April 8 Update

In This Week’s Update:

  • Reactions to Last Week’s Court Decisions
  • DOL’s AHP Rule FAQ
  • State Updates: AZ, CO, FL, LA, ME, NE, NJ, & RI
  • Webinar on Medicaid Buy-In
  • Consumer-Focused Health System Transformation
  • Webinar on the Integrated Care for Kids Model
  • Q&A with NJ’s DHS Commissioner

Reactions to Last Week’s Court Decisions

As the dust settles on recent health care court decisions, Manatt Health has shared their thoughts on the recent developments in the work requirements litigation. In a new expert perspective, Manatt reviews in detail decisions in the Kentucky and Arkansas cases and considers the next steps and implications for states of the rulings.

Labor’s AHP Rule FAQ

Also last week, in response to the ruling invalidating the U.S. Department of Labor’s (DOL) Association Health Plan (AHP) rule, DOL released an FAQ, which is analyzed by Katie Keith in a blog post for Health Affairs. In her post, Keith also provides a summary of the activity in Congress last week in response to the letter issued by the U.S. Department of Justice in support of the ruling that the entire Affordable Care Act should be invalidated based on the elimination of the individual mandate tax penalty.

State Updates: AZ, CO, FL, LA, ME, NE, NJ, & RI

  • Arizona – The Arizona Health Care Cost Containment System, in partnership with the Centers for Health Care Strategies and Adaptation Health, hosted the Medicaid Innovation Challenge focused on connecting market-ready solutions for social determinants of health and digital member engagement with managed care leaders. Recordings of the day’s events are available for viewing.
  • Colorado – Governor Polis, Lieutenant Governor Primavera and a variety of stakeholders unveiled the Polis-Primavera Roadmap to Saving Coloradans Money on Health Care. The roadmap outlines short and long-term action steps that will begin to reduce patient costs and improve the health care system overall.
  • Florida – The Centers for Medicare & Medicaid Services (CMS) approved an amendment to Florida’s 1115 Managed Medical Assistance waiver that will allow the Agency for Health Care Administration, through a pilot program, to pay for flexible services for people with severe mental illness or substance use disorders, including temporary housing assistance.
  • Louisiana – Governor John Bel Edwards signed a Memorandum of Understanding with Louisiana Delta Community College to create a collaborative pilot work training initiative that will connect Medicaid expansion recipients to viable training opportunities. The goal of the pilot is to develop a work training promotion program model that can be customized by communities across Louisiana.
  • Maine – CMS notified the state of its approval of Maine’s State Plan Amendments (SPAs) to expand Medicaid under the Affordable Care Act. The coverage is retroactive to July 2, 2018, the date prescribed in the 2017 ballot measure approved by voters.
  • Nebraska – The Department of Health and Human Services announced that it submitted the necessary SPAs to CMS to expand the group of Medicaid-eligible Nebraskans to include adults 19 to 64 whose income is at or below 138 percent of the federal poverty level. The state is also planning to submit a Section 1115 waiver to establish a tiered benefit system and condition eligibility on work or community engagement.
  • New Jersey
    • Human Services Commissioner Carole Johnson announced that as of April 1, New Jersey Medicaid plans will no longer require prior authorization before patients can access medication-assisted treatment for opioid addiction.
    • First Lady Tammy Murphy and Health Commissioner Shereef Elnahal joined state and local partners in Atlantic City on April 4 for a Health Equity forum as part of National Minority Health Month. A second forum is scheduled for April 18. The forums will focus on ways to close racial health gaps and address social determinants of health by promoting a lifestyle of wellness and encouraging disease prevention.
  • Rhode Island – The chairs of the health committees in both the House and the Senate introduced legislation that would ensure the standards of the Affordable Care Act remain in effect in Rhode Island, even if the courts or Congress were to eliminate the federal laws that created it.


Upcoming Webinar – State Medicaid Buy-Ins: Key Questions to Consider

Thursday, April 25, 2019 from 2:00 to 3:00 p.m. ET

Lawmakers across the country are considering “Medicaid buy-in” or public option programs to stabilize the Affordable Care Act (ACA) insurance market and offer a coverage option that is more affordable and accessible than current options in the individual and employer markets. State Health and Value Strategies, in partnership with Manatt Health, will host a webinar for states on the evolving concept of Medicaid buy-in/public option. During the webinar, speakers from Manatt Health will discuss six key questions that state policymakers need to consider when choosing a buy-in model, designing its features, and introducing a Medicaid buy-in program. These considerations include (1) goal setting, (2) sources of cost-savings, (3) potential impacts on existing insurance markets, (4) federal 1332 waiver considerations, (5) implementation capacity, and (6) key steps for implementation.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e4552a7919c29545260ce042391c9b49e


Policy Priorities for Consumer-Focused Health System Transformation

Altarum’s Healthcare Value Hub released a Policy Roadmap and Toolkit designed to provide policymakers and other stakeholders with actionable information to guide the transformation of the U.S. health care system to the benefit of the people the system is intended to serve: consumers. The Roadmap highlights promising federal, state and local policies that achieve the health system transformation goal of ensuring that the health care system works seamlessly with public health, social sectors and community members to address the goals and needs of the people it serves and advance health equity. To produce the roadmap, Altarum relied heavily on informal interviews with experts from a wide variety of policy fields and it includes proof-of-concept examples of where policies are already working to make the U.S. health system more patient-centered.


Webinar on the Integrated Care for Kids Model: Prevention, and Building a Community of Health

InCK Marks Resource Network and the Robert Wood Johnson Foundation are hosting a webinar on April 9 on the federal Integrated Care for Kids (InCK) model. The webinar will describe how the InCK Model provides an opportunity to build a more preventive child health system overall. During the webinar Martha Davis, Senior Program Officer at the Robert Wood Johnson Foundation, will discuss how the InCK model aligns with the Foundation’s efforts to build a culture of health through more preventive and holistic responses to children and families. Charles Bruner, manager of the InCK Marks network sponsoring the webinar, will describe features of the InCK Model that emphasize prevention and how the root cause analysis” and “risk stratification” sections can emphasize preventive approaches and a culture of health. Register here for the webinar.


Promoting Addiction Treatment in Medicaid: A Q&A with New Jersey’s Department of Human Services Commissioner

The Center for Health Care Strategies sat down with Carole Johnson, New Jersey’s Department of Human Services Commissioner, to learn how she is advancing New Jersey’s strategies to combat the opioid epidemic. Through support from the Robert Wood Johnson Foundation, the Center for Health Care Strategies is providing technical assistance to New Jersey in support of activities to improve health outcomes for Medicaid beneficiaries. In January 2019, New Jersey announced a multi-faceted OUD strategy that includes enhanced Medicaid reimbursement for providing medication-assisted treatment (MAT) through an office-based addiction treatment (OBAT) model and the establishment of Centers of Excellence to support community-based clinicians providing addiction treatment.