March 11 Update

In This Week’s Update:

  • MIECHV Notice of Funding Opportunity
  • Primary care scorecard
  • Partnerships With Faith-Based and Neighborhood Organizations
  • State updates: AZ, CO, NE, NH, NM, NV, NY, OR, PA, RI, UT & V

    HRSA Issues MIECHV Notice of Funding Opportunity
    On February 29, the Health Resources and Services Administration (HRSA) issued a notice announcing the opportunity to apply for base and matching funds under the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) grant program. Through the program, states and territories may provide voluntary, evidence-based home visiting services to pregnant people and parents/caregivers of children from birth until kindergarten. Interested applicants have 90 days (until May 29) to respond, and HRSA anticipates awarding funding on September 30. (For more information, see HRSA’s guidance on the notice of funding opportunity.)

    The Health of U.S. Primary Care: 2024 Scorecard Report
    The national Primary Care Scorecard released by the Milbank Memorial Fund assesses the health of primary care using measures of access, financing, workforce/training and research. The report and data dashboard examine critical measures of primary care performance nationally and across states. The assessment identifies five reasons why primary care in the U.S. is inaccessible for so many: 1) the primary care workforce is not growing fast enough; 2) the number of trainees on the professional pathway is low and too few primary care residents have community-based training; 3) the U.S. continues to underinvest in primary care; 4) technology has become a burden to primary care; and 5) research to identify, implement, and track novel care delivery and payment solutions is lacking.

    Partnerships With Faith-Based and Neighborhood Organizations
    A final rule was posted to the federal register amending the regulations for agencies, including HHS, to clarify protections for enrollees and prospective enrollees of federally funded social services and the rights and obligations of organizations providing such services. In accordance with the executive order of February 14, 2021, Establishment of the White House Office of Faith-Based and Neighborhood Partnerships, this clarification should promote maximum participation by enrollees and providers in the agencies’ covered programs and activities and ensure consistency in the implementation of those programs and activities.

