January 19 Update

In This Week’s Update:

  • Final 2022 NBPP Rule
  • No Surprises Act
  • COVID-19 State Updates: MI, NC, WA, WI 
  • Other State Updates: AZ, CO, NJ, OR, OH, PA, TX
  • Advancing Equity in the Nation’s COVID-19 Public Health Response and Recovery Efforts: Options for a New Administration
  • Immigrant Access to COVID-19 Vaccines: Key Issues to Consider

Final 2022 NBPP rule

The Centers for Medicare & Medicaid Services (CMS) issued a rule finalizing a number of proposed provisions for the annual Notice of Benefit and Payment Parameters for 2022 (the 2022 payment notice). State Health and Value Strategies (SHVS) is reviewing the final rule and will update its expert perspective on the considerations for state oversight of insurance markets and the state-based marketplaces. 

No Surprises Act

SHVS posted the slides and recording of the SHVS webinar held last Friday, The COVID-19 Relief Package and the “No Surprises Act”: Implications for States. As a complement to the webinar, SHVS also published a new expert perspective, The No Surprises Act: Implications for States, summarizing the provisions of the No Surprises Act that have implications for state regulators. SHVS also published a summary of the other health care provisions included in the 2021 Consolidated Appropriations Act, including COVID-19 relief and other Medicaid provisions. 

COVID-19 State Updates: MI, NC, WA, WI 

  • Michigan – The Michigan Department of Health and Human Services announced new guidance for schools. The state’s goal is to have all Michigan school districts offer an in-person learning option for students no later than March 1, and earlier if possible. 
  • North Carolina – The North Carolina Department of Health and Human Services is partnering with health systems, local health departments, and community health centers across the state to host large community vaccine events for people currently eligible to be vaccinated. More than 45,000 vaccines are expected to be given through these events.
  • Washington – Governor Jay Inslee signed the “Healthy Washington – Roadmap to Recovery” proclamation, which he had initially announced two weeks ago. The new plan eases some restrictions and outlines the metrics that will be used to determine phases for each region. The Department of Health will evaluate these metrics weekly and will announce any changes to current phase status every Friday.
  • Wisconsin
    • The Department of Health Services (DHS) has released two new data features on its COVID-19 vaccine data page. The first is a new visualization that shows the number of Wisconsinites who have successfully completed their COVID-19 vaccine series. The second new feature allows users to filter the COVID-19 vaccines administered per day graph by county or health care emergency readiness coalition region. These data represent where the individual who was vaccinated lives and include Wisconsin residents who have received a COVID-19 vaccine.
    • DHS also announced a newsletter the public can sign up for to get direct information about the COVID-19 response and vaccine rollout. Every Friday, a COVID-19 update newsletter will be sent via email to people who sign up to receive it. Registration is now open, and archived copies of the weekly newsletter will also be available.


Other State Updates: AZ, CO, NJ, OR, OH, PA, TX

  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) submitted its 1115 Waiver demonstration renewal request to CMS on Dec. 22, 2020. The final renewal packet, including a summary of the public comments received, can be found on the AHCCCS Waiver Renewal web page. The current demonstration expires on Sept. 30, 2021. AHCCCS is seeking a five-year extension of many existing demonstration authorities.
  • Colorado – The Colorado Department of Health Care Policy & Financing released the second edition of Reducing Prescription Drug Costs in Colorado – Cost Drivers and Solutions to Address Them. One of the key findings in the report is that less than two percent of the drugs being prescribed to Coloradans drive nearly 50 percent of total prescription drug expenditures.
  • New Jersey – The New Jersey Department of Human Services announced it has awarded 18 grants to help communities across the state develop and/or implement inclusive initiatives that support the health and well-being of individuals with disabilities where they live, work, learn, and play. The grant program will support communities and ensure that the voice and needs of people with disabilities are included in healthy community planning. 
  • Ohio – The Ohio Department of Medicaid announced Gainwell Technologies was selected to be the agency’s single pharmacy benefits manager (PBM). The single PBM is structured as a specialized managed care health plan that will be rewarded for patient wellness and health outcomes.
  • Oregon – The Implementation Committee for Oregon’s Sustainable Health Care Cost Growth Target Program adopted recommendations to the Legislature, including setting Oregon’s health care cost growth target at 3.4 percent for the first five years (2021-2025). The 3.4 percent target is based on historical economic data including Oregon’s gross state product and median wage. The committee will submit a full report detailing their recommendations to the Legislature.
  • Pennsylvania – Department of Human Services Secretary Teresa Miller announced that enrollment statewide for Medicaid has increased by 300,076 people since February 2020, for a total enrollment of 3,131,639 people since November—a 10.6 percent increase.
  • Texas – The Department of Health and Human Services is launching a new website featuring videos and the latest information and helpful resources to promote Texas Targeted Opioid Response, a statewide public health effort to fight against opioid addiction and overdose. The new website, TXopioidresponse.org, is available in English and Spanish and provides tips for safe opioid use, as well as information about the dangers of misusing prescription opioid medications.

Advancing Equity in the Nation’s COVID-19 Public Health Response and Recovery Efforts: Options for a New Administration

The presidential transition and the incoming Biden-Harris administration’s commitment to addressing the equity issues associated with the COVID-19 pandemic provide an opportunity to identify programmatic and policy approaches that can ensure the kind of participation in containment and prevention strategies that will address the disproportionate disparities in health outcomes related to race and class in this country. A new paper prepared by George Washington University, through a partnership with the Georgia Health Policy Center and with support from the Robert Wood Johnson Foundation, identifies the services that are essential to an equity-centric approach to the COVID-19 pandemic, as well as the infrastructure and workforce needed to ensure these services are available and have an equity focus. It reviews a set of administrative and legislative steps that the new presidential administration can take to strengthen the immediate response to the pandemic and address the long-term health and social needs the pandemic has exacerbated. Finally, it offers a strategy for “building back better” in the long term.


Immigrant Access to COVID-19 Vaccines: Key Issues to Consider

As COVID-19 vaccine distribution continues and expands to larger segments of the population, it is important to consider how to prevent disparities and ensure equitable access to the vaccine. Ensuring all individuals have access to the vaccine, and achieving a high vaccination rate across communities, will be necessary to mitigate the disproportionate impacts of the pandemic for underserved populations, prevent widening disparities going forward, and achieve broad population immunity. A new issue brief by the Kaiser Family Foundation provides an overview of key issues to consider for reaching noncitizen immigrants as part of COVID-19 vaccination efforts. The nearly 22 million noncitizen immigrants living in the U.S. today face increased risks and challenges associated with the pandemic. Many noncitizen immigrants work in essential jobs that are likely to be included in initial priority groups for COVID-19 vaccination, but they face a variety of potential barriers to obtaining the vaccine. As such, targeted efforts to reach noncitizen immigrants as part of vaccination efforts will be central for preventing disparities in vaccination.