April 6 Update

In This Week’s Update:

  • Additions to SHVS COVID-19 Resource Page
  • New CMS Rules and Guidance
  • SAMHSA Emergency Grant
  • COVID-19 State Updates: ID, MA, MD, MN, MT, NJ, NY, WA, WI
  • Other State Updates: CA, NJ
  • Eligibility for Coverage and COVID-19
  • Impact on Access to Food for Older Adults
  • COVID-19 Changes to HCBS Using Appendix K


Additions to SHVS COVID-19 Resource Page

Since launching its new COVID-19 Resources for States, the State Health and Value Strategies (SHVS) team has been busy updating the site with new resources, including a wide array of state materials. If you have materials you are willing to share through the resource page, please contact SHVS. SHVS also continues to produce original content on the topic of COVID-19 and just today published a new expert perspective, Grace Periods: A Good Start But Not Sufficient, which highlights the risks to consumers of traditional grace periods, during which insurance coverage cannot be cancelled for nonpayment of premiums when not paired with additional protections.


New CMS Rules and Guidance

Last week, CMS issued new rules and waivers of federal requirements to ensure that local hospitals and health systems have the capacity to absorb and effectively manage potential surges of COVID-19 patients. CMS also updated their COVID-19 Frequently Asked Questions for state Medicaid and CHIP agencies.


SAMHSA Emergency Grant

The Substance Abuse and Mental Health Services Administration (SAMHSA) announced an emergency grant to address mental health and substance use disorders during COVID-19. States are eligible for up to $2 million in funding to provide crisis intervention services, mental and substance use disorder treatment, and other related recovery supports for children and adults impacted by the COVID-19 pandemic. Applications are due Friday, April 10.


COVID-19 State Updates

  • Bulletins and Notices to Providers and Insurers
    • Minnesota – Governor Tim Walz announced that Minnesota’s health plans have agreed to waive cost-sharing for treatment of COVID-19. This move comes in response to the Governor’s Commissioners of Health and Commerce sending a letter on March 13 urging the health plans to remove barriers to coverage during the COVID-19 pandemic.
    • Washington – The Office of Insurance Commissioner issued an emergency order to carriers authorizing increased flexibilities on the use of telemedicine, providing a minimum 60-day grace period, and waiving cost-sharing requirements for testing for non-COVID-19 conditions, such as influenza.
  • Expanding Workforce Capacity
    • Idaho – Governor Brad Little suspended an additional 18 regulations to ensure residents have greater access to telehealth and medical professionals can more easily obtain necessary licenses to quickly engage in the response effort.
    • New Jersey
      • Governor Phil Murphy signed an executive order authorizing the Division of Consumer Affairs to temporarily reactivate the licenses of recently retired health care professionals and grant temporary licenses to doctors licensed in foreign countries. The executive order also temporarily permits certain health care professionals to perform acts outside of their ordinary scope of practice and grants broad civil immunity to health care professionals and facilities providing services in support of New Jersey’s COVID-19 response efforts who are acting in good faith.
      • The Department of Health and Division of Consumer Affairs hosted a live video conference for health care providers with top infectious disease specialists and epidemiologists about the state’s COVID-19 response, providing updates on emerging state-level data and research and guidance for prevention, testing, treatment, and telehealth opportunities under new state guidance.
  • Major Disaster Declarations – 17 states, D.C., and 3 territories requested major disaster declarations, all of which were granted by the President.
  • Section 1135 Waivers – CMS approved Section 1135 Medicaid waivers requests from 10 states last week, bringing the total number of approved waivers to 44. All Section 1135 approval letters are posted as they are issued on the CMS website.
  • Special Enrollment Periods (SEP)  
    • MarylandMassachusettsNew York, and Washington  – The state-based exchanges in these states extended their SEPs so uninsured residents can apply for and enroll in health insurance coverage.
  • Other
    • Montana – Governor Steve Bullock issued a Directive implementing measures at correctional facilities in Montana to protect inmates and staff and curtail the spread of COVID-19.
    • New Jersey – The New Jersey Departments of Children and Families and Human Services issued guidance for the Emergency Child Care Assistance Program for children of workers designated as ‘essential’ under Governor Murphy’s Executive Order 110. Through this program, the state will help support child care costs by offering between $336- $450 a week for essential workers.
    • New York – Governor Andrew Cuomo announced that consumers and businesses experiencing financial hardship due to COVID-19 may defer paying premiums under individual and small group health insurance policies through June 1. During this period, health plans will be required to continue to pay claims, not to report late payments to credit rating agencies, and to work with individuals to help them transition to new coverage, if appropriate.
    • Washington – The Washington State Department of Financial Institutions launched a resource page listing financial resources for Washington consumers impacted by COVID-19.
    • Wisconsin – Governor Tony Evers announced the State of Wisconsin Emergency Operations Center is opening two state-run voluntary isolation facilities in Madison and Milwaukee and is providing guidance to local communities throughout Wisconsin.


Other State Updates

  • California – The state submitted an amendment to their Section 1115 demonstration and is proposing to extend the Global Payment Program for an additional six months and allow beneficiaries in Orange County to voluntarily dis-enroll from CalOptima and enroll in a Program for All Inclusive Care for the Elderly organization. The federal public comment period is open until April 30.
  • New Jersey – The state submitted a request to amend its FamilyCare Comprehensive Section 1115 demonstration. The goal of the amendment is to extend NJ FamilyCare coverage for eligible pregnant women to 180 days postpartum and to test the impact of supplementing and extending existing incentives for a Substance Use Disorder Promoting Interoperability Program. The federal public comment period is open until May 1. For more information on Medicaid’s crucial role in combating the maternal mortality and morbidity crisis, see here.


COVID-19 and Health Coverage Programs FAQ

The Center on Budget and Policy Priorities, through their Health Reform: Beyond the Basics project, published an FAQ for navigators, assistors, and state and local officials to support consumers with questions about who is eligible to enroll in coverage. The outbreak of COVID-19 has prompted job losses and income reductions, leading many families to seek new sources of health coverage or additional help paying for it. The FAQ provides answers to frequently asked questions across three topic areas: enrollment options, changes to eligibility, and access to COVID-19 testing and treatment.


The Impact of COVID-19’s Closure of Meal Sites On Older Adults

The Milbank Fund published a blog post on the implications for seniors and older adults of the restricted access to and closure of senior centers and churches, many of which offer group meals through a federal–state nutrition program. The closure of these sites, which provide meals for more than 1.5 million people over age 60 each year, will likely have harmful effects on the health and well-being of their participants. The authors of the blog post outline a number of actions that states can pursue, such as meal delivery, but also call for a coordinated national effort with more federal resources and flexibility for states to develop short- and long-term plans to address food insecurity and social isolation among this population.


COVID-19 Changes to HCBS Using Appendix K: Approval Trends

One of the important mechanisms for ensuring people with disabilities have access to the home and community-based services (HCBS) they need to stay safely at home is an Appendix K to existing 1915(c) waivers. The National Health Law Program has published a factsheet on the CMS guidance for using Appendix K for the COVID-19 pandemic. The factsheet provides an overview of Appendix K instructions and the template issued by CMS and examines the trends in the Appendix Ks approved thus far.