December 7 Update

In This Week’s Update:

  • New SHVS Expert Perspectives
  • COVID-19 State Updates: AZ, ME, OH, OR & PA
  • Other State Updates: OK, TX & WI
  • Webinar: Supporting Children and Youth with Special Health Care Needs During COVID-19
  • COVID-19 & State Medicaid Budgets
  • Systemic Racism & Health Care, COVID-19 & Treatment
  • Building Racial Equity Into The Walls Of Health Policy


New SHVS Expert Perspectives

Last week, State Health and Value Strategies (SHVS) published two new expert perspectives. Proposed 2022 Notice of Benefit & Payment Parameters: Implications for States provides an overview of the proposed 2022 Notice of Benefit and Payment Parameters rule and highlights provisions that have implications for state oversight of insurance markets and state-based marketplaces. Additionally, the expert perspective Audio-Only Medicaid Telehealth Policies discusses the legal authority that permits states to continue to authorize Medicaid reimbursement for audio-only telehealth after the public health emergency ends.


COVID-19 State Updates: AZ, ME, OH, OR & PA

  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) covers all forms of telehealth services including asynchronous, remote patient monitoring, teledentistry, and telemedicine. As a result of COVID-19, between November 2019 and November 2020, AHCCCS has seen a 165 percent increase in telehealth utilization. The AHCCCS Medical Coding Resources was recently updated with additional medical coding information and guidance.
  • Maine – Governor Janet Mills and Health and Human Services Commissioner Jeanne Lambrew announced a grant program to support health care organizations that serve residents with MaineCare. Backed by $30 million in Federal CARES Act Coronavirus Relief Funds (CRF), the Maine Health Care Financial Relief Program is a new opportunity modeled on the Maine Economic Recovery Grant program. Health care organizations that were ineligible for funding under that program may apply for the new grants.
  • Ohio – The Ohio Department of Medicaid is joining forces with the five Medicaid managed care organizations and Area Agencies on Aging to support Ohioans most vulnerable to COVID-19. From now through the holidays, individuals living in nursing and assisted living facilities can receive additional social and emotional supports through a joint “friendly caller” initiative.
  • Oregon – The Oregon Health Authority released new data analysis showing how COVID-19 impacted the health care system during the first half of 2020. Data show that hospitals and other providers saw a large decline in utilization during the late spring, which led to significant drops in revenue. Drops in utilization led to fewer payouts for coordinated care organizations and commercial insurers, both of which ended the quarter with increased revenue compared to 2019.
  • Pennsylvania – Governor Tom Wolf announced the award of $3 million in grant funding to 15 municipalities and organizations to assist Pennsylvanians currently experiencing homelessness. Under the program, funding will be provided for emergency shelter and temporary emergency shelter to expand shelter for those experiencing homelessness in the wake of the coronavirus pandemic. The funds will be used to assist communities and homeless providers prepare for, prevent the spread of, and respond to the pandemic by providing emergency shelter, targeted street outreach, and temporary emergency shelter for individuals experiencing homelessness this winter.


Other State Updates: OK, TX & WI

  • Oklahoma – The state submitted an amendment application and a phase-out plan for the Insure Oklahoma (IO) program of the SoonerCare demonstration. The amendment and phase-out plan seek to modify the IO program by phasing out the IO Individual Plan and establishing a new income band for the IO Employer-Sponsored Insurance. These changes are requested in response to the new state Medicaid expansion. The federal public comment period will be open through Dec. 31, 2020.
  • Texas – The Texas Health and Human Services Commission announced its intent to submit to the Centers for Medicare & Medicaid Services a Section 1115 waiver extension application to continue the state’s Medicaid managed care programs, including STAR, STAR+PLUS, and STAR Kids, through Sept. 30, 2027. The waiver extension request seeks to support the development of a coordinated care delivery system, to improve outcomes while containing cost growth, and to transition to quality-based payment systems across health plans and providers.
  • Wisconsin – The state is requesting an amendment to its section 1115 demonstration “SeniorCare” to expand the targeted prescription drug benefit offered under the demonstration to include coverage of vaccinations recommended by the Advisory Committee on Immunization Practices (ACIP) for administration to adults. The federal public comment period is open through Jan. 1, 2020.


