April 13, 2018: 2019 CMS Payment Notice Rule, Building State Evaluation Capacity

Weekly updates on the latest state-level health care news from Heather Howard, program director of State Health and Value Strategies.

On Monday the Centers for Medicare & Medicaid Services (CMS) issued the final 2019 Payment Notice Rule. Our colleague Sabrina Corlette from Georgetown’s Center on Health Insurance Reforms has authored an expert perspective for State Health and Value Strategies that focuses on the major provisions of the Payment Notice and accompanying guidance documents that have significant implications for states. Next Friday, April 20, SHVS will host a webinar on the Payment Notice Rule that will feature technical experts Sabrina Corlette and Justin Giovannelli from Georgetown, Joel Ario from Manatt Health and Jason Levitis to discuss implications for states (see the link below to register). Updates follow.

  • Arizona — The Arizona Health Care Cost Containment System (AHCCCS) submitted a waiver amendment request seeking the authority to limit retroactive coverage for new AHCCCS members to the month of application. AHCCCS is seeking a waiver from the requirement to provide prior quarter coverage in order to limit retroactive coverage to the same month in which a member applies for Medicaid.
  • Louisiana

o   The Louisiana Department of Insurance released a description of its draft Section 1332 waiver application to implement a reinsurance program and is accepting public comments on the draft through May 9. We have updated our map to include a link to the description.

o   Governor John Bel Edwards and Louisiana Department of Health Secretary Dr. Rebekah Gee announced a report from the Public Administration Institute at Louisiana State University that highlights the economic impact of Medicaid expansion. The report shows that Medicaid expansion is leveraging an infusion of $1.85 billion in federal funds to create or retain nearly 19,200 jobs and support nearly $3.6 billion in economic activity for the state of Louisiana.

  • North Carolina — The Office of Minority Health and Health Disparities in the North Carolina Department of Health and Human Services announced the release of its Health Equity Report for 2018. The report documents progress and areas for continued improvement, such as infant mortality and financial barriers to health care.
  • New Hampshire – The Department of Health and Human Services released its implementation plan for the state’s planned transition to managed long-term services and support (LTSS). Under the program, New Hampshire will integrate LTSS services and nursing facilities into the current Medicaid Care Management program.
  • New Jersey

o   The Department of Health launched an awareness campaign aimed at reducing opioid dependency in pregnant women and their newborns. The campaign will include distribution of awareness materials, targeted corner store and bus advertising, promoted social media, a new website and outreach to community partners and health care providers.

o   The Department of Human Services, Division of Medical Assistance and Health Services released a notice for public comment on of its plans to seek approval from CMS for an amendment to the State Plan to cover Diabetes Self-Management Education, Diabetes Prevention Programs and Medical Nutrition Therapy, which would be effective July 1, 2018.

  • Texas – The Texas Health and Human Services Commission released a draft request for proposal for statewide dental managed care plans for children enrolled in Medicaid and the Children’s Health Insurance Program. A final RFP is expected to be released on June 18, 2018, with implementation set for January 2020.

Upcoming Webinar – Save the Date!

Analysis of the 2019 Affordable Care Act Payment Notice: Implications for States

Friday, April 20, 2018 2:00 to 3:00 PM ET

On April 9, the U.S. Department of Health & Human Services released its annual Notice of Benefit and Payment Parameters, a collection of policies governing the Affordable Care Act’s (ACA) marketplaces, insurance reforms, and premium stabilization programs. The first such annual notice issued under the Trump Administration, it contains a number of provisions that require state officials to make important decisions on short notice that will affect plan benefits, premiums, and marketplace operations. State Health and Value Strategies is hosting a webinar, together with experts Sabrina Corlette and Justin Giovannelli from Georgetown’s Center on Health Insurance Reforms, Joel Ario from Manatt Health and Jason Levitis, to help participants untangle the rule and its many implications for states.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e8b0dce005a15580564ed650d0be84f2f

Building State Capacity to Evaluate Innovative Medicaid Policies

Our friends at the National Governor’s Association (NGA) are launching  a new 12-month project that will provide governors’ senior staff and other state officials with technical assistance to build data and evaluation into the consideration and development of new Medicaid proposals, as well as new policies that have already been approved by the Centers for Medicare and Medicaid Services (CMS). States participating in this project will attend a multi-state convening in the summer of 2018 and receive ongoing technical assistance from the NGA Center, national experts and consultants. Applications are due April 25. See the attached overview with details of how to apply.

Innovations in Integrated Care Management: How to Adapt Lessons from Spain for the US

The Robert Wood Johnson Foundation, in partnership with the Petris Center at UC Berkeley’s School of Public Health, is hosting a webinar on April 17 featuring health policy experts from the US—including our friends Steve Cha from CMS and MaryAnne Lindebland from Washington state—and Spain that will explore the most promising innovations in integrated care from Spain. The webinar will explore efforts ranging from social care integration and emergency care integration, to area “care pathway” agreements across sectors. Panelists and the audience will discuss how these innovations can help further healthcare delivery system reforms in the US, especially for Medicare and Medicaid and will describe both the innovations from Spain and related US innovations to date.

Effects of Short-Term Limited Duration Plans on the ACA Compliant Individual Market

Wakely Consulting Group was retained by the Association for Community Affiliated Plans to conduct a qualitative and quantitative review of the effects of the recent short-term limited duration insurance (STLDI) proposed regulation on the ACA-compliant individual health insurance market. The paper analyzes the proposed STLDI regulatory change and the potential effects it could have on the ACA-compliant individual market. Wakely analyzed the impact using a variety of methodologies to develop a range of enrollment decreases and premiums increases within the ACA-compliant individual market.