February 3 Update

In This Week’s Update:

  • CMS Guidance on Capped Medicaid Funding
  • Public Charge Rule Moving Forward
  • State Updates: HI, IL, NC, NV, NY & OR
  • 2021 Notice of Benefit and Payment Parameters
  • Advancing the Health Sector’s Role in Housing
  • Data on Maternal Mortality in the U.S.


CMS Guidance on Capped Medicaid Funding

Last week, the Centers for Medicare & Medicaid Services (CMS) issued guidance inviting states to apply for capped funding Medicaid demonstrations. State Health and Value Strategies (SHVS) published a brief on the state implications of this guidance and is hosting a webinar for state officials on Thursday, February 6 from 2 p.m. to 3 p.m. that will provide states with an initial analysis of the CMS guidance and discuss the potential implications for states.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e96dce66dee26ee122d26360802217094


Public Charge Rule Moving Forward

Last week, in a 5-4 decision, the Supreme Court allowed the Department of Homeland Security’s (DHS) public charge final rule to go into effect. As a result of the ruling, the government will move forward on February 24, 2020 with its changes to public charge in all states except Illinois, where an injunction applicable only to that state continues to be in effect. Last fall, SHVS conducted a webinar on the final rule and its implications for states. A slide deck and recording of the webinar as well as an FAQ are available on the SHVS website.


State Updates: HI, IL, NC, NV, NY & OR

  • Hawaii – The Hawaii Department of Human Services awarded managed care contracts to AlohaCare, Hawaii Medical Service Association (HMSA), United, and Ohana Health Plan/WellCare. AlohaCare and WellCare will serve Oahu, while HMSA and United will serve statewide. The new contracts begin July 1, 2020 and run through December 31, 2025, with four optional renewal years.
  • Illinois
    • Governor J.B. Pritzker signed SB 667 into law, which caps out-of-pocket insulin costs at $100 for a 30-day supply. The majority of the law’s provisions go into effect in January 2021. However, provisions requiring an insulin pricing report take effect immediately.
    • Executive Order 2020-02 issued by Gov. Pritzker establishes the Governor’s Opioid Overdose Prevention and Recovery Steering Committee to better address racial disparities in responding to the opioid crisis. Illinois is also dedicating $4.1 million state dollars to expand recovery and prevention services for individuals with opioid use disorder across the state.
  • Nevada – The Division of Health Care Financing and Policy released a notice announcing that the Division will be gathering stakeholder comments and feedback on initiatives under consideration to enhance the state’s Medicaid managed care program. The Division intends to issue the next managed care request for proposals in January 2021.
  • New York – NY State of Health, the state’s official health insurance marketplace, announced that consumers will have an additional week to enroll in a Qualified Health Plan for 2020. The Open enrollment deadline has been extended until February 7 to provide consumers with more time to enroll.
  • North Carolina – Mental health leadership at the Department of Health and Human Services will be traveling across North Carolina over the next several months on a mental health town hall listening tour to hear the concerns and experiences of consumers, families, and advocates. Meetings will be held in Wilmington, Winston-Salem, and five other locations to be announced.
  • Oregon – Governor Kate Brown announced the membership of the Vaping Public Health Work Group, assembled by EO 19-09, to address the epidemic of vaping-related illness and youth vaping in Oregon. The Work Group will discuss the health risks of vaping and make public policy recommendations for long-term solutions to address the vaping epidemic.


2021 Notice of Benefit and Payment Parameters

CMS released its proposed 2021 Notice of Benefit and Payment Parameters rule, which sets requirements and standards for Affordable Care Act insurance reforms and the health insurance marketplaces. Among other items, the rule proposes maintaining 2020 user fee levels for the operation of Healthcare.gov (although they seek comment on whether they should lower those rates), recalibrating the risk adjustment methodology to reduce burdens on small insurers, and making modest adjustments to special enrollment period policies. The proposed rule would also require states to annually report on state benefit mandates that are in addition to the essential health benefits and would allow insurers to discount the use of drug manufacturers’ coupons in calculating an enrollee’s annual maximum out-of-pocket costs. CMS seeks comment on whether enrollees who automatically re-enroll should have their premium tax credits reduced to $0 unless they return to the marketplace for a new eligibility determination. Public comments are due by March 2, 2020.


Advancing the Health Sector’s Role in Housing

The Center for Budget and Policy Priorities recently published two papers and a Health Affairs blog post describing how the health sector can help address patients’ housing needs. The first paper examines how Medicaid can work with housing providers and others to address social needs. The second explores how housing and health partners can collaborate to close the housing affordability gap. The Health Affairs blog summarizes the key points in the two papers along with some policy recommendations. For those interested in the topic, SHVS also recently published an issue brief, State Investments in Supportive Housing.


Maternal Mortality in the United States

The Center for Disease Control and Prevention’s National Center for Health Statistics (NCHS) issued three new reports on maternal life expectancy and mortality in 2018. The reports describe changes in how NCHS will code, publish, and release maternal mortality data and present official 2018 maternal mortality estimates using a new coding method. The analysis includes state-specific changes in maternal mortality rates associated with implementing the new method. Additionally, wide racial and ethnic gaps were highlighted by the new coding method. The reports found that the maternal death rate for non-Hispanic black women was more than double than that of white women: 37.1 deaths per 100,000 live births compared to 14.7. It was also more than three times the rate for Hispanic women (11.8). The new coding method is intended to mitigate errors in data collection and provide an improved estimate of maternal mortality moving forward.