January 7 Update: Texas v. Azar; Final Open Enrollment Period Snapshot; Medicaid Webinars; Tracking Section 1115 Waivers

Over the holidays, Judge Reed O’Connor issued a stay and partial final judgment in Texas v. Azar. Doing so allowed the parties to immediately appeal his recent decision to invalidate the entire Affordable Care Act (ACA) to the Fifth Circuit Court of Appeals. The December 30th ruling ensures the ACA remains fully in effect in all 50 states and DC. Following the decision, on January 3rd. 16 states and the District of Columbia filed an appeal to the Fifth Circuit Court of Appeals. Check out this Health Affairs blog post for background on the case and an update on the legal proceedings.

In case you missed it, the Centers for Medicare & Medicaid Services (CMS) released the final snapshot for the federal health insurance exchange 2019 open enrollment period, showing steady enrollment with more than 8.4 million consumers enrolled.  By comparison, 8.7 million people had enrolled at the same time last year. CMS will release additional data in March, including final plan selection data from state-based exchanges. Updates follow.

  • Arizona – Governor Doug Ducey announced the appointment of Jami Snyder as the director of the Arizona Health Care Cost Containment System (AHCCCS). Snyder has served as deputy director of AHCCCS since December of 2017 and replaces Tom Betlach.
  • Colorado – The Department of Health Care Policy and Finance released its Fiscal Year 2017 – 18 Annual Report, which includes data on who the Department serves, analyses of the Department’s expenditures as well as profiles of individual beneficiaries.
  • Maine – On her first day in office, Governor Janet Mills signed Executive Order Number 1, directing the Maine Department of Health and Human Services to begin implementation of Medicaid expansion as passed by Maine voters. Governor Mills also wrote to federal officials requesting the formal approval of the State Plan Amendments filed by the previous administration and amended by her administration.
  • Minnesota – MNsure, the state’s official health insurance marketplace, reminded consumers that they have until January 13 to sign up for coverage effective February 1. As a state-based marketplace, Minnesota has an extended open enrollment period.
  • New Jersey – Legislation establishing the New Jersey Caregiver Task Force was signed into law. The Task Force will evaluate support services available to caregivers, recommend improvements and expansion of such services, and is required to provide an initial report within a year of its organization.
  • Oregon – The Oregon Health Authority awarded a total of $49,000 to seven community-based agencies to help inform the priorities for the next State Health Improvement Plan. Funded agencies will use the $7,000 “mini-grants” to host community events and listening sessions, and disseminate surveys to get feedback from communities most affected by health disparities.
  • Virginia – Governor Ralph Northam announced that more than 200,000 Virginia adults are now enrolled in Medicaid expansion and will have health coverage starting January 1. The Cover Virginia Call Center has received nearly 170,000 calls since it began accepting Medicaid applications under the new eligibility rules on November 1.
  • New Jersey and Wisconsin – The final two states received notification letters from CMS that they will receive almost a combined $308 million in federal pass-through funding under the Section 1332 waiver program. Both New Jersey and Wisconsin use the funds to operate reinsurance programs in their states. In total, the estimated 2019 pass-through funding for all eight states is about $942 million. To track the latest developments, see the SHVS map.

Upcoming Webinar – Save the Date!

Managing Managed Care: Best Practices for Medicaid Pharmacy

Wednesday, January 23, 2:00 to 3:00 p.m. ET

The prescription drug benefit continues to grow as a portion of Medicaid expenditures. State Medicaid programs commonly rely on contracted Managed Care Organizations (MCOs) and their subcontracted Pharmacy Benefit Managers (PBMs) to manage the prescription drug benefit offered to Medicaid enrollees. What tools do states have available to ensure the MCOs and the PBMs are managing the drug benefit effectively and efficiently? State Health and Value Strategies will host a webinar addressing the complexities of state Medicaid oversight of the pharmacy benefit in the managed care environment. The webinar will offer states real world tips on how to best monitor and evaluate operational and financial performance of their MCOs and their subcontracted PBMs.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e8505028c75e4c8f94d2bf9f09954d200


Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State

The Kaiser Family Foundation recently developed a resource page that aggregates tracking information on pending and approved Section 1115 Medicaid demonstration waivers. The resource page contains links to tables and maps summarizing which states have pending or approved waivers for Medicaid work requirements, behavioral health, eligibility and enrollment restrictions, and/or those containing provisions related to benefits, copays, and health behaviors. The page also includes detailed waiver topic tables as well as links to related issue briefs on those topics.


Medicaid Innovation Accelerator Program Webinar: States Share Lessons Learned in Building Data Dashboards

CMS’s Medicaid Innovation Accelerator Program (IAP) is hosting a national webinar for state Medicaid agencies interested in learning about state Medicaid approaches and experiences in developing public-facing and internal dashboards on Thursday, January 17 from 3:00 pm to 4:00 pm ET. During the interactive webinar, presenters from New Jersey and Washington Medicaid agencies will provide an overview of approaches used for data visualization, the process used to select metrics to display, and lessons learned in the development of their dashboards. New Jersey recently published their FamilyCare Data Dashboards and Washington’s presentation will focus on its rapid cycle monitoring for opioid projects. Register here for the webinar.