July 12 Update

In This Week’s Update:

  • New SHVS expert perspectives   
  • State updates: MD, MT, ND, NH, NY, OK, OH, WA & WI
  • Lessons From Early Rate Filings   
  • Advancing Medicare and Medicaid Integration
  • Medicare Coverage Gap Fact Sheet


State Health and Value Strategies released two new expert perspectives:


  • The No Surprises Act Interim Final Rule: Implications for States summarizes provisions of the latest interim final rule (IFR) on implementing the “No Surprises Act ” that affect state regulators. Comments on the IFR are due 60 days after its posting in the Federal Register and will inform future rulemaking. IFR is effective once published for plan years beginning on or after January 1, 2022.
  • The State of Play: A Mid-Year Update on the Public Option at the Federal and State Level provides insight on the latest state activity on public option proposals in Colorado, Nevada, Oregon and Washington state. This year, these states all advanced legislation to study, implement, or strengthen their public option programs. This activity suggests that the public option will continue to be an important health reform initiative in states. 


State Updates


  • Maryland – Governor Larry Hogan announced a $72 million maternal and child health care transformation initiative aimed at improving related health disparities for Marylanders statewide. To support care transformation, Maryland’s Health Services Cost Review Commission (HSCRC) will provide $10 million in annual funding beginning July 1 for the next four years. Maryland’s Public Health Services will receive $2 million annually. Maryland Medicaid will receive $8 million annually and also will be eligible to receive matching federal funds each year, bringing a combined total of $72 million to the initiative. HSCRC has designated funds for both new statewide programs and expansion of existing health care services, all of which may be sustained even after funding expires in 2025. 
  • Montana – The Department of Public Health and Human Services announced that it is seeking public comment on its federal application to expand mental health and substance use treatment services through the Healing and Ending Addiction through Recovery and Treatment (HEART) Initiative. The HEART Initiative is intended to address the state’s drug epidemic that is devastating communities by expanding access to mental health and substance use disorder treatment across the full spectrum of care.
  • New Hampshire – The New Hampshire Department of Health and Human Services (DHHS) released the Council on Housing Stability’s three-year Strategic Plan, which provides a roadmap to coordinate action and deploy resources to meet the state’s housing needs. Led by DHHS in partnership with the New Hampshire Department of Business and Economic Affairs and the Community Development Finance Authority, the plan seeks to increase housing availability by 13,500 units by 2024 to ensure that homelessness in New Hampshire is rare, brief and one-time whenever possible.
  • New York – The New York State Department of Health issued a guidance document regarding the Medicaid program’s continued coverage of telehealth services for the duration of the federal public health emergency (PHE). The guidance is designed to maintain Medicaid providers’ ability to use telemedicine and digital health to deliver health services for the remainder of the federal PHE and will remain in effect until the federal PHE expires or the Department of Health issues permanent Medicaid telehealth rules. 
  • North Dakota
    • The North Dakota Department of Human Services announced it selected Blue Cross Blue Shield of North Dakota to provide Medicaid Expansion managed care services across the state. The four-year contract begins January 1, 2022 with optional extensions.
    • The North Dakota Department of Health is encouraging businesses to support workplaces earning their Infant Friendly Workplace designation, awarded to employers who adopt breastfeeding support policies. These policies should include guidelines for adequate break times; a clean, private location for milk expression; and available resources for clean water and breast milk storage.
  • Oklahoma – The Oklahoma Health Care Authority is providing additional dental benefits to all adult SoonerCare members. The adult limited dental benefit will add the following services in addition to the current medically necessary extraction benefit: preventive care, including cleanings, fluoride, and periodontal scaling; exams; x-rays; restorative care (fillings); and partial and full dentures.
  • Ohio – Governor Mike DeWine announced on July 8 that more than two dozen local drug task forces in Ohio will receive RecoveryOhio grant funding to support efforts that disrupt the drug trade and promote substance use awareness, prevention, and recovery. A total of $2 million in grants from Governor DeWine’s RecoveryOhio Law Enforcement Fund will be awarded among 27 existing drug task forces to intensify their efforts to identify high-level drug traffickers, dismantle large drug trafficking organizations, interrupt the flow of money and drugs from international cartels, and prevent the sale of illegal narcotics to those suffering from substance use disorder.
  • Washington – The Washington Health Care Authority surveyed roughly 65,000 Washington middle and high school students to ask them about COVID-19. Early results show many students reported feeling sad or depressed most days during the pandemic. But the majority of students in each grade also reported a high degree of resilience, saying they were optimistic about the future. The results of the survey offer important information to schools planning for how to best support students as they return to full-time in-person learning this fall. The survey covered a range of topics, including pandemic worries and behaviors, mental health and well-being, physical activity, and substance use.
  • Wisconsin – The Wisconsin Department of Health Services (DHS) released maps and corresponding downloadable data tables that break down COVID-19 vaccinations by new geographic boundaries. The new maps allow Wisconsinites to view existing COVID-19 vaccination data by municipalities (cities, towns, and villages), zip code tabulation areas, school district boundaries, and census tracts. DHS also recently released an additional filter option for the COVID-19 Vaccines for Wisconsin Residents dashboard. Users can now select to view vaccination data for just the adult population ages 18 and older.


Health Plans Prepare for 2022 in Early Rate Filings

To assess how individual market insurers are developing their 2022 premium rates, a new blog post by the Georgetown University Center on Health Insurance Reforms reviews early proposed rate filings in the District of Columbia (D.C.), Maine, Oregon, Vermont, and Washington State. These early rate filings can provide hints about how insurers are responding to market trends, policy changes, and emerging drivers of health care costs. This year, insurers have had to make decisions about benefits, network design, and premium pricing in the wake of a devastating worldwide pandemic and federal policy changes that could dramatically expand coverage under the Affordable Care Act.


Advancing Medicare & Medicaid Integration

The Center for Health Care Strategies, with support from Arnold Ventures, launched a new funding opportunity designed to provide states with the support to meaningfully improve Medicare-Medicaid integration for their dual-eligible populations. The initiative will assist states in designing Medicare-Medicaid integration models, expanding access to integrated programs, or improving service delivery for dual-eligible individuals, with a focus on addressing issues of health equity. Medicaid agency staff, state officials committed to advancing Medicare-Medicaid integration, and state technical assistance partners with experience supporting the development of integrated programs are invited to join an informational webinar on July 21 at 1:00 pm ET to learn more about the initiative and application process.


The Medicaid Coverage Gap: State Fact Sheets

Over 2.2 million uninsured adults are in the Medicaid coverage gap — too poor to qualify for Affordable Care Act (ACA) marketplace assistance but ineligible for Medicaid because their state hasn’t adopted the ACA’s Medicaid expansion. Closing the coverage gap would increase health insurance coverage, reduce racial health disparities, and improve health care access, health outcomes, and financial security. The Center on Budget and Policy Priorities launched a series of state fact sheets providing some basic facts about adults in the coverage gap in each state that hasn’t adopted Medicaid expansion. Each fact sheet notes how many residents in the state fall into the coverage gap and how closing the coverage gap can help their residents overall.