Imminent March, April expiration dates indicate changes are on the horizon for pharmacy services.
In January 2020, the Trump administration declared a national COVID-19 emergency and a public health emergency (PHE), which were set to expire March 1 and April 11, 2023, respectively.1
On January 29, 2023, the Office of Management and Budget (OMB) announced it will extend the emergency declarations to May 11, 2023, and end both declarations on the same date.1
OMB intends to provide the additional time for the emergency orders to lapse to give health systems and medical providers time to prepare for the changes. Under the PHE, special rules were enacted, including the requirement that private insurers cover coronavirus testing and services without cost-sharing and prior authorization. Medicare beneficiaries also received benefits for free, at-home COVID-19 tests and treatments without cost sharing. Vaccines will continue to be covered for those with insurance but will be more costly for uninsured Americans. Some individuals may also have to pay out of pocket for certain COVID-19 treatments, such as nirmatrelvir/ritonavir (Paxlovid). Hospitals will no longer receive higher Medicare payment rates for treating patients with COVID-19 and other flexibilities. The Title 42 border policy will also end, which otherwise allowed border officials to ignore asylum claims and expel foreign nationals for the sake of protecting public health.1
Although key PHE-linked flexibilities, such as telehealth and hospital-at-home, are extended until 2024 through the Consolidated Appropriations Act, 2023, changes will be forthcoming regarding reimbursement of vaccines and COVID-19 therapeutics.2 Importantly, not all COVID-19 related authorities are linked to the end of the PHE. For example, the Public Readiness and Emergency Preparedness Act provides for pharmacist vaccination, testing, and treatment authorities. It expires October 1, 2024, unless it is extended.3 Pharmacy stakeholders will see 5 changes resulting from the end of the PHE. These are as follows:
The dismantling of the COVID-19 supplemental benefits and accommodations will continue to evolve. Additional changes may occur from time to time, depending on the withdrawal of various enactments intended to deal with the pandemic. For many of the pharmacist initiatives that came into existence during this time, states should prepare their own new laws and regulations to continue to maintain the important contributions the emergency provisions entitled pharmacists to undertake. Pharmacists have demonstrated a central role during the pandemic and they should continue to be allowed to make these demonstrated contributions in a postpandemic world.
1. Statement of administration policy. Office of Management and Budget. January 30, 2023. Accessed February 15, 2023. https://www.whitehouse.gov/wp-content/uploads/2023/01/SAP-H.R.-382-H.J.-Res.-7.pdf
2. Public health emergency to end May 11. News release. American Hospital Association. February 7, 2023. Accessed February 15, 2023. https://www.aha.org/special-bulletin/2023-02-07-public-health-emergency-end-may-11
3. PREP Act guidance. US Department of Health and Human Services. Updated March 12, 2021. Accessed February 15, 2023. https://www.phe.gov/Preparedness/legal/prepact/Pages/PREP-Act-Guidance.aspx
4. Medicare COVID-19 shot payment. Centers for Medicare & Medicaid Services. Updated December 23, 2022. Accessed February 15, 2023. https://www.cms.gov/medicare/covid-19/medicare-covid-19-vaccine-shot-payment
5. Prescribing controlled substances via telehealth. US Department of Health and Human Services. January 28, 2021. Accessed February 15, 2023. https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/prescribing-controlled-substances-via-telehealth/
6. What does the end of the public health emergency mean for pharmacy? American Society of Health-System Pharmacists. January 26, 2023. Accessed February 27, 2023. https://www.ashp.org/News/2023/01/26/what-does-the-end-of-the-public-health-emergency-mean-for-pharmacy?loginreturnUrl=SSOCheckOnly© artinspiring / Adobe Stock
About the Author
Ned Milenkovich, PharmD, JD, is chair of the health care practice at Much in Chicago, Illinois.