CMS Announces Medicare Will Cover COVID-19 Vaccines With No Cost to Beneficiaries

On October 28, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it had published a new Interim Final Rule with Comment Period (IFC) containing measures meant to remove regulatory barriers to ensure that Americans have access to affordable COVID-19 treatments and vaccines, when available. More specifically, FDA-approved COVID-19 vaccines will be covered for Medicare beneficiaries with no out-of-pocket costs. Private health plans (including non-grandfathered group health plans and health insurance carriers offering non-grandfathered group or individual health insurance coverage) must provide coverage, without cost-sharing, for qualifying coronavirus preventive services, including COVID-19 vaccines. Furthermore, the IFC includes enhanced payments for eligible inpatient cases that involve the use of certain new products authorized or approved to treat COVID-19. During the public health emergency, CMS will also pay for authorized or approved COVID-19 therapies separately from the Comprehensive Ambulatory Payment Classification to encourage the administration of these treatments in hospital outpatient settings.

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