August 3 Update: CMS issues final rule for short-term plans; New SHVS issue brief on risk-bearing provider organizations; Advancing infant and early childhood mental health

This week, the Departments of Health and Human Services, Labor, and Treasury issued a final rule clarifying the definition of, and expanding access to, short-term, limited-duration insurance coverage (short-term plans). The rule extends the federally permissible duration of short-term plans to up to 12 months, clarifies that renewals or extensions are permitted for up to 36 months, and proposes a standard disclosure that would advise consumers that the coverage was not required to comply with the Affordable Care Act’s consumer protections. The new rule is effective 60 days after publication in the federal register, such that short-term plans could be available for sale by early October. State Health and Value Strategies posted an expert perspective on our website authored by our friend and colleague Sabrina Corlette from Georgetown’s Center on Health Insurance Reforms that provides a summary of the final rule and options for states. Updates follow.

  • Kentucky – Citing “inconsistent implementation of co-pays among MCOs,” the Cabinet for Health and Family Services announced that it is suspending enforcement of co-payments for managed care.
  • Maine – On Monday, the state’s Section 1332 waiver request to implement a reinsurance program was approved by the Centers for Medicare & Medicaid Services (CMS). We have updated our map tracking 1332 waiver activity.
  • New Hampshire – CMS is accepting comments on the state’s application to extend its 1115 demonstration for the next five years through September 2, 2018. In the application, New Hampshire is requesting to provide beneficiaries health care through the state’s managed care system rather than the current Premium Assistance Program, among other changes to the program.
  • New York – Governor Andrew M. Cuomo announced the launch of “Able New York,” a multi-agency initiative that will emphasize enhanced accessibility to state programs and services for New Yorkers with disabilities. The Department of Health will lead the first phase of the initiative with a series of policies aimed at supporting community living for New Yorkers with physical disabilities.
  • Oregon – The Oregon Health Authority announced the publication of the State Health Assessment, published every five years. The current report finds that while Oregon has made gains on reducing rates of opioid-related deaths and HIV infections, social factors such as housing affordability, food insecurity and educational outcomes are undermining improvements in health outcomes.
  • Pennsylvania – Insurance Commissioner Jessica Altman sent a letterto the U.S. Departments of Labor and Health and Human Services outlining the state Insurance Department’s position on the implementation of a federal rule aiming to expand association health plans. The Commissioner also issued a statement on the final rule expanding short-term limited duration health plans.
  • Wisconsin – On Sunday, CMS announced the approval of Wisconsin’s Section 1332 waiver application to implement a reinsurance program. We have updated our map with a link to the letter from CMS.

New SHVS Issue Brief: Risk-Bearing Provider Organizations

This week, SHVS published a new issue brief, Safeguarding Financial Stability of Provider Risk-Bearing Organizations, which explores options for states as they consider oversight of risk-bearing organizations (RBOs), with a focus on states that have elected to act to protect against provider insolvency. An accompaniment to the issue brief, Case Studies: State Examples of Safeguarding Financial Stability of Provider Risk-Bearing Organizations, provides a deeper dive into approaches in four states: California, Massachusetts, New York and Texas. Bailit Health will present the issue brief to the Regulatory Framework B Task Force tomorrow at the National Association of Insurance Commissioners’ Summer National Meeting in Boston, Massachusetts.

Advancing Infant and Early Childhood Mental Health

The ZERO TO THREE Policy Center released a new paper, Advancing Infant and Early Childhood Mental Health: The Integration of DC:0-5™ Into State Policy and Systems, that discusses why and how states are integrating DC:0-5 into state policy and systems. DC:0-5, published by ZERO TO THREE in December 2016, is a tool used by clinicians to accurately diagnose and classify infant and early childhood mental health disorders. The paper provides examples of some of the strategies that states have used to allow, promote, or require the use of DC:0-5, and provides recommendations for further improvements in state infant and early childhood mental health policy and practice. For those interested in more information on DC:0-5, please see DC:0-5™: Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood: A Briefing Paper.

Leading Through Emergencies: A Toolkit for Medicaid Directors

Our friends and colleagues at the National Association of Medicaid Directors released a toolkit for Medicaid directors and their staff to help lead their agencies through emergency situations. It provides high-level information intended to support their decision making before, during, and post-emergency. Based on consultations with state officials in California, Florida, Louisiana, Oklahoma, and Texas, the resource features background on available authorities, including Section 1135 waivers; an emergency checklist, encompassing mitigating strategies for before, during, and after crisis; and key emergency tips and strategies for states.

State Strategies to Incorporate Oral Health into Medicaid Payment and Delivery Models

The National Academy for State Health Policy released a report recommending first steps to integrating oral health into Medicaid health home or other payment and delivery models for adults and children with high-costs or chronic conditions. The report is based on interviews with Medicaid officials in six states (Alabama, Missouri, Ohio, Rhode Island, South Dakota, and Washington) and identifies key policy questions and considerations, as well as promising state strategies and “early wins” to help improve oral health for those with chronic or high-cost medical conditions.