June 3 Update

In This Week’s Update:

  • New CMS Podcast Episode
  • New CMS Funding Opportunity
  • State Updates: AL, CA, CT, CO, FL, MD, MN, & NM
  • New SHVS Webinar: Health Equity & Managed Care
  • Work Requirements Targets Face Barriers
  • Early Childhood Briefing Series
  • Enhancing Access to Family Planning in Medicaid

New CMS Podcast Episode

Last week, the Centers for Medicare and Medicaid Services (CMS) released the latest episode of their podcast, CMS: Beyond the Policy. The episode, entitled “CMS Innovation Center: Where We Are, How Models are Developed and the Next Steps in Value,” features a discussion on the direction of the CMS Innovation Center with CMS Administrator, Seema Verma and CMS Innovation Center Director, Adam Boehler. The episode is moderated by Tom Corry, the CMS Director of the Office of Communications.

New CMS Funding Opportunity

In case you missed it, CMS released a new funding opportunity announcement for the navigator program for 2020 and 2021, as well as a series of frequently asked questions and an overview of the application process. CMS intends to fund the navigator program in the 34 states with a federally facilitated marketplace at $10 million per year, for a total of $20 million. For background and more information, see this Health Affairs blog post.

State Updates: AL, CA, CT, CO, FL, MD, MN, & NM

  • Alabama – The Alabama Medicaid Agency is seeking public comment on its proposal to renew the Alabama Home and Community-Based Intellectual Disabilities Waiver. The waiver supports Alabama citizens who have a diagnosis of intellectual disabilities, and who would otherwise require the level of care offered in an Intermediate Care Facility for Individuals with Intellectual Disabilities to remain in the community.
  • California – Covered California, the state’s official health insurance marketplace, announced a total of $6.3 million in grant funding to 105 community-based organizations and clinics to support enrollment efforts. The investment is part of Covered California’s proposed $111 million marketing, outreach and sales budget for next year.
  • Connecticut – Governor Ned Lamont announced the selection of Dr. Deidre Gifford to serve as commissioner of the Department of Social Services. Dr. Gifford comes to Connecticut after serving as deputy director for the Center for Medicaid and CHIP Services at CMS where she oversaw the full scope of Medicaid functions at the federal agencies.
  • Colorado – Governor Jared Polis signed a bill that caps the price of insulin so that patients will not pay more than $100 a month for the drug beginning January, 2020. The new law also requires Attorney General Phil Weiser to investigate why the price of insulin has increased in recent years.
  • Florida – The Agency for Health Care Administration issued a request for information to develop an estimate of the total vendor costs of managing the import of prescription drugs from Canada. HB 19, which was passed by the legislature, directs the Agency to establish a Canadian importation program and contract with a vendor to provide the necessary services.
  • Maryland – The Maryland legislature passed legislation establishing a state board to cap payments for expensive medications. The board will be able to set an upper limit for the drugs that would apply to state and local government insurance plans, including prisons. Governor Larry Hogan said he would allow this legislation to take effect without his signature.
  • Minnesota – Governor Tim Walz is expected to sign later today a health and human services budget bill that will extend the state’s reinsurance program. As a reminder, SHVS’s map tracks all state Section 1332 activity and you can find links to state applications and legislation there.
  • New Mexico – Governor Michelle Lujan Grisham announced her plan to increase Medicaid hospital reimbursement rates for inpatient and outpatient services by $168.7 million effective July 1. The hospital reimbursement increases are part of a multi-phase strategy to address low Medicaid reimbursement rates.

 

Upcoming Webinar – Advancing Health Equity in Medicaid Managed Care: An Introduction for States

Thursday, June 20, 2:00 to 3:00 p.m. ET

State Health and Value Strategies will host the first webinar in a series on advancing health equity through Medicaid managed care organizations. The five-part series will assist states interested in addressing disparities in health outcomes among Medicaid managed care beneficiaries as a step towards achieving health equity. The first webinar in the series, Advancing Health Equity in Medicaid Managed Care: An Introduction for States, will review the foundational principles of health equity, barriers to its realization, and the impact of health disparities on well-being. Understanding key definitions and concepts of health equity will help inform efforts aimed at advancing health equity–and reducing disparities in health outcomes–in state Medicaid managed care programs.

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=e2f22b8d9238463aa12098cd6bcffecb8

 

Many Adults Targeted by Medicaid Work Requirements Face Barriers to Sustained Employment

To shed light on the potential implications of work requirements in Medicaid programs, a new study by Urban Institute examines employment barriers faced by Medicaid enrollees potentially subject to work requirements and the attendant risks of coverage loss if they do not work 20 hours per week throughout the year. The analysis, which was funded by the Robert Wood Johnson Foundation and draws upon the Health Reform Monitoring Survey, shows that adults who are enrolled in Medicaid and who would potentially be subject to work requirements are more likely to face significant barriers to employment and are less likely to consistently work 20 hours per week compared with privately insured adult. Barriers include difficulty finding work and employer restrictions on schedules, lacking a high school degree, having multiple chronic health conditions, having limited access to transportation, and living in neighborhoods where the poverty rate exceeds 20 percent.

 

Early Childhood Briefing Series

The Robert Wood Johnson Foundation recently released a series of information-packed issue briefs on early childhood development, all written with a state policy and decision-maker audience in mind. These six briefs cover topics including family economic stability, early care and education, maternal and child health, the importance of the first three years, healthy food and nutrition, and family and medical leave. Each brief addresses the basics of program structure, financing, and operations; summarizes the available research on health impacts; forecasts the most pressing challenges state leaders will face; and point toward best practices from around the country. These briefs can be used to educate governors and legislators about key policies to promote healthy development. It is another set of tools to support states in implementing policies that will improve health and well-being within their own borders, and across the country, in the most equitable manner possible.

 

Enhancing Access to Family Planning in Medicaid: A Toolkit for States

Funded by Arnold Ventures, a new Manatt Health report Enhancing Access to Family Planning Services in Medicaid: A Toolkit for States provides an overview of the issues that affect access to family planning services and supplies, and the policy options available to state Medicaid agencies to enable access to the full range of family planning services and supplies. To facilitate evaluation of a state’s current family planning landscape and also to monitor progress toward improved access, this toolkit also provides examples of data analyses that states can undertake to gather baseline and ongoing data regarding family planning access.