June 1 Update

In This Week’s Update:

  • COVID-19 and the Fee-for-service Payment Model
  • COVID-19 State Updates: CA, CO, MA, NJ, NV, RI, VA, WA & WI
  • Other State Updates: IN, NE, OK & OR
  • Health Equity Principles for COVID-19
  • Practices and Resources for Quarantine Hotels
  • New Report Suggests Surge in Medicaid Enrollment


COVID-19 and the Fee-for-service Payment Model

Dan Meuse of SHVS has written an expert perspective on how provider revenue losses during the COVID-19 pandemic could have been avoided with a payment model that is not based on fee-for-service. The post raises several important points about the need to shift from paying for volume to paying for value.


COVID-19 State Updates: CA, CO, MA, NJ, NV, RI, VA, WA & WI

Bulletins and Notices to Carriers

  • Washington – Insurance Commissioner Mike Kreidler extended his emergency order directing all state-regulated health insurers to make additional coverage changes to aid consumers during the coronavirus pandemic, including changes to telehealth coverage, diagnostic testing for flu and other illnesses as part of a COVID-19 visit, and drive-up testing sites.

Special Enrollment Periods

  • California – Covered California announced that over 123,000 people had enrolled in health care coverage since the exchange announced a special-enrollment period in response to the COVID-19 pandemic.
  • Massachusetts – The Health Connector announced in an Administrative Bulletin another extension to the SEP in response to the COVID-19 emergency through June 23, 2020.
  • Nevada – The Silver State Health Insurance Exchange enrolled 6,017 Nevadans during its SEP, which ran through May 15. Of those enrolled, 5,479 are new consumer enrollments related to the Exceptional Circumstance SEP and 538 enrollments due to loss of minimum essential coverage.
  • New Jersey – The Department of Banking and Insurance launched the Get Covered New Jersey public awareness campaign—which typically runs during the ACA Open Enrollment Period—to promote health insurance options available to residents whose health coverage or income is affected amid the COVID-19 pandemic and may be eligible for coverage through the ACA Marketplace or Medicaid.

COVID-19 Testing

  • Colorado – Governor Jared Polis signed an executive order that increases Colorado’s Medicaid home health workforce and eliminates copays for COVID-19 testing for individuals who rely on Medicaid. 
  • Washington – The Department of Health issued an order that will require widespread testing within long-term care facilities. Residents and staff in nursing homes will be tested within approximately two weeks, with a completion date goal of June 12. All residents and staff in assisted-living facilities with a memory care unit will be tested within four weeks, with a completion date goal of June 26.


  • California – Governor Gavin Newsom launched California Connected, the state’s comprehensive contact tracing program and public awareness campaign. The state’s program is led by the governor in collaboration with the California Department of Public Health, local public health departments, the University of California, San Francisco (UCSF), and the University of California-Los Angeles (UCLA), which have launched a robust online training academy to develop a culturally competent and skilled contact tracing workforce.
  • Massachusetts – The Baker-Polito Administration announced $56 million to combat urgent food insecurity for some Massachusetts families and individuals as a result of COVID-19.
  • Nevada – Governor Steve Sisolak requested the assistance of Nevada’s Patient Protection Commission in the state’s response to, and long-term recovery from, the impact of COVID-19. The Commission will help inform policymakers in assessing the health needs of Nevadans, including incorporating a lens of health disparities and health equity.
  • Rhode Island – Governor Gina Raimondo announced an additional $5 million in funding for the Housing Help RI emergency rental assistance fund. This money is available to low-income renters who have been impacted by the COVID-19 emergency and are at immediate risk of homelessness.
  • Virginia – The Virginia Department of Medical Assistance Services (DMAS) announced it received federal approval for an emergency 1135 waiver. The waiver allows Virginia to streamline the process for health care providers to enroll in the Medicaid program and receive reimbursement, and provides new staffing flexibilities to support access to home health and hospice aides.
  • Wisconsin – The Department of Health Services announced $10 million in funding for health care providers serving the state’s most underserved populations. The funds, provided through the federal CARES Act, will reimburse clinics for expenses stemming from the COVID-19 pandemic. Clinics can apply for funding beginning June 5 through June 30.


Other State Updates: IN, NE, OK & OR

  • Indiana – The state awarded contracts for Hoosier Care Connect, the state’s Medicaid managed care program for aged, blind, and disabled (ABD) beneficiaries, worth a total of $6.4 billion. Implementation is expected April 1, 2021, with contracts running four years, with two optional one-year renewals. Hoosier Care Connect serves approximately 90,000 individuals.
  • Nebraska – The Department of Health and Human Services released a new expansion report, which provides an update of activities to the state legislature.
  • Oklahoma – The federal government is seeking public comments on the state’s Section 1115 Healthy Adult Opportunity waiver. Public comments are accepted until June 27.
  • Oregon – The Oregon Department of Consumer and Business Services announced that Oregon consumers can get a first look at requested rates for 2021 individual and small group health insurance plans. In the individual market, six companies submitted rate change requests leading to a weighted average increase of 2.2 percent. In the small group market, nine companies submitted rate change requests leading to a weighted average increase of 3.9 percent.


Health Equity Principles for State and Local Leaders in Responding to, Reopening and Recovering from COVID-19

The Robert Wood Johnson Foundation published an issue brief that outlines health equity principles for state and local leaders to consider in designing and implementing their responses to enable communities and their residents to recover fully and fairly from COVID-19. The principles are not a detailed public health guide for responding to the pandemic or reopening the economy, but rather a compass that continually points leaders toward an equitable and lasting recovery. The five principles can be used to guide the nation toward an equitable response and recovery and help sow the seeds of long-term, transformative change. 


Promising Practices and Resources for Quarantine Hotels

The National Center for Complex Health and Social Needs, in partnership with the National Alliance to End Homelessness and the Corporation for Supportive Housing, is hosting a webinar on promising practices and resources for quarantine hotels. Quarantine hotels/motels are a common approach among health and community-based organizations working to protect the individuals experiencing homelessness or housing instability during the COVID-19 pandemic. While promising practices are beginning to emerge, these resources are incomplete. The webinar on June 4 at 2:00 p.m. EST will provide an overview for programs that are newer to housing and may not be aware of the resources that do exist or how to adapt them to their environment. Register here.


State Trends Point to Surge in Medicaid Enrollment

new analysis published by Families USA reports that in April and May states began to experience dramatic increases in Medicaid enrollment. The analysis compares states’ March, April, and May enrollment levels against their January enrollment levels. Findings show enrollment increases beginning in March or April and then rapidly accelerating. Most states saw modest or no enrollment growth from January to March (0% to 3%), significant increases from January to April (0% to 6%), and massive increases from January to May for those states that have reported (3% to 10%).