Feds issue coverage plan for COVID-19 vaccine and treatments

WASHINGTON (AP) — Federal health officials Wednesday issued insurance coverage rules designed to deliver on the promise that every American will have access to free COVID-19 vaccines when they are approved.

The regulations from the Centers for Medicare and Medicaid Services, or CMS, will also increase what Medicare pays hospitals for COVID-19 treatments. The changes arrive at a time when coronavirus infections are rising in much of the country, signaling a third wave that could eclipse the number of cases seen earlier this year.

Congress and President Donald Trump have already enacted legislation that calls for vaccines to be free, but the new rules were needed to align that policy with the many arcane payment requirements for public and private insurance.

“CMS is acting now to remove bureaucratic barriers while ensuring that states, providers and health plans have the information and direction they need to ensure broad vaccine access and coverage for all Americans,” agency head Seema Verma said in a statement.

The rules aim to resolve potential legal issues over whether Medicare could cover a vaccine that receives “emergency use authorization” from the Food and Drug Administration. That's a step short of full approval, and questions arose about whether Medicare could pay under its standard coverage policies.

Under Wednesday's announcement:

— Seniors with traditional Medicare will pay nothing for COVID-19 vaccines, and any copays and deductibles are waived.

— The government will pay private Medicare Advantage plans to administer the vaccine to seniors. Enrollees will not be charged.

— Workplace and individual health insurance plans will cover the COVID-19 vaccine as a preventive service, with no cost sharing. The requirement applies to the vast...