March 21, 2023

Dear USET/USET SPF Family,

The COVID-19 National Emergency and Public Health Emergency (PHE) declared in 2020 for the response to the COVID-19 pandemic is set to expire on May 11, 2023. The PHE allowed for flexibilities and special rules during the COVID-19 pandemic. The next two months are set to be a transition period to prepare for the changes due to the ending of these emergency declarations. USET Tribal Epidemiology Center (TEC) and USET SPF aim to support Tribal Nations during this transitional period and will deliver pertinent informational alerts highlighting changes and the impact.

These changes include availability, access, and cost differences related to testing, vaccines, and treatments varying by insurance coverage. Emergency Use Authorizations (EUA) for testing, vaccines, and treatments will continue past the ending of the PHE and FDA’s ability to authorize products will not be impacted. COVID-19 vaccines under EUA, including Pfizer monovalent and bivalent, Moderna monovalent and bivalent, Novavax, and Janssen, will still be authorized to be used. COVID-19 treatments such as Paxlovid and Lagevrio will still be widely accessible, however some insurances may begin to see out of pocket costs.

Additionally, certain waivers and broad flexibilities will end or slowly come to a close. For example, certain Medicare and Medicaid waivers and flexibilities for healthcare providers, coverage for COVID-19 testing, and the requirement of COVID-19 laboratory test or vaccination data reporting to the CDC will be impacted. Flexibilities outside the direct scope of health care and medicine will also be impacted. One of these flexibilities set to conclude in March 2023 with significant impact is the conclusion of the enacted temporary benefit increase to the Supplemental Nutrition Assistance Program (SNAP).

While there are many policy changes, access to COVID-19 vaccinations and treatments such as Paxlovid and Lagevrio will remain available. Many telehealth flexibilities that were put into place during the pandemic, for instance audio-only services specifically for Medicare and Medicaid recipients will continue and/or extended through December 31^st, 2024. Medications like Buprenorphine for opioid use and methadone take-home tests for opioid treatment will still be available.

Additional information is linked below for your convenience. The USET TEC is available to assist with any questions or concerns. Please do not hesitate to contact us at usetepi@usetinc.org.

Sources:

• White House Statement of Administration Policy- Termination of the Public Health Emergency Declared with Respect to COVID-19
• FDA: FAQs: What happens to EUAs when a public health emergency ends?
• HHS Fact Sheet: COVID-19 Public Health Emergency Transition Roadmap
• Medicaid and CHIP: Continuous Enrollment Unwinding
• Center on Budget and Policy Priorities: Temporary Pandemic SNAP Benefits Will End in Remaining 35 States in March 2023
• FDA: Moderna COVID-19 Vaccine EUA
• FDA: Pfizer-BioTech COVID-19 Vaccine EUA
• FDA: Novavax COVID-19 Vaccine EUA
• FDA: Janssen COVID-19 Vaccine EUA

Established in 1969, the United South and Eastern Tribes, Inc. (USET) is a non-profit, inter-Tribal organization serving thirty-three (33) federally recognized Tribal Nations from the Northeastern Woodlands to the Everglades and across the Gulf of Mexico. USET is dedicated to enhancing the development of Tribal Nations, improving the capabilities of Tribal governments, and improving the quality of life for Indian people through a variety of technical and supportive programmatic services.