End of the COVID-19 Public Health Emergency (PHE)
The Public Health Emergency (PHE) provided several pandemic-era flexibilities and waivers for hospitals, health systems, providers, and patients to ensure robust health care access to testing and various treatments. Below you can find more resources about the flexibilities and waivers that will expire and remain after the termination of the PHE on May 11, 2023.
- Medicaid Continuous Enrollment Provision
- Expanded Supplemental Nutrition Assistance Program (SNAP) Flexibilities
- Check SNAP eligibility here or at portal.ct.gov/dss/SNAP/
- Able-bodied adults without dependents (ABAWD) work requirements are suspended through November 30, 2023
- Expanded Temporary Assistance for Needy Families (TANF)
- Check TANF eligibility here at portal.ct.gov/DSS/Economic-Security
- Audio-Only Telehealth for Certain Services
- Insurance providers can restrict payment for certain audio-only telehealth services
- This waiver ends 151-days after May 11, 2023
COVID-19 Tests, Vaccines, and Treatments
Most Americans will not experience disruptions to accessing COVID-19 tests, vaccines, and treatments, including approved therapeutics like Paxlovid and Lagevrio. Broad access to these treatments will continue to be provided free of charge, until some transition to the commercial market in Fall 2022.
- Medicare Coverage for COVID Vaccinations
- COVID-19 vaccinations are permanently covered under Medicare Part B without cost sharing
- Medicare Coverage for COVID Treatments
- Medicare coverage for oral antivirals, such as Paxlovid and Lagevrio will be permanent.
- Medicaid and CHIP COVID Coverage
- Coverage without cost-sharing for COVID-19 tests, vaccinations, and treatments
- Medicare Telehealth Access
- The Consolidated Appropriations Act, 2023, extends many telehealth flexibilities through December 31, 2024, including:
- Expanding the geographic requirement to all Medicare beneficiaries, not just those in rural areas;
- Removing the requirement to have an in-person health care facility listed as an available telehealth provider;
- Allowing audio-only telehealth visits for beneficiaries unable to access both audio and video either through a smartphone or computer.
- Medicare Advantage plans may offer additional telehealth benefits
- Individuals in a Medicare Advantage plan should check with their plan about coverage for telehealth services.
- After December 31, 2024 when these flexibilities expire, some Accountable Care Organizations (ACOs) may offer telehealth services that allow primary care doctors to care for patients without an in-person visit, no matter where they live. If your health care provider participates in an ACO, check with them to see what telehealth services may be available.
- Medicaid and CHIP Telehealth Access
- For Medicaid and CHIP, telehealth flexibilities are not tied to the end of the PHE and have been offered by many state Medicaid programs long before the pandemic. Coverage will ultimately vary by state. CMS encourages states to continue to cover Medicaid and CHIP services when they are delivered via telehealth.
- Certain Private Insurance Access to Telehealth
- Coverage for telehealth and other remote care services will vary after the end of the PHE. For additional information on your insurer’s approach to telehealth, contact your insurer’s customer service number located on the back of your insurance card.
- Buprenorphine Access for Opioid Use Disorder Treatment in Opioid Treatment Programs (OTPs)
- Early in the COVID-19 pandemic, the Substance Abuse and Mental Health Services Administration (SAMHSA) released guidance allowing patients to start buprenorphine in an OTP by telehealth without the required in-person physical examination first.
- This flexibility has proven to be safe and effective in engaging people in care such that SAMHSA proposed to make this flexibility permanent as part of changes to OTP regulations in a Notice of Proposed Rulemaking that it released in December 2022. SAMHSA has committed to providing an interim solution if the proposed OTP regulations are not finalized prior to May 11.
- Expanded Methadone Take-Home Doses for Opioid Use Disorder Treatment
- Early in 2020, SAMHSA allowed an increased number of take-home doses to patients taking methadone in an OTP. Research and feedback from patients, OTPs, and states have demonstrated that this flexibility has allowed people with opioid use disorder to stay in treatment longer, supported recovery, and has not resulted in increases in methadone-related overdoses.
- SAMHSA announced it will extend this flexibility for one year from the end of the COVID-19 PHE, which will be May 11, 2024, to allow time for the agency to make these flexibilities permanent as part of the proposed OTP regulations published in December 2022.