In This Week’s Update:

• New CMS guidance
• Upcoming SHVS Webinar
• The State of Public Health
• Maternal Health: New CMS Resources
• Promoting Health Equity Through State Medicaid Managed Care Strategies
• State updates: CA, IL, IN, KY, ME, MN, MT, NV, OR, RI & WA

New CMS Guidance
Last week, CMS released two State Health Official (SHO) letters with new guidance for states:

• SHO #24-001 describes the 2025 updates to the child and adult core sets of quality measures. Starting in fiscal year 2025, states will need to report these measures by race/ethnicity (using the revised 2024 OMB standards), sex, and geography. CMS has also added several provisional measures related to prenatal and postpartum care, which will not be subject to the new reporting requirements.
• SHO #24-002 indefinitely extends state reporting of certain Medicaid and CHIP metrics required by the Consolidated Appropriations Act, 2023. The CAA reporting requirements on renewal outcomes were set to expire on June 30, 2024. CMS will also continue reporting state and national data publicly on renewal outcomes. Updates follow.
   

  The State of Public Health
  The latest episode of Heather Howard’s podcast, the Princeton Pulse, features a conversation with Dr. Ashish Jha, globally-renowned public health leader and Dean of the Brown University School of Public Health. An accomplished physician and researcher, Dr. Jha is acclaimed for driving improvements in public health policy and practice. Most notably, his groundbreaking work on pandemic preparedness and response led to a role at the White House, where he served as COVID-19 Response Coordinator. With an eye toward the future, the conversation addresses emerging challenges such as climate change, the sustainability of funding for public health, and managing healthcare costs, and how to counter these challenges through evidence-informed policies, technological innovation, and sustained, collaborative engagement.

  Maternal Health: New CMS Resources
  CMS published the 2024 Medicaid & CHIP Beneficiaries at a Glance: Maternal Health Infographic which provides a snapshot of demographics, health outcomes, risk factors, access and utilization, and disparities among enrollees seeking pregnancy-related care and those with a recent live birth. As the infographic illustrates, CMS is in a unique position to improve perinatal outcomes and equity through quality improvement and measurement and by supporting value-based care. The data analysis helped inform the Medicaid and CHIP Maternal and Infant Health Initiative summer 2024 webinar series as well as two affinity groups to come this fall on the topics of maternal mental health and substance-use and maternal hypertension and cardiovascular health.

  Promoting Health Equity Through State Medicaid Managed Care Strategies
  States are increasingly identifying and implementing Medicaid managed care (MMC) strategies to confront longstanding and persistent health inequities and improve culturally and linguistically appropriate care. A new SHVS expert perspective highlights primary care assignment and continuity of care, an MMC approach that was newly added to the Compendium of Medicaid Managed Care Contracting Strategies to Promote Health Equity, which describes nine approaches states are taking within their MMC programs to promote health equity. The latest edition of the Compendium features examples from more than 20 states, including Florida, Georgia, New Hampshire, New Mexico, and Rhode Island, five states that are new to the Compendium.

  
  State updates: CA, IL, IN, KY, ME, MN, MT, NV, OR, RI & WA

• California
  • Effective July 1, the Department of Health Care Services will launch children’s presumptive eligibility (CPE) and newborn gateway portals to improve access to coverage and care for new families. Through CPE, providers may grant temporary, full scope coverage to eligible applicants through an online portal. The newborn gateway portal is for reporting the birth of a baby with linkage to Medi-Cal and the Medi-Cal Access Infant Program within 72 hours after birth or 24 hours after discharge, whichever is sooner.
  • Governor Gavin Newsom signed SB 233 which will allow Arizona abortion providers in good standing to temporarily provide abortion care to patients from Arizona who travel to California for that care.
• Illinois
  • Governor JB Pritzker announced the passage of bills comprising the Healthcare Protection Act, which will protect patients through an array of targeted reforms, including banning the following: step therapy, prior authorization for crisis mental healthcare, junk insurance plans, and ending unchecked rate increases for large group insurance companies.
  • Governor Pritzker announced the passage of the Birth Equity Initiative (HB5142). The initiative will work to close the gap in maternal mortality between Black women and other new parents, and ensure Illinois will meet pregnancy, birthing, and postpartum needs across the state.
• Indiana – Governor Eric J. Holcomb announced $150 million in funding for fiscal year 2025 for Indiana’s 92 counties through Health First Indiana (HFI). HFI provides discretionary funding to counties for core public health services that address issues such as childhood lead poisoning, heart disease, tobacco cessation, obesity, and maternal and infant mortality.
• Kentucky – The Kentucky Cabinet for Health and Family Services released an updated chart of the Department for Medicaid Services’ public health emergency flexibilities and unwinding decisions.
• Maine – Governor Janet Mills announced she is appointing Deputy Commissioner Sara Gagné-Holmes to serve as Acting Commissioner of the Maine Department of Health and Human Services, effective June 1, 2024.
• Minnesota – The Minnesota Department of Health (MDH) launched Minnesota’s statewide Office of American Indian Health. The office was created to improve the health and wellbeing of American Indian communities in Minnesota and to ensure Native communities are represented in all MDH public health activities.
• Montana – The Department of Public Health and Human Services (DPHHS) announced the publication of the Behavioral Health System for Future Generations Commission’s draft report. The commission held numerous public meetings with community stakeholders and subject matter experts to inform the report’s recommendations. The draft report includes a summary of 21 recommendations and 5 near-term initiatives that are already in various stages of implementation by DPHHS.
• Nevada – The state released a request for information (RFI) to inform the state’s upcoming procurement of the new public option. The RFI includes a number of questions about how to achieve health equity goals, including questions about race, ethnicity, language, and other demographic data collection.
• Oregon
  • The Oregon Health Authority released its annual report on cost growth trends for health insurance plans and large provider organizations across the state. The report provides insight into healthcare spending in the commercial, Medicaid, and Medicare markets statewide, and for 30 health plans and 53 provider organizations. More than half of plans and provider organizations met the cost growth target.
  • The Division of Financial Regulation announced rate change requests from carriers for plan year 2025. The average increase is 9.3% in the individual market and 12.3% in the small group market.
• Rhode Island – The Rhode Island Department of Health is highlighting new data which underscores the health challenges faced by transgender youth in high school. According to the data brief, 71% of Rhode Island high school students who are transgender say they’ve felt sad or hopeless for two or more weeks during the past year.
• Washington
  • The Office of the Insurance Commissioner announced 13 health insurers filed an average requested rate increase of 11.3% for Washington’s individual health insurance market for plan year 2025. The proposed plans and their rates are currently under review and final decisions will be made this fall.
  • The Health Care Authority is inviting carceral facilities to join the Reentry Demonstration Initiative, a new voluntary initiative under the Medicaid Transformation Project. This initiative provides essential pre-release services for individuals leaving incarceration, including care management, substance-use disorder treatment and recovery support, and infectious diseases. The first group of carceral facilities implementing the Reentry Initiative will launch on July 1, 2025.