    State Updates

  • Arizona
    • Governor Katie Hobbs announced a partnership with RIP Medical Debt to launch Affordable Arizona: Tackling Medical Debt for Working Families. The program will forgive up to $2 billion in medical debt for up to one million Arizonans by using $30 million in COVID-19 relief funds to purchase the debt for pennies on the dollar. As a reminder, a recent episode of my podcast, the Princeton Pulse, discusses the problem of medical debt in America and innovative ways to erase debt for pennies on the dollar, with a guest from RIP Medical Debt and a reporter from KFF Health News who has reported on this topic extensively.
    • The Arizona Health Care Cost Containment System (AHCCCS) announced that organizations that employ certified community health workers will be able to register as AHCCCS providers and be reimbursed for providing Medicaid services.
  • Colorado – The Colorado Behavioral Health Administration (BHA) announced that it has received feedback from nearly 400 individuals, including behavioral health professionals, advocates, and providers, to collaboratively design a new system for behavioral health safety net services in the state, known as the Behavioral Health Administrative Service Organizations (BHASOs). The feedback will inform the request for proposals which BHA will employ to select BHASO vendors.
  • Nebraska – The Department of Health and Human Services Division of Developmental Disabilities announced the launch of Nebraska’s home and community-based services waiver, the Family Support Waiver. This waiver began March 1 and will provide services to 850 children from birth to 21 years of age with intellectual or developmental disabilities. Each participant has a maximum annual budget of $10,000.
  • Nevada – The Nevada Division of Health Care Financing and Policy (DHCFP) held a public workshop on the expansion of Medicaid managed care statewide. The workshop provided an overview of DHCFP’s goals for the statewide expansion of managed care and procurement process. A summary of stakeholder feedback collected  through a request for information and rural outreach was also provided during the workshop.
  • New Hampshire – The New Hampshire Insurance Department issued a letter to UnitedHealth Group and UnitedHealthcare concerning the response to the cybersecurity attack at Change Healthcare. In the letter, Commissioner DJ Bettencourt emphasized the urgent need for collaborative efforts to address the challenges stemming from the cyberattack, including the financial impacts on healthcare providers and disruptions in healthcare services.
  • New Mexico
    • Governor Michelle Lujan Grisham signed three healthcare related bills to improve affordability and access. House Bill 7 reduces insurance costs for small businesses, their employees, and low- to moderate-income individuals. Senate Bill 14 finalizes the establishment of the Health Care Authority, a single unified department responsible for healthcare purchasing, oversight and policy. Senate Bill 17 establishes the Medicaid Directed Payment Program, which will leverage hospital assessments to generate $1.3 billion in federal funds for hospitals in the state.
    • The New Mexico Human Services Department is collaborating with Medicaid managed care organizations (MCOs) to protect provider and customer data following the cyberattack at Change Healthcare. These actions include allowing alternative methods to submit claims and helping transition to another source for claim submission. Additionally, MCOs have established provider customer service units to address provider support needs and are actively monitoring claims volume. The Office of Superintendent of Insurance (OSI) issued a bulletin to direct insurance carriers and pharmacy benefit managers to notify OSI of the scope of the impact of the cyberattack.
  • New York – HHS and the Department of Treasury approved New York’s section 1332 state innovation waiver application to expand the Essential Plan, the state’s Basic Health Program, to residents with incomes up to 250% of the federal poverty level and to individuals with Deferred Action for Childhood Arrival (DACA) status. Starting April 1, 2024, the waiver will expand affordable coverage to an additional 100,000 New Yorkers, including 70,000 people currently enrolled in qualified health plans who will be eligible for more savings, 12,000 DACA individuals, and 20,500 currently uninsured individuals.
  • Oregon – The Oregon Health Authority announced that certain Oregon Health Plan (OHP) members may now qualify for new climate-related benefits. Eligible OHP members may receive air conditioners, heaters and air filters, as well as mini refrigeration units for storing medications, or portable power supplies to operate medical equipment. OHP also announced grants to support the capacity of community partners to deliver new health-related social needs services to eligible OHP members.
  • Pennsylvania
    • The Pennsylvania Department of Health announced that it will hold a statewide Health Equity Summit that will bring together healthcare professionals, state agencies, non-profit organizations, foundations, faith-based organizations and more working toward the goal of eliminating health disparities in Pennsylvania by 2030. Panel discussions with subject experts will touch on such topics as maternal health, environmental justice and climate change, and health equity policy.
    • The Pennsylvania Department of Human Services (DHS) advised Medicaid providers on how they may continue to bill DHS directly for fee-for-service claims while Change Healthcare remains unavailable due to the cyberattack. DHS has also directed pharmacy providers who may be unable to use an alternate vendor to fulfill claims to issue temporary, short-term supplies of necessary medications. Once billing issues are resolved, pharmacists will be able to retroactively bill for the short-term dispensations.
  • Rhode Island
    • The Rhode Island Executive Office of Health and Human Services (EOHHS) and its Medicaid program are responding to the disruption caused by the Change Healthcare cyberattack by launching a new system for pharmacies to process claims. The agency also authorized pharmacies to provide prescriptions for up to 30 days and asked pharmacies to continue to fill members’ prescriptions as written by providers and process claims as normal. EOHHS and Medicaid will pay all eligible claims submitted by pharmacies.
    • Governor Dan McKee and EOHHS announced the awarding of approximately $650,000, via two grant programs, for home stabilization service providers. Home stabilization programs provide an array of time-limited services to eligible Medicaid members, including home tenancy support, life skills training, and other modeling and teaching services for individuals who require support in maintaining a home, and home finder services to individuals who require support in securing and transitioning to housing.
  • Utah
    • CMS announced Utah’s extension of comprehensive coverage for postpartum individuals for a full 12 months through Medicaid and CHIP. Utah is the 45th state to be approved for the extended coverage, and an additional 4,000 people in Utah will be eligible for Medicaid and CHIP coverage for an entire year after pregnancy. As a reminder, SHVS published an issue brief on the American Rescue Plan option to extend postpartum coverage.
    • With the ongoing Change Healthcare network and system outages, Utah Medicaid is working with Utah pharmacies to make sure Medicaid members are able to access the medications they need. State staff made 21,000 outbound calls to members, with 12,600 resulting in speaking with the member or leaving a voicemail with general information related to the current pharmacy problem and how to navigate it. Utah Medicaid has asked pharmacies to provide up to a 30-day supply of medications at no cost to Medicaid members and has created a system for interim reimbursement for pharmacies that are providing medications for Medicaid members.
  • Vermont – The Department of Vermont Health Access has posted a variety of communications in response to the Change Healthcare outage. The resources include a list of frequently asked questions about the outage, regulations and best practices for pharmacists dispensing controlled substances during the service outage, claim submission information, and other resources for pharmacies and prescribers.