With the end of the Public Health Emergency (PHE) coming soon, you might be wondering what all that means. What does it mean for reimbursements? What will change? What won’t change? How will it potentially impact pharmacies? What will it mean for patients? Unfortunately, we don’t have all the answers yet. However, we will share what we do know to shed a little light on the end of PHE and what pharmacies can expect.
On January 30 of this year, the Biden administration announced that the COVID-19 Public Health Emergency, which has been in place since 2020, was set to end on May 11. This provided the healthcare system with just over 100 days notice to ensure continuity of care and a smooth transition. So, what does the end of the PHE mean? It likely means that changes are coming to the reimbursement of vaccines and COVID-19 medications as coverage shifts from the government to private individual and group insurance. COVID-19 vaccines are expected to be covered by most insurance companies, while tests and treatments, depending on the plan, will likely be available via patient cost sharing. We won’t experience these changes until January 1, 2024, per the PHE provisions. For Medicaid patients, COVID-19 testing, vaccines, and treatments will be covered for a year after the end of PHE.
However, for pharmacies there’s a bit of a silver lining, not all COVID-19 authorities are tied to the end of the PHE. Authorities provided under the Public Readiness and Emergency Preparedness (PREP) Act, including pharmacist vaccination, testing, and treatment, do not expire until October 1, 2024. Read more >