In This Week’s Update:
- PHE Likely to be Extended
- Advancing Health Equity Learning Collaborative
- A Community-Centered Approach to Data Sharing and Policy Change: Lessons for Advancing Health Equity
- Optional Medicaid Health Home Benefit
- State updates: AZ, CA, CO, GU, HI, IL, MA, MD, MN & OH
PHE Likely to be Extended
Last week marked the deadline for HHS to provide states with 60-days notice that the federal COVID-19 public health emergency (PHE) would be ending October 13, 2022. In the absence of such notice, it can be assumed that the PHE will be extended on October 13 for an additional 90 days, until January 11, 2023. As a reminder, SHVS has a one-stop resource page to support states as they plan for unwinding the PHE and recently updated our communications resources Planning for the End of the Continuous Coverage Requirement: Communications Resources for States.
Advancing Health Equity Learning Collaborative
The Advancing Health Equity Program (AHE) is seeking teams of state Medicaid agencies, Medicaid health plans, healthcare provider organizations, individuals, and communities experiencing inequities to work together to eliminate unjust differences in health and healthcare using an anti-racist approach. AHE is looking for individuals and organizations who are passionate about improving healthcare for those who have been historically marginalized. Learning Collaborative participants will receive training, tailored coaching, and peer support to advance health equity by changing the way care is delivered and paid for in their communities. The deadline to submit a letter of intent is August 22, with applications to be submitted by September 23.
A Community-Centered Approach to Data Sharing and Policy Change: Lessons for Advancing Health Equity
Data Across Sectors for Health (DASH), together with the Center for Health Care Strategies (CHCS) and with support from the Robert Wood Johnson Foundation, is leading a national initiative, Learning and Action in Policies and Partnerships, to test new ways to support community-based data-sharing efforts. The first cohort included six communities—in Arizona, Connecticut, Rhode Island, South Carolina, Washington, D.C., and Washington—that sought to strengthen relationships between communities and state agencies to address health equity priorities via data-sharing efforts. A recently published issue brief shares lessons from these six pilot sites to help guide additional states and community-based organizations (CBOs) in enhancing community data-sharing capabilities and fostering relationships between state governments, CBOs, and community members with lived expertise.
Optional Medicaid Health Home Benefit for Medically Complex Children
On August 1, CMS released a State Medicaid Director (SMD) letter laying out a new option for states to cover “health home” services for Medicaid-eligible children and youth with medically complex conditions. This benefit was established in Section 1945A of the Social Security Act, as part of the Medicaid Services Investment and Accountability Act (P.L. 116-16) that was added in 2019. States may adopt this optional Medicaid benefit beginning October 1, 2022, and will receive a 15-percentage-point increase in their federal Medicaid matching rate (up to a maximum rate of 90%) for the first six months the benefit is in operation. For more information about this optional Medicaid benefit, Manatt Health reviews the SMD in more detail in a recent Health Highlights.
Also last week, in case you missed it, CMS released a notice of proposed rulemaking to promote consistent use of nationally standardized quality measures in Medicaid and the Children’s Health Insurance Program (CHIP) to help identify gaps and health disparities. While currently voluntary, under this new rule reporting for the full Child Core Set, behavioral health measures in the Adult Core Set, and the two Medicaid Health Home Core Sets becomes mandatory in federal fiscal year 2024. CMS will be accepting comments on the proposed rule through October 21, 2022.
State updates: AZ, CA, CO, GU, HI, IL, MA, MD, MN & OH
- Arizona – The Arizona Health Care Cost Containment System (AHCCCS) is hosting listening sessions for enrollees of the Arizona Long Term Care System for Elderly and Physically Disabled (ALTCS-EPD), their family members and providers to solicit input for new health plan contracts for the program. AHCCCS is looking to learn more about what is working well and where there are opportunities for improvement.
- California – Governor Gavin Newsom unveiled California’s Master Plan for Kids’ Mental Health which adds 40,000 new mental health workers, invests $4.1 billion on a community schools strategy to connect kids and families to essential services, including health screenings and meals, and $5 billion on a Medi-Cal initiative to better integrate health and behavioral health services for low-income kids.
- The Polis-Primavera administration and the Colorado Department of Health Care Policy & Financing (HCPF) announced partnerships with key supply chain partners that will help Colorado operationalize the importation of lower cost medications from Canada. In 2019 Governor Polis signed legislation which authorized HCPF to seek approval from the federal government to establish an importation program that will provide access to Canada’s lower priced drugs to Colorado employers and consumers.
- On August 10, legislation (HB22-1285), recently signed into law by Governor Jared Polis ensuring Colorado hospitals are in compliance with federal transparency laws, took effect across the state. The law allows patients who believe a hospital was not in compliance with federal laws to file a lawsuit to have their debt forgiven and other fees covered. The law also requires hospitals to post standard prices on a public website to increase transparency and accountability.
- Guam – The territory of Guam submitted a new section 1115 demonstration application to CMS seeking to waive participation in the Medicaid Drug Rebate Program (MDRP). Participating in the MDRP would require Guam to carry and cover more drugs than they believe is feasible due to the remote location of the island. Guam seeks to waive participation in the MDRP to maintain the existing capacity of pharmacy providers and avoid excess costs and labor for pharmacies. The federal comment period will be open through September 14, 2022.
- Illinois – Governor JB Pritzker and the Department of Healthcare and Family Services announced the launch of the Program of All-Inclusive Care for the Elderly (PACE) to better meet the needs of older adults across Illinois. The PACE program provides older adults in Illinois who are dually eligible for Medicaid and Medicare and who are certified by the state as qualifying for nursing home care, but are able to safely continue living in the community at the time of their enrollment, with customized and coordinated medical care and social services.
- Massachusetts – The Massachusetts Executive Office of Health and Human Services (EOHHS) released a request for information (RFI) seeking input on its Medicaid MassHealth risk adjustment methodology. The primary objectives of the RFI are to: understand potential strategies for addressing the social determinants of health (SDoH) in risk adjustment; identify potential alternative data sources for use in risk adjustment, including those related to SDoH; and obtain feedback on MassHealth’s current risk adjustment approach. Responses to the RFI are due September 23. For more information on filling gaps in data when risk adjusting for social factors, see this SHVS issue brief.
- Minnesota – The Minnesota Department of Human Services released a request for proposals seeking a current Minnesota Health Care Programs provider agency to coordinate and deliver culturally and developmentally appropriate school-based substance use disorder services to students and families throughout Minnesota.
- Hawaii, Maryland & Ohio – CMS approved the extension of Medicaid and CHIP coverage for 12 months after pregnancy in Hawaii, Maryland, and Ohio. As a result, up to an additional 34,000 people annually—including 2,000 in Hawaii; 11,000 in Maryland; and 21,000 in Ohio—will now be eligible for Medicaid or Title XXI-funded Medicaid expansion CHIP coverage for a full year after pregnancy. As a reminder, SHVS published an issue brief on the American Rescue Plan’s Act option to extend postpartum coverage.