August 26 Update

In This Week’s Update:

  • Helping States Provide Medicaid Services to Incarcerated Youth
  • SHVS Webinar: CMS Guidance for Providing Medicaid and CHIP services to Incarcerated Youth
  • Enforcing Mental Health Parity: State Options to Improve Access to Care
  • Medicare Drug Price Negotiations Offer Potential Opportunities for States
  • Ensuring Coverage for Individuals Receiving Home- and Community-Based Services
  • State updates: AR, CO, MA, ND, NJ, NM, NY, RI & VT

 

Helping States Provide Medicaid Services to Incarcerated Youth
Following the release of the Centers for Medicare & Medicaid Services (CMS) State Health Official (SHO) letter on July 23, “Provision of Medicaid and CHIP Services to Incarcerated Youth,” Manatt Health developed an operational plan template summarizing CMS’ implementation guidance on section 5121 of the Consolidated Appropriations Act, 2023 (CAA) and offering potential policy and operational design components for states to consider to be responsive to each plan requirement. The policy and operational design components in the template are illustrative examples, not CMS requirements, and are designed to assist states in navigating the various design decisions associated with each requirement.

 

SHVS Webinar: CMS Guidance for Providing Medicaid and CHIP services to Incarcerated Youth
State Health and Value Strategies (SHVS) hosted a webinar on CMS’ implementation guidance in the SHO letter and the CAA requirements for the provision of Medicaid and CHIP services for incarcerated children and youth. We have posted a recording and the slide deck from the webinar on our website. Updates follow.

 

Medicare Drug Price Negotiations Offer Potential Opportunities for States
CMS announced the first round of Maximum Fair Prices (MFPs) for ten commonly-used, costly prescription drugs as part of the Medicare Drug Price Negotiation Program. CMS estimates that if the MFPs had been in effect last year, Medicare would have saved $6 billion across the ten drugs, suggesting aggregate net savings of 22%. Though MFPs apply to Medicare enrollees only, a blog post from the National Academy for State Health Policy highlights how the publication of MFPs presents an opportunity for states.

 

Ensuring Coverage for Individuals Receiving Home- and Community-Based Services
On August 19, CMS released a CMCS informational bulletin and accompanying slide deck reminding states of their obligation to comply with federal Medicaid renewal requirements and identifying optional state strategies to ensure continuity of coverage among individuals receiving Medicaid HCBS. For HCBS recipients who are disenrolled from Medicaid for procedural reasons (e.g., failure to return the renewal form) and likely to re-enroll, CMS encourages states to reserve a portion of HCBS waiver slots, prioritize entry into the HCBS program, allow for provisional person-centered service plans—which identify the essential Medicaid services that will be provided for 60 days, and rely on a level of care re-evaluation [for section 1915(c) and 1915(k)] or assessment of needs-based criteria [for section 1915(i)] completed within the past 12 months to determine eligibility.

 

State updates: AR, CO, MA, ND, NJ, NM, NY, RI & VT

  • Arkansas – The Arkansas Department of Human Services launched an educational campaign to raise public awareness about the availability of HCBS for Medicaid enrollees. At the center of this campaign, a new website, ar.gov/HCBS, offers information about the specific HCBS programs and services available, who they are designed to benefit, what they provide, and how to apply for them.
  • Colorado – The Colorado Behavioral Health Administration (BHA) and 988 Crisis Hotline Enterprise Board announced the launch of a campaign to increase awareness and utilization of the 988 Colorado Mental Health line. To inform the marketing campaign, BHA conducted research with youth, adults, and behavioral health referrers to provide feedback on the proposed messaging, website and creative directions.
  • New Jersey – Governor Phil Murphy announced that the state is eliminating $100 million in medical debt for approximately 50,000 residents by leveraging over $500,000 in American Rescue Plan Act funds. Eligible residents include those with incomes up to 400% of the federal poverty level or those with medical debt equal to 5% or more of their annual income. This effort is part of the $10 million appropriation included in the 2024 state budget for medical debt cancellation. For more information on state efforts to cancel medical debt, see a recent Health Affairs Forefront article and the SHVS expert perspective which tracks state cancellation efforts and prohibitions on medical debt reporting.
  • New Mexico – The New Mexico Health Care Authority announced the appointments of three new division directors. Jennifer Rodriguez will lead the Developmental Disability Supports Division; Dan Lanari will head the Division of Health Improvement; and Colin Baillio will direct Health Care Coverage Innovations. Congratulations to the team!
  • New York – Governor Kathy Hochul announced nearly $40 million has been awarded for the next phase of the Youth Employment Program, which aims to reduce gun violence by providing job opportunities and training to at-risk youth in communities across the state. The effort is part of New York’s Gun Involved Violence Elimination (GIVE) initiative.
  • North Dakota – North Dakota Health and Human Services announced the continuation of the Behavioral Health School Grant program for the 2024-2025 school year. This program is funded through an appropriation of $9.5 million from the 2023 legislative session. In the 2023-2024 school year, eligible school districts and special education units applied for grant funds totaling over $2.7 million for direct services, curriculum, and professional development, with over $1.9 million specifically directed towards behavioral health services for students.
  • Rhode Island – Governor Dan McKee signed into law a healthcare legislative package which includes protections such as the prohibition of medical debt reporting to credit bureaus, increasing access to mental health support, and enhancing the healthcare workforce.
  • Vermont – Governor Phil Scott and Human Services Secretary Jenney Samuelson announced the appointment of DaShawn Groves as the new Commissioner of the Department of Vermont Health Access, which is responsible for administering the Vermont Medicaid program and Vermont Health Connect, the state’s health insurance Marketplace. Groves most recently worked as the Special Projects Officer to the Medicaid Director at the Department of Health Care Finance for the District of Columbia. Congratulations DaShawn!