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COVID-19: CMS Guidance Update

On April 21st, CMS released a memo titled "Information Related to Coronavirus Disease 2019 - COVID-19", which supersedes the previous guidance memo released on March 10th.

Within CMS' most recent guidance, we continue to see a loosening of requirements in order for health plans to immediately address and respond to the needs of their members during the COVID-19 crisis.

Among other modifications to previous guidance, CMS has temporarily relaxed the policy around mid-year benefit enhancements (as outlined below and attached). With this memo, CMS is providing broad stroke permission for organizations to reduce or remove specific COVID-19 related cost sharing, as well as the ability to provide additional mid year benefit enhancements around non-health care related needs, such as covering meal delivery or transportation.

Contact us at for 30 minutes (gratis) with one of our clinical, pharmacy or operations experts to discuss next steps for implementing CMS' updated guidance.

"CMS is exercising its enforcement discretion to adopt a temporary policy of relaxed enforcement in connection with the prohibition on mid-year benefit enhancements (73 Federal Register 43628), such as expanded or additional benefits or more generous cost-sharing under the conditions outlined in this memorandum, when such mid-year benefit enhancements are provided in connection with the COVID-19 outbreak, are beneficial to enrollees, and are provided uniformly to all similarly situated enrollees."


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