Medicaid and CHIP guide for COVID-19 testing and vaccination

Aug. 31, 2021

Implementing the American Rescue Plan Act of 2021 (ARP), the Biden-Harris Administration is issuing guidance to states as they navigate the options available to advance COVID-19 vaccination and testing. Centers for Medicare & Medicaid Services (CMS) will provide guidance to states about additional ARP funding for states to promote the importance of COVID-19 vaccination for eligible children and adults enrolled in Medicaid.

The guidance reinforces that COVID-19 vaccines are available to nearly all Medicaid and Children's Health Insurance Program (CHIP) beneficiaries for free.

Under the ARP, states can receive a temporary increase in the Federal Medical Assistance Percentage (FMAP) if they newly extend Medicaid coverage to certain low-income adults. Additionally, the ARP temporarily makes 100% federal matching funds available for states' Medicaid and CHIP expenditures for COVID-19 vaccine administration. Also, state expenditures for Medicaid services received through Urban Indian Organizations and certain Native Hawaiian health care entities will receive a temporary match at 100% FMAP.

CMS is reinforcing that Medicaid will cover diagnostic and screening testing for COVID-19 when that testing is consistent with Centers for Disease Control and Prevention (CDC) recommendations.

Children with disabilities are uniquely impacted by the COVID-19 pandemic. CMS is committed to ensuring that children who are currently relying on remote learning continue to have access to the same services that are available and covered while attending school in person.

The ARP requires that states cover COVID-19 vaccines and their administration for nearly all Medicaid and CHIP beneficiaries with no cost sharing, thus ensuring that cost is not a barrier to anyone who wants to get vaccinated. The guidance provides information on the ARP's temporary 100% federal match for state expenditures on COVID-19 vaccines and vaccine administration for those with Medicaid and CHIP. The temporary increase in federal matching funds provide assurance to states that the federal government will continue to pay for COVID-19 vaccination costs.

Under the ARP, CMS will provide a temporary increase in federal funding to states that newly elect to expand Medicaid coverage to certain low-income adults, by offering a temporary five-percentage-point increase in federal matching funds for certain Medicaid expenditures for a maximum of two years. Additionally, these states will qualify for the 90% federal matching funds already available through the Affordable Care Act (ACA) for medical services for newly eligible Medicaid-expansion enrollees.

Addressing health inequity and serving the needs of low-income Americans, including individuals with disabilities and indigenous people of color who rely on these essential health programs, is a top priority for CMS. American Indians, Alaska Natives, and Native Hawaiians suffer health disparities at higher rates compared to other U.S. racial and ethnic groups. Under the ARP, state expenditures for Medicaid services received through Urban Indian Organizations and certain Native Hawaiian health care entities will be matched at 100% FMAP from April 1, 2021 through March 31, 2023.

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