March 28 Update

In This Week’s Update:

  • Medicaid churn learning collaborative 
  • Creating new opportunities for doulas
  • New unwinding resources for states 
  • Overview of the Public Charge Proposed Rule
  • State Strategies to Support Telehealth Infrastructure
  • State updates: AK, CO, IL, IA, NV, NC, VA, WA & WI 

State Medicaid Churn Learning Collaborative Opportunity

The Benefits Data Trust Medicaid Churn Learning Collaborative will help states navigate the end of the Public Health Emergency for their Medicaid members. 

Benefits Data Trust, with support from the Robert Wood Johnson Foundation, is currently accepting state applicants to join a new 12-month learning collaborative that will provide a unique opportunity for state Medicaid agencies to receive individually tailored technical assistance to develop and advance policies and practices that reduce Medicaid churn – the cycling of individuals on and off Medicaid. 

The technical assistance provided through this opportunity — at no cost to states — will support states in preparing for the end of the COVID-19 federal public health emergency and the subsequent termination of the Medicaid continuous coverage requirement.

To learn more, visit the FAQ page and complete an interest form HERE by end-of-day April 15, 2022

Creating New Opportunities for Doulas

As many states seek to improve pregnancy and childbirth outcomes among people of color, strategies to expand the maternity care workforce and implement an accessible doula network are increasingly a priority. For example, New Jersey began providing Medicaid coverage of doula services in January 2021. California is seeking to implement coverage for doulas as part of a broad set of activities to improve maternity care implemented under the SB-65 California Momnibus Act and recent state budget provisions. On March 29, the Center for Health Care Strategies will host a webinar, made possible by the California Health Care Foundation, which will explore challenges and opportunities to expand the maternity care workforce and highlight California and New Jersey’s experiences in implementing the doula benefit. National and state experts will share key considerations for developing a doula workforce.

Overview of the Public Charge Proposed Rule

A new issue brief, Overview of the Public Charge Proposed Rule was recently released which provides an analysis of key provisions of the 2022 notice of proposed rulemaking (NPRM) released on February 17 by the Department of Homeland Security. Comments on the 2022 NPRMare due on April 25. For help communicating with immigrant populations about their public charge concerns, see our issue brief on education and outreach strategies.

 New Unwinding Resources for States 

The Centers for Medicare & Medicaid Services (CMS) released additional templates and resources to support state reporting around enrollment and renewal efforts when the federal public health emergency (PHE) concludes. The resources include 1) a “Renewal Distribution Report” form in which states will be required to summarize their renewal plans, with a focus on mitigating inappropriate coverage loss during the unwinding period and 2) an “Unwinding Eligibility and Enrollment Data Reporting” Excel workbook and specifications document, which aims to support states in reporting on certain metrics around timely application processing, renewal initiation and completion, reason for termination, and fair hearings. CMS also previewed that states will eventually report on these metrics on a monthly basis. For more information, see our recent expert perspective, New CMS Guidance on Expectations for Unwinding Federal Medicaid Continuous Coverage, and our unwinding resource page

State Strategies to Support Telehealth Infrastructure

The COVID-19 pandemic has exacerbated the opioid crisis, contributing to a nearly thirty percent increase in drug overdose deaths during the first year of the pandemic. Early efforts to mitigate access to opioid use disorder treatment challenges included federal flexibilities to support telehealth provision of treatment. Many states have embraced the modality and are now exploring opportunities to support and fund the infrastructure components necessary to support telehealth service delivery. On April 7 the National Academy for State Health Policy will host a webinar in collaboration with Mercer, featuring state policy leaders from South Carolina and Nevada, who will discuss how their states have navigated restrictions around use of federal funds to support telehealth infrastructure while ensuring sufficient coverage to meet healthcare demand.

State Updates

  • Alaska – Governor Dunleavy’s Executive Order 121, to divide the Department of Health and Social Services (DHSS) into two smaller departments, was enacted into law and takes effect July 1. DHSS, which is currently the state’s largest department, will be divided into a Department of Health and a Department of Family and Community Services. Governor Dunleavy noted that “reorganization will create an environment for innovation and greater responsiveness.”
  • Colorado – The Colorado Department of Health Care Policy & Financing announced it has entered into two value-based contracts with Novartis Pharmaceuticals Corporation for its Entresto drug therapy used to treat heart failure and Zolgensma drug therapy used to treat spinal muscular atrophy. These new contracts hold the drug manufacturer financially accountable to the clinical outcomes demonstrated in clinical trials and will help deliver savings to state and federal budgets as well as taxpayers in the form of manufacturer refunds when drug therapies do not meet the defined clinical health outcomes for Medicaid members who are taking them. 
  • Illinois – Governor Pritzker announced the 2022 State of Illinois Overdose Action Plan, a comprehensive, equity-centric outline for combating the opioid epidemic. Additionally, the Governor named David T. Jones as the state’s Associate Secretary for Behavioral Health at the Illinois Department of Human Services, to be known as the Chief Behavioral Health Officer. 
  • Iowa – The Iowa Departments of Public Health and Human Services released the final change package and functional organizational chart, bringing them one step closer to becoming a single agency. The documents will serve as the roadmap to bring together both agencies under a single leadership structure, with the goal of strengthening coordination amongst existing services and providing more comprehensive services to all Iowans.  
  • Nevada – Governor Steve Sisolak announced plans to host the first-ever Healthcare Provider Summit on April 19, a daylong forum with community partners, stakeholders and state agencies focused on ways to bridge gaps in care and provide the best possible service to Nevadans.
  • North Carolina – The North Carolina Department of Health and Human Services released a coordinated action plan to address the urgent crisis of children with complex behavioral health needs who come into the care of child welfare services. The action plan represents the work of a multi-sector team of stakeholders that is working to transform the way that the child welfare, behavioral health and other systems that support children and families work together.
  • Virginia – The Virginia Department of Medical Assistance Services announced information and resources for partners in preparing for the end of the public health emergency in the March edition of their Partner Points newsletter. The newsletter included a toolkit to guide stakeholders and advocates as they assist Medicaid members with the end of the public health emergency.  
  • Washington 
    • The Washington State Health Care Authority released the findings from the 2021 Healthