June 15 Update: CMS guidance on opioids; Recording of policy academy on global budgeting now available; Summit on maternal mortality

The Centers for Medicare & Medicaid Services (CMS) announced the release of guidance that provides states with information on how CMS can support their efforts to address the opioid crisis. The guidance consists of an informational bulletin on the design of approaches to covering treatment services for Medicaid eligible infants with Neonatal Abstinence Syndrome and a state Medicaid Director letter that advises states on which funding authorities may support health information technology efforts that could be used for the prevention and treatment of negative opioid outcomes. Next week State Health and Value Strategies is hosting a webinar on the status of state efforts to secure waivers to use federal Medicaid funding to provide care in Institutions for Mental Disease. See the link below to register.

Also this week, the Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2018 Report to Congress on Medicaid and the Children’s Health Insurance Program that clarifies regulations on protecting the privacy of patients with substance use disorder to support integration of care. The report also includes recommendations to change statutory provisions that prevent state Medicaid programs from paying the lowest price for certain drugs. Updates follow.

  • Colorado – The Department of Health Care Financing and Policy published an infographic on supporting rural health care in Colorado. The infographic includes several data points about rural and frontier enrollment in Health First Colorado, the state’s Medicaid program, and profiles a pediatric practice in the south west region of the state.
  • Maine – The state’s Section 1332 waiver application to implement a reinsurance program was deemed complete by CMS. We have updated our map to reflect the progress of Maine’s application.
  • Minnesota – The Commerce Department announced that health insurance companies are proposing mostly decreased premium rates for 2019 in Minnesota’s individual health insurance market. The average proposed rates show decreases that range from three percent to more than 12 percent, reflecting the positive results of the state’s reinsurance program enacted in 2017. Health insurers submitted proposed rates for all 87 counties.
  • Mississippi – The Division of Medicaid released a request for qualifications for the state’s Children Health Insurance Program (CHIP). Managed care organizations must submit letters of intent by June 29 and proposals are due July 27.
  • Pennsylvania — The Department of Human Services, in conjunction with the Pennsylvania eHealth Partnership Program, awarded nearly $8 million in grant funds to help connect hospitals, nursing homes, and ambulatory practices to the Pennsylvania Patient & Provider Network (P3N). P3N enables electronic health information exchange across the state.
  • Rhode Island – Governor Gina Raimondo announced this week a new partnership that allows customers of HealthSource RI, the state’s official health insurance marketplace, to visit any CVS Pharmacy store nationwide and pay their monthly health insurance premium at the checkout. CVS Pharmacy will accept credit cards, debit cards and cash as payment.
  • Vermont – The state’s amendment to their 1115 demonstration waiver was approved by CMS. In their amendment, the state requested an IMD waiver.
  • Washington – The Office of the Insurance Commissioner released draft rulemaking on short-term limited duration medical plans and is accepting comments through June 26. The proposed rule would limit short-term plans to three months and make them nonrenewable.

Upcoming Webinar – Save the Date!

Waivers of the Institutions for Mental Disease (IMD) Exclusion: Emerging Opportunities and Challenges

Thursday, June 21, 2018 12:30 to 1:30 p.m. ET

State Health and Value Strategies, together with technical assistance experts from Manatt Health, will host a webinar to discuss the status of state efforts to secure waivers to use federal Medicaid funding to provide care in Institutions for Mental Disease (IMD). The webinar will review the requirements states must meet to secure an IMD waiver; the status of requests and approvals; and issues and opportunities arising as states pursue and increasingly implement the IMD waiver. We will be joined by leadership from the New Jersey Department of Human Services, which received approval of its IMD waiver in October 2017 and is now in the implementation phase.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ee50b37f7ab9d0892a190d1a2656686e4

Global Budgeting: Recording of State Policy Academy Now Available

State Health and Value Strategies recently collaborated with the Milbank Memorial Fund to support a Policy Academy for states on Global Budgeting for Rural Hospitals. The State Policy Academy was hosted by Johns Hopkins University and took place in Baltimore, Maryland on May 30.  Funding for the Policy Academy was provided by the Robert Wood Johnson Foundation and Milbank Memorial Fund. To view a recording of the morning sessions of the Academy, which features experts on hospital global payments from around the country, and the agenda for the full day meeting, you can visit the event website.

Maternal Mortality: Watch the Webcast of the HRSA Summit Next Week

The Health Resources and Services Administration (HRSA) is hosting a summit on maternal mortality June 19 through June 21. The summit will bring together leading subject matter experts from within and beyond U.S. borders to highlight innovative strategies in reducing maternal mortality. In addition to experts from the U.S., invited countries include Brazil, Canada, Finland, India, Rwanda, and the United Kingdom, as well as the World Health Organization. While the summit is invitation only, HRSA is making the plenaries available to the public via a webcast. They will also be hosting a twitter discussion which you can follow along using the hashtag #HRSAMaternalMortality.

Drivers of 2019 Health Insurance Premium Changes

The American Academy of Actuaries released an issue brief detailing the major drivers of 2019 premium rate changes for individual insurance coverage that is subject to Affordable Care Act (ACA) rules. Rate change drivers include projected increases in health care costs, recent and pending federal public policy changes, such as the repeal of the individual mandate penalty and the pending availability of short-term limited duration plans and association health plans, and changes in risk pool composition and insurer assumptions. The authors also note how individual state actions could have an impact on 2019 premiums, such as new state reinsurance programs, the imposition of individual mandate penalties, and rules that would either facilitate or prohibit the sale of plans that do not comply with ACA requirements.