In This Week’s Update:

• New SHVS Resources
• COVID-19 State Updates: AK, AZ, MN, NC, OR, UT, WV, WI
• Other State Updates: DE, MN, NJ
• Medicaid’s Role in Behavioral Health
• Medicaid Expansion and Children
• COVID-19 State LTSS Resource Guide

 

New SHVS Resources

Last week State Health & Value Strategies (SHVS) published new and updated resources for states. A new expert perspective, MCO Strategies to Promote COVID-19 Vaccine Uptake, outlines four recommendations for states to engage their managed care plans to assist in efforts to successfully and rapidly vaccinate the Medicaid population.  

SHVS posted the slides and a recording of a webinar held last week, Analyzing Health Disparities in Medicaid Managed Care. SHVS also updated the SHVS compendium Medicaid Managed Care Contract Language: Health Disparities and Health Equity to incorporate language from requests for proposals in Hawaii, Oklahoma, and North Carolina (for the state’s managed behavioral health care program) and excerpts from Ohio’s request for applications for managed care and managed behavioral health care. In addition, this version includes language from New York’s Value-Based Payment Roadmap.

 

COVID-19 State Updates: AK, AZ, MN, NC, OR, UT, WV, WI

• Alaska – The Alaska Department of Health and Social Services announced that as of Feb. 14, 2021, the State of Alaska’s Declaration of Public Health Disaster Emergency, which was in place to manage its response to COVID-19, expired.
• Arizona – Gov. Doug Ducey and the Arizona Health Care Cost Containment System (AHCCCS) announced a new initiative that will make it easier for Medicaid members to get transportation to drive-through COVID-19 vaccination appointments. AHCCCS will reimburse nonemergency medical transportation providers for driving eligible Medicaid members to and from their COVID-19 vaccination appointments, including reimbursement for time spent waiting during the drive-through vaccination process. 
• Minnesota – The Minnesota Department of Human Services presented a report on telemedicine utilization during the COVID-19 pandemic at a House Health Finance and Policy hearing on Feb. 23. Increased access to telemedicine has resulted in improved attendance at appointments; fewer no-shows; fewer late arrivals; easier access to treatment and involvement of patients’ family members; and receipt of health care services that otherwise would have been skipped due to illness or fear of contracting COVID-19, travel distance, or lack of transportation.
• North Carolina – The North Carolina Department of Health and Human Services’ Office of Rural Health will present two Vaccine 101 training sessions on March 3 to provide rural North Carolina community members accurate and timely information about the COVID-19 vaccine, address vaccine hesitancy, and help slow the spread of the virus.
• Oregon – The Oregon Health Authority published a report on COVID-19 race, ethnicity, language, and disability (REALD) data that highlights the inequitable impact of the disease on specific racial and ethnic groups, as well as challenges faced by those with language, disability, and health access barriers. In 2020, the Oregon Legislature passed a law (House Bill 4212) that requires health care providers to collect REALD information at health care visits related to COVID-19, and to share this information with the Oregon Health Authority. 
• Utah – The Utah Department of Health renewed a statewide public health order aimed at limiting the spread of COVID-19 in Utah communities. The order replaces a previous order that expired on Feb. 22, and is effective through March 25, 2021.
• West Virginia – ​The Department of Health and Human Resources’ Bureau for Public Health recently renewed federal waivers allowing for continued safe operation of the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) during the COVID-19 pandemic. The waivers from the United States Department of Agriculture’s Food and Nutrition Service allow current WIC participants and eligible families to be certified, obtain benefits, and receive nutrition and breastfeeding education virtually as the COVID-19 pandemic continues.
• Wisconsin – The Department of Health Services announced that Wisconsin students who are enrolled at least half time in an institution of higher learning and meet certain criteria can now participate in FoodShare and receive assistance to purchase groceries during the pandemic. The provision loosening federal restrictions on these students was included in the COVID-19 relief bill passed by Congress and signed into law in December 2020. The duration of these provisions is determined by the length of the federal public health emergency.

 

Other State Updates: DE, MN, NJ

• Delaware – The Department of Health and Social Services is inviting medical providers and practice managers in primary care, women’s health, infectious disease, and psychiatry to participate in a program that will train providers to treat opioid use disorder (OUD) among Medicaid recipients in primary care and other outpatient settings. Office-Based Opioid Treatment (OBOT) involves prescribing safe, effective, and FDA-approved medications, and the OBOT Fellowship Program will help practices design and implement clinical and operational workflows to use medications to treat OUD.
• Minnesota – A recent report published by the Department of Health shows Minnesota’s uninsured rate remained at a rate of about five percent through July 2020 due in part to government efforts to maintain health care coverage for low-income Minnesotans, support employers and people, and make insurance available through public programs and MNsure (the state’s official health insurance marketplace).
• New Jersey – The Department of Banking and Insurance published a report on whether the state’s surprise billing law, the Out-of-Network Consumer Protection, Transparency, Cost Containment, and Accountability Act, is successfully protecting consumers and reducing overall health care costs. The report provides some insight into who is using the arbitration process and the outcomes. This is the second report issued on the law and covers arbitrations in 2020.

 

Medicaid Forward: Behavioral Health

The COVID-19 public health emergency, its economic fallout, and longstanding racial and ethnic inequities are affecting the nation’s mental health and well-being. These crises are also destabilizing the behavioral health care system, making it more difficult to meet the increased behavioral health needs of the population. Medicaid and the Children’s Health Insurance Program, as the insurance providers for more than 77 million individuals (including many with complex physical and behavioral health needs), will play a vital role in supporting the recovery of our nation. A new report, crafted by an Executive Working Group of Medicaid leaders and national behavioral health experts convened by the National Association of Medicaid Directors, offers states options to consider to promote the health and well-being of members and expand access to behavioral health services. It includes strategies along a continuum of need, ranging from upstream prevention and health promotion for all Medicaid beneficiaries to increasing access to behavioral health treatment for unique subpopulations in Medicaid.

 

Children Are Left Behind When States Fail to Expand Medicaid

While the Affordable Care Act’s Medicaid expansion was designed to help the large number of uninsured adults who could not afford private insurance, the policy change has proven to be immensely helpful to children too, according to a new report by the Georgetown University Center for Children and Families. Children in states that expanded Medicaid are almost twice as likely to have health coverage than those in states that have not. The report points to the strong link between child and parent health insurance status. When parents gain Medicaid coverage, they are more likely to get the help they need to be healthy and effective parents and more likely to take their children to the doctor to get the care they need. Children in nonexpansion states have been falling behind on health coverage compared to their peers; their uninsured rates grew at nearly three times the rate of children in Medicaid expansion states between 2016 and 2019. The report also highlights how Medicaid expansion improves maternal and infant health by increasing access to preconception and prenatal care that helps babies get a healthier start in life.

 

COVID-19 State LTSS Resource Guide

With support from The SCAN Foundation, Manatt Health published an updated and expanded COVID-19 State LTSS Resource Guide. The resource guide identifies federal and state Medicaid flexibilities available to state officials and other stakeholders and how those flexibilities are being deployed during COVID-19 to help ensure access to long-term services and supports (LTSS). The resource guide also highlights state policy goals in implementing regulatory flexibilities available during the COVID-19 public health emergency, as well as specific examples of how states are ensuring continued access to LTSS by expanding remote service delivery options, expanding and stabilizing providers and the LTSS workforce, maintaining continuity of care for LTSS recipients through modified assessment policies and processes, and extending home care to new populations.