February 20 Update

In This Week’s Update:

  • Opportunities to Advance Equitable Maternal Care
  • New Translated Communications Resources
  • Transforming Maternal Health 
  • Annual Medicaid Managed Care Organization Survey
  • Consumer-Centric Approach to State-Based Marketplaces
  • State updates: AZ, CA, CO, MD, MN, MT, NC, NM, NV, NY, OR & PA


Opportunities to Advance Equitable Maternal Care

Last week, State Health and Value Strategies (SHVS) published a new issue brief that spotlights the opportunity to enhance health equity in maternity care through payment. The issue brief discusses the landscape of Medicaid reimbursement trends for midwifery and doula coverage and recommends strategies to enhance access to a diversity of maternal care providers through equitable reimbursement.


New Translated Communications Resources 

Also last week, SHVS published translated versions of communications resources to help states encourage renewal completions in the final months of unwinding the Medicaid continuous coverage requirement. As a reminder, these messages and social graphics were informed by consumer research. The resources are available in Spanish, Chinese, French, French Creole, German, Gujarati, Hindi, Italian, Japanese, Korean, Polish, Portuguese, Russian, Tagalog and Vietnamese. Updates follow.

Transforming Maternal Health
CMS will host a Transforming Maternal Health (TMaH) Model overview webinar on Wednesday, February 28, 2024 at 1:00 p.m. ET. TMaH aims to improve maternal healthcare by partnering with state Medicaid agencies to develop a whole-person approach to pregnancy, childbirth and postpartum care that addresses the physical health, mental health, and social needs experienced during pregnancy. State Medicaid agencies and other interested stakeholders, such as maternity care providers and managed care plans, are encouraged to attend the webinar to learn more about the TMaH model’s structure, care delivery transformations, and resources available to participants.

Annual Medicaid Managed Care Organization Survey

The Institute for Medicaid Innovation released its annual Medicaid managed care organization survey. Supported by the Robert Wood Johnson Foundation, the 12 sections of the survey contain questions identified through workgroups and committees to elicit responses that will ultimately support the work of policymakers, researchers, and health plan representatives. This year, the survey features an in-depth look at how health plans are incorporating sexual orientation and gender identity, transgender healthcare, gender-affirming services, and other relevant issues into their coverage.


Consumer-Centric Approach to State-Based Marketplaces

A decade after the Affordable Care Act was passed, millions of Americans have accessed and enrolled in high-quality, affordable health insurance coverage through State-Based Marketplaces (SBMs). New York was among the original states to establish an SBM and one of the first states to implement a “single point of entry” model for consumers. A recent article from Maximus reflects on the efforts to stand up the state’s SBM, what changed over the last decade, and what lies ahead for states that are transitioning from the federal exchange to their own SBM.


State updates: AZ, CA, CO, MD, MN, MT, NC, NM, NV, NY, OR & PA

  • Arizona – The Arizona Health Care Cost Containment System released a request for proposals (RFP) for a Housing and Health Opportunities (H2O) Program Administrator. The H2O program, scheduled for implementation on October 1, 2024, is aimed at expanding housing services for Medicaid enrollees who are homeless or at risk of becoming homeless. 
  • California – The Department of Health Care Services (DHCS) published quality ratings and imposed monetary sanctions on Medi-Cal managed care plans (MCP) that do not meet required performance levels. These actions are bolstered by the new MCP model contract that took effect on January 1, 2024 and strengthen quality and health equity requirements for MCPs. Additionally, for the first time, DHCS is releasing quality ratings for county behavioral health plans, based upon performance.
  • Colorado 
    • The Colorado Department of Health Care Policy & Financing (HCPF) launched its Payment Variation Tool for employer groups, insurance purchasers and business leaders. The new tool uses claims data to compare hospital inpatient payments statewide and identify low-cost providers by filtering medical procedure codes. 
    • HCPF will host a kick-off meeting to engage stakeholders about how Colorado’s Medicaid program and Child Health Plan Plus can better support the health-related social needs (HRSN) of members. Topics will include HRSN initiatives underway at HCPF, national opportunities, collaborations across the state, and the collection of input from attendees on their priorities.
  • Maryland – Governor Wes Moore announced two investments to improve access to abortion care statewide. First, the administration has allocated $5 million for fiscal year 2025 to increase Medicaid provider reimbursement for abortion care and reproductive services. Second, the Maryland Department of Health has awarded a $10.6 million grant to the University of Maryland, Baltimore, to administer Maryland’s Abortion Care Clinical Training Program.
  • Minnesota – The Department of Human Services released an RFP to develop and/or provide services for older Minnesotans to live and age in the community of their choice. Awards will allow communities to develop the capacity and maintain culturally competent home and community-based services for individuals aged 65 and older who are at-risk of long-term nursing facility use and/or spending down into Medical Assistance.
  • Montana – The Department of Public Health and Human Services is accepting proposals for a $10 million, one-time grant program aimed at increasing residential bed capacity for providers of congregate community living that primarily serve individuals living with a serious mental illness or developmental disability diagnosis.
  • Nevada – CMS and the Department of the Treasury have determined Nevada’s section 1332 waiver application complete and opened a 30-day federal public comment period, which will be open through March 14, 2024. If approved, the waiver will establish a public option program and a market stabilization program in the state.
  • New Mexico – The New Mexico Senate unanimously confirmed Kari Armijo as the Cabinet Secretary for the New Mexico Human Services Department. Prior to leading the Human Services Department, Secretary Armijo worked for the department for more than two decades. Congratulations Kari! 
  • New York – Governor Kathy Hochul announced the opening of a new mobile medication unit (MMU) to provide substance-use treatment services in the South Bronx. MMUs offer a wide range of services and are authorized to dispense medication to treat substance-use disorders, including methadone and buprenorphine. Such sites are designed to reach individuals who may face barriers to accessing traditional treatment.
  • North Carolina – The North Carolina Department of Health and Human Services is investing $5.5 million into the FIT Wellness program, part of the North Carolina Formerly Incarcerated Transition Program, to improve reentry services for the justice involved population. FIT Wellness delivers psychiatric and physical healthcare services along with connections to community supports such as housing, transportation and phones for people in the state prison system who have serious mental illness.
  • Oregon – CMS approved Oregon’s protocol for how HRSN benefits will be delivered under the state’s section 1115 Medicaid waiver demonstration. The protocol, effective through September 30, 2027, provides detailed requirements for the state’s HRSN services including member eligibility and provider qualifications.
  • Pennsylvania – The Department of Human Services released a bulletin to inform providers that, effective February 1, 2024, certified perinatal doulas may enroll in the Medicaid program, which will enable managed care organizations to enter into network agreements with doulas.