Webinar: Supporting Children and Youth with Special Health Care Needs During COVID-19

Tuesday, Dec. 15, 2020, 1:00 to 2:00 p.m. EST

The COVID-19 pandemic has created significant health and economic hardships for many children and families—particularly children and youth with special health care needs. Children who receive health services in school settings to support their education are losing access to those services. A pre-COVID-19 shortage of home health providers has worsened due to the pandemic, placing a significant burden on families who rely on home health services. The result is gaps in care and caregiver burnout, putting children and youth with special health care needs at risk of regression and long-term negative health outcomes. Recognizing these risks, states and the federal government have broadly expanded telehealth coverage, established continuous coverage requirements and eased regulatory requirements for delivery of services. SHVS is hosting a webinar, produced by Manatt Health, the American Academy of Pediatrics, Family Voices, and the Georgetown Center for Children and Families with funding from the Robert Wood Johnson Foundation and the Lucile Packard Foundation for Children’s Health, that will explore strategies for state Medicaid agencies to enforce coverage requirements and make permanent the temporary regulatory flexibilities that have expanded access to services during the pandemic. To request accommodations due to disability for this event, please contact Stephanie Benjamin ( at least 48 hours in advance.

Registration (required) at the following link:


COVID-19 & State Medicaid Budgets: How Short-Term Cuts Could Result in Long-Term Harm to Children

As state policymakers grapple with COVID-19 and the accompanying recession, access to continuous health coverage for children could be at risk, leaving access to care for millions of children nationwide in question during a global pandemic. The Commonwealth Fund and the Georgetown University Center for Children and Families will host a briefing with experts on Wednesday, Dec. 9 to discuss the findings of a new issue brief and the importance of ensuring stable health coverage to children and families. The briefing will cover a summary of new research on the long-term benefits of Medicaid coverage for children and birthing people; projections of the impact of state Medicaid cuts on state health care systems; and Medicaid’s return on investment for the state and federal government, as well as the broader societal returns. 


Systemic Racism & Health Care, COVID-19 & Treatment

Discrimination and bias in the health care system has contributed to the pandemic’s dramatic impact on Black, Latino, and Native American populations. These communities have faced disproportionate numbers of cases, hospitalizations, and/or deaths while experiencing documented barriers to testing and treatment. The National Institute for Health Care Management (NIHCM) Foundation published an infographic that explores the history of racial bias and discrimination in health care and during the pandemic, outlines short-term strategies to narrow disparities from COVID-19 and respond to vaccine hesitancy, and highlights long-term strategies to address systemic racism and improve health outcomes. As a reminder, SHVS has a webpage dedicated to sharing health equity resources for states, including its latest publication that highlights State Strategies for Overcoming Barriers to Advance Health Equity.


Building Racial Equity Into The Walls Of Health Policy

A new Health Affairs blog post authored by Dr. Nathan Chomilo, Medical Director for the State of Minnesota’s Medicaid program and a practicing pediatrician and internal medicine hospitalist with Park Nicollet Health Services/HealthPartners, highlights how racial equity can be built into research and policy and why this is an important step as states and policymakers seek to dismantle structural racism in the health care system. Dr. Chomilo notes several examples of how stakeholders can assess research and policy for racial equity at the start. These examples include 1) requiring a racial equity assessment at the start of the development of research proposals aimed at answering policy questions to help ensure investigators have, at the very least, stopped to ask how their work may or may not contribute to structural racism or advance racial justice and 2) improving and standardizing ways to collect race, ethnicity, and language (REL) demographic data for not only public payers such as Medicare and Medicaid but all health insurers, social safety-net programs, and education systems. As a reminder, an SHVS expert perspective, Exploring Strategies to Fill Gaps in Medicaid Race, Ethnicity, and Language Data, provides an overview of current REL data collection standards and provides suggestions for how states could leverage alternative sources of data in order to improve REL data completeness.