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Understanding the changes that come with the end of the Public Health Emergency

Understanding the changes that come with the end of the Public Health Emergency

The Public Health Emergency (PHE) for COVID-19 expired on May 11, 2023. The PHE allowed patients and healthcare providers to access COVID-19 vaccinations, testing, treatments, and services more easily during the pandemic. The end of the PHE will have changes that affect some healthcare costs and access to services. Here is a quick guide to what will, won't, or could be changing now that the PHE has expired.

What WILL be affected:

Certain Medicare and Medicaid waivers

  • During the COVID-19 PHE, a combination of emergency authority waivers, regulations, and regulatory guidance were used to expand access to care and to give health care providers the flexibilities needed to help keep people safe.
  • Many of these waivers and flexibilities were necessary to expand hospital capacity to care for higher numbers of patients needing care during the pandemic.
  • No longer necessary, many waivers related to increasing care capacity will end when the PHE expires.

3-Day Skilled Nursing Facility (SNF) waiver

  • During the pandemic, Medicare temporarily waived the requirement for a 3-day prior hospitalization before covering the cost for a skilled nursing facility (SNF)
  • After May 11, patients who get referred to a SNF without 3 days in the hospital will either be denied admission to the SNF or may be surprised by an unexpected bill when Medicare won't cover it.
  • WellSpan has worked with our SNF Preferred Provider Network and independent practice partners to ensure awareness of the change regarding 3-day requirements for a covered admission.

Coverage for COVID-19 testing

  • Medicare
    • Medicare Part B beneficiaries will continue to have coverage without cost sharing for laboratory-conducted COVID-19 tests when ordered by a provider.
    • Access to free over-the-counter (OTC) COVID-19 tests will end though, consistent with the statute on Medicare payment for OTC tests set by U.S. Congress.
  • State Medicaid
    • State Medicaid programs must provide coverage without cost sharing for COVID-19 testing until September 30, 2024.
  • Private Insurance
    • Private insurance companies are not required to cover tests without cost sharing for OTC or laboratory tests.
    • However, coverage may continue if plans choose to continue to include it. If you are unsure if you have coverage for COVID-19 testing, please reach out to your insurance company.

Reporting of COVID-19 laboratory results and immunization data

  • COVID-19 testing data reporting will not be required from labs.
  • The CDC will stop producing the color-coded Community Level reports and maps of transmission rates.


What WON'T be affected:

Access to COVID-19 vaccinations and certain COVID-19 treatments

  • Access to COVID-19 vaccinations and certain COVID-19 treatments will generally not be affected.
  • The FDA's Emergency Use Authorizations for COVID-19 products (including tests, vaccines, and treatments) will not be affected.

Out-of-pocket expenses for COVID-19 vaccinations

  • Out-of-pocket expenses for COVID-19 vaccinations will not be affected for most patients.
  • Most patients will continue to pay nothing out-of-pocket for the COVID-19 vaccine. Most private insurance plans will continue to fully cover vaccines without a co-pay as a preventive health service.
  • COVID-19 vaccinations are covered under Medicare Part B without cost sharing, and this will continue.
  • Medicaid will continue to cover all COVID-19 vaccinations without a co-pay or cost sharing through September 30, 2024.

Telehealth (video visits) through Medicare

  • Individuals with Medicare can continue to see providers virtually using telehealth.
  • Coverage for most Medicare telehealth services will remain in place through December 2024.

Telehealth (video visits) through Medicaid

  • Individuals with Medicaid can continue to see providers virtually using telehealth.
  • States already had significant flexibility with respect to covering and paying for Medicaid services delivered via telehealth prior to the COVID-19 PHE and will continue to be available after the COVID-19 PHE ends.


What MAY be affected:

Out-of-pocket expenses for certain COVID-19 treatments

  • Out-of-pocket expenses for certain COVID-19 treatments may change, depending on an individual's insurance coverage.
  • Changes would be similar to costs that one may experience for other drugs. Talk with your pharmacy for exact out-of-pocket expenses associated with COVID-19 treatments (i.e. Paxlovid).

Telehealth (video visits) prescribing of controlled substances

  • On May 3, the Drug Enforcement Administration (DEA) announced a temporary extension of PHE flexibilities allowing providers to prescribe controlled substances via telehealth until further notice.
  • This allowed for some prescribing of controlled substances, such as buprenorphine, to patients without an in-person interaction.
  • While this has been extended, the prescription of controlled substances via telehealth may change. Please continue to check back as any new rules are announced.