December 3 Update: Section 1332 Waiver Concepts Released; Report on Reinsurance; Implementing Trauma-Informed Care

Section 1332 waivers were in the health care policy news spotlight this week. On Thursday, Centers for Medicare & Medicaid Services (CMS) Administrator Seema Verma announced the release of four waiver concepts designed to illustrate how states can waive certain Affordable Care Act provisions under Section 1332 of the law. For more information about the four waiver concepts, see this CMS fact sheet and a discussion paper, which describes each concept in detail. Manatt Health have written an Expert Perspective for State Health and Value Strategies on the new waiver concepts that breaks down the potential new options for states.

In case you missed it, last week State Health and Value Strategies hosted a webinar on the proposed rule governing health reimbursement arrangements (HRAs). The webinar explored the implications for states and possible state responses. The slide deck as well as a recording of the webinar are available here. Updates follow.

  • Alaska – The Alaska Department of Health and Social Services (DHSS) announced the release of the 2018- 2022 Statewide Opioid Action Plan, which provides a collaborative blueprint for DHSS, other state agencies and partner organizations to address the state’s opioid epidemic. The five-year action plan was developed with broad input from multiple agencies and community partners.
  • Maryland – Maryland Health Connection, the state’s official health insurance marketplace, is hosting free enrollment events across the state the weekend of December 4 with partner Seedco who will provide consumers with expert help to understand their coverage options and the financial assistance available.
  • New York – The New York State Office of Alcoholism and Substance Abuse Services announced “We Can’t Lose Anyone Else,” a bi-lingual campaign designed to inform and educate New Yorkers about opioid addiction and the resources available to help. The campaign includes three public service announcement videos that will air on television statewide beginning November 26 for four weeks. The PSAs are available to view here.
  • North Carolina
    • Governor Roy Cooper announced that an additional 1,200 pharmacies will participate in the Controlled Substance Reporting System. North Carolina is also activating a digital gateway to provide pharmacists and prescribers one-click access to patient information and data to identify those at risk for prescription drug addiction, overdose and death.
    • The North Carolina Department of Health and Human Services is accepting comments on the draft North Carolina Early Childhood Action Plan through December 21. The Action Plan focuses on improving outcomes related to the health, safety and well-being, and developmental and academic readiness, for children from birth to age eight.
  • Oregon – The Oregon Drug Use Review/Pharmacy & Therapeutics Committee, which advises the Oregon Health Authority on prescription drug coverage, recommended a change in prior authorization criteria which will expand treatment access to all Oregon Health Plan patients with chronic hepatitis C, without fibrosis restrictions.
  • Pennsylvania – The Department of Human Services’ Refugee Resettlement Program hosted its third annual Refugee Health Conference for service providers to discuss how providers can better serve refugee populations and help them through the transitions to resettlement.
  • South Carolina – Effective January 1, 2019, South Carolina Department of Health and Human Services proposes to amend their State Plan to include covered services for opioid treatment programs. These services provide medically necessary treatment to eligible Medicaid beneficiaries with a confirmed diagnosis of opioid use disorder.
  • Tennessee – The state submitted a request to CMS to amend the TennCare Demonstration to integrate behavioral health services with home and community-based services at the provider and service delivery level for beneficiaries with both intellectual and developmental disabilities and extremely challenging behavioral support needs. Federal comments on the proposed amendment will be accepted through December 23.

Considering Reinsurance? New Report Assesses Effectiveness of State-Based Reinsurance in Three States

Georgetown’s Center on Health Insurance Reforms released a new report this week that evaluates progress in three states—Alaska, Minnesota and Oregon–that have operational reinsurance programs. To assess the effectiveness of these programs, the report’s authors reviewed rate filings and 1332 waiver applications and interviewed state regulators and insurer representatives in all three states to determine whether the programs have met their stated goals. The report outlines how these three state reinsurance programs have been largely effective, directly reducing individual market premiums and maintaining insurer participation in the marketplace. Additionally, the report includes insight from stakeholders on the challenges they faced and lessons learned from instituting a state reinsurance program.

New Resource for States Interested in Applying for Integrated Care for Kids Grants

A new website has been launched to serve as a resource to states and Medicaid agencies in reviewing and applying for the new Integrated Care for Kids (InCK) competitive grant model. The website includes a guiding framework, a description of the basics of the InCK Model, tips on getting started in state planning, and a beginning compilation of resources around different key issues in child health policy transformation under Medicaid. The Center for Medicare and Medicaid Innovation (CMMI) will award eight states $16 million each to support transformation of their Medicaid child health programs through both more preventive services and alternative payment models for children experiencing high health costs.

Website Shares Resources for Implementing Trauma-Informed Care

Developed by the Center for Health Care Strategies with support from the Robert Wood Johnson Foundation, the new Trauma-Informed Care Implementation Resource Center offers a one-stop information hub for health care providers and other stakeholders interested in implementing trauma-informed care. It houses resources developed by experts from across the field, including foundation knowledge regarding the impact of trauma on health and trauma-informed care and information for state and federal policymakers interested in supporting trauma-informed care.