergency declaration means Medicare beneficiaries will face out-of-pocket charges for over-the-counter Covid-19 home testing and treatment. However, people with Medicare will continue to have no fees for medically necessary Covid-19 tests performed in the laboratory and ordered by their health care providers.
Covid-19 vaccinations will continue to be covered at no cost to all Medicare beneficiaries.
According to the Kaiser Family Foundation, those with private insurance could face fees for lab tests, even if ordered by a provider. Vaccinations will continue to be free for people with private insurance who go to in-network providers, but going to an out-of-network provider could result in a fee once federal supplies run out.
And privately insured people will no longer be able to get free at-home tests from pharmacies and retailers unless their insurers choose to cover them.
Americans with private insurance were not billed for the monoclonal antibody treatment since they were prepaid by the federal government, although patients may be billed for the office visit or administration of the treatment, according to Kaiser . But that’s unrelated to the public health emergency, and the free treatments will be available until the federal supply runs out. The government has already exhausted some of the treatments, so those with private insurance may already be paying some of the costs.
Uninsured people had been able to access free tests, treatment and vaccines through another pandemic relief program. However, federal funding ran out in the spring of 2022, making it harder for people without coverage to get free services.
Additionally, “the ability of healthcare providers to safely dispense controlled substances via telemedicine without in-person interaction is affected; however, there will be regulation that will propose to extend these flexibilities,” according to the letter’s backgrounder.
One of the most significant pandemic improvements for states is no longer related to the public health emergency. Congress severed the connection in December as part of its government funding package for fiscal year 2023, something state Medicaid officials had urged lawmakers to do.
States will now be able to begin processing new Medicaid determinations and de-enroll residents who are no longer eligible, beginning April 1. They have 14 months to review the eligibility of their beneficiaries.
Under a Covid-19 relief package passed in March 2020, states were not allowed to deport people from Medicaid during the public health emergency in exchange for additional federal matching funds. Medicaid enrollment has skyrocketed to a record 91 million since then.
A total of about 15 million people could be excluded from Medicaid when the continuous enrollment requirement ends, according to an analysis released by the Department of Health and Human Services in August. About 8.2 million people would no longer be eligible, but 6.8 million people would be laid off even if they are still eligible, the department estimated.
However, many who opt out of Medicaid could qualify for other coverage.