February 18 Update

In This Week’s Update:

  • Interoperability and Patient Access Proposed Rule
  • State Updates: MN, MO, NJ, NM, NY, OH, PA, VA, & TX
  • Analysis of Premium Tax Credits in 2020 NBPP
  • 50-State Analysis of Drug Overdose Trends
  • Advancing Interoperability

Proposed Interoperability and Patient Access Rule

Last week, the Centers for Medicare and Medicaid Services announced proposed policy changes supporting its MyHealthEData initiative to improve patient access and advance electronic data exchange and care coordination throughout the health care system.  The Interoperability and Patient Access Proposed Rule outlines opportunities to make patient data more useful and transferable through open, secure, standardized, and machine-readable formats while reducing restrictive burdens on healthcare providers.

State Updates: MN, MO, NJ, NM, NY, OH, PA, VA, & TX

  • Minnesota – Commissioner Tony Lourey appointed Marie Zimmerman as Assistant Commissioner for Health Care and Minnesota’s Medicaid Director. In her role, Marie will oversee and lead Minnesota’s Medicaid program, Medical Assistance, and its Basic Health Plan, MinnesotaCare. Most recently, Marie served as a Vice President at Hennepin Healthcare, but prior to that she served as Minnesota’s state Medicaid director for four years.
  • Missouri – The Department of Social Services released the results of an independent evaluation of the Missouri Medicaid program. The Rapid Response Review examined the entire Medicaid program, including health care outcomes, participant experiences, operational efficiencies and cost management and identifies challenges within the current program and opportunities to continue to modernize the Medicaid program.
  • New Jersey – New Jersey Department of Health (NJDOH) Commissioner Dr. Shereef Elnahal announced that the NJDOH is investing $7 million in a youth education campaign and ‘Youth Action Teams’ that are developing social media messages to prevent middle and high school students from using JUUL and other e-cigarette products. The announcement came as a result of findings from a new report on the rising rates of youth e-cigarette and tobacco use by the Centers for Disease Control and Prevention. The funding will be used to support 11 regional “quit centers” in counties with the highest incident of cancers and tobacco related diseases as well as the NJ Quitline.
  • New Mexico
    • Last week, the New Mexico State Senate unanimously confirmed David R. Scrase, M.D. as Secretary of the Human Services Department. Secretary Scrase most recently served as a Professor of Internal Medicine and Geriatrics at the University of New Mexico (UNM) School of Medicine.
    • Governor Michelle Lujan Grisham directed the state Human Services Department (HSD) to seek federal approval to reverse several policy decisions previously made on the state’s Medicaid program that would impact nearly 700,000 New Mexicans. In a letter sent by HSD to the Centers for Medicare and Medicaid Services, the state requested reversal of co-payments for beneficiaries for non-emergency use of the hospital emergency department and non-preferred prescription drugs, premiums for members of the Medicaid Adult Expansion Group, and limitations on retroactive eligibility.
  • Ohio – The Ohio Department of Medicaid (ODM) released a request for proposals for actuarial services for Medicaid Managed Care. ODM is seeking a contractor to assist in gathering and analyzing data to develop program decisions and payment updates to achieve the goal of fiscal soundness and access to quality care.
  • Pennsylvania
    • Governor Tom Wolf announced his administration, through the departments of Human Services and Health, is awarding five grantees $3 million in support for community health workers in North Philadelphia’s Health Enterprise Zone (HEZ). These programs created projects that will use community health workers to address health disparities in children, older adults, and those who are frequent users of medical services by increasing health promotion and education in the HEZ.
    • The Department of Human Services is planning to expand the Living Independence for the Elderly (LIFE) Program LIFE to serve additional counties to satisfy participant needs and interest. The Department’s goal is to have LIFE services available across all of the Commonwealth. The Department will solicit information from organizations interested in serving additional counties.
  • Virginia – The Virginia Department of Medical Assistance Services (DMAS) is seeking participants for a new Medicaid Member Advisory Committee. This advisory committee — made up entirely of Virginia Medicaid members, family members or other representatives — will play a key role in the review of new and existing health policies and services, making recommendations to the DMAS Director. The committee will meet quarterly, with the first meeting taking place in March.
  • Texas – The Texas Health and Human Services department, working with state partners, announced an updated the School-Mental Health Resource Guide. The guide provides a reference list and other resources to help parents and teachers find assistance for children with behavioral health needs.

Analysis of Premium Tax Credits in 2020 NBPP

Jason Levitis published a piece for Brookings addressing the premium tax credit changes in the proposed Notice of Benefit and Payment Parameters (NBPP) for plan year 2020. The piece summarizes policy concerns related to proposed changes in the methodology to index parameters of several provisions of the Affordable Care Act (ACA)  and then examines whether these changes may be vulnerable to legal challenge. As a reminder, State and Health Value Strategies hosted a webinar last month on the proposed 2020 NBPP. Webinar slides and a recording can be accessed here. Comments on the proposed rule are due February 19, 2019.


50-State Analysis of Drug Overdose Trends

A new analysis (including two-page state-specific fact sheets) out of the University of Minnesota State Health Access Data Assistance Center (SHADAC) looks into the evolving opioid crisis across the states. Researchers found wide state variation in opioid overdose death rates and pointed to evidence that the crisis is expanding beyond opioids, to involve non-opioid illicit drugs including cocaine and psychostimulants (e.g., methamphetamine).

Advancing Interoperability, Information Sharing, and Data Access: Improving Health and Healthcare for Americans

A new report by the Healthcare Leadership Council (HLC) and the Bipartisan Policy Center (BPC) examines ways to further advance the interoperability of systems and electronic information sharing to support better health outcomes and higher-quality, safer, more cost-effective, and patient-centered care for individuals. HLC and BPC drew upon the experiences and expertise of more than 100 individuals representing various sectors of health care, including clinicians, hospitals and health systems, health plans, EHR and other technology developers, data analytics companies, and patients. The report prioritizes two areas: (1) bringing information to the point of care to support care delivery and (2) meeting the information needs of individuals to support their health and healthcare.