CMS-Related COVID-19 Action

March 19, 2020

Yesterday, the Centers for Medicare & Medicaid Services (CMS) issued Frequently Asked Questions (FAQs) to clarify coverage for the diagnosis and treatment of the Coronavirus Disease 2019 (COVID-19) by catastrophic health plans. A catastrophic health plan generally may not provide coverage of an essential health benefit before an enrollee meets the plan’s deductible.  Through these FAQs, CMS is announcing that the agency will not take enforcement action against any health issuer that amends its catastrophic plans to provide coverage without imposing cost-sharing requirements for COVID-19 related services before an enrollee meets the catastrophic plan's deductible. CMS encourages states to take a similar enforcement approach.

Yesterday, CMS announced recommendations that all elective surgeries, non-essential medical, surgical, and dental procedures be delayed during the 2019 Novel Coronavirus (COVID-19) outbreak. CMS says that as more healthcare providers are increasingly being asked to assist with the COVID-19 response, it is critical that they consider whether non-essential surgeries and procedures can be delayed so they can preserve personal protective equipment (PPE), beds, and ventilators.

The recommendations were issued to preserve equipment and free up healthcare workforce to care for the patients who are most in need CMS said. It urged healthcare providers to encourage patients to remain home, unless there is an emergency, to protect others by limiting their exposure to the virus.

Yesterday, CMS posted an update to its Frequently Asked Questions (FAQs) on its COVID-19 Medicaid webpage to aid state Medicaid and Children’s Health Insurance Program (CHIP) agencies in their response to the outbreak. The document includes answers to questions related to the flexibilities CMS is affording to states in managed care, benefits, financing, 1115 demonstrations, and leveraging “1135” waivers offered as part of the President’s declaration of a national emergency. As questions and issues continue to come into CMS, FAQs will continue to be issued to provide clear communication with states. Additionally, Medicaid and CHIP agencies can email their specific questions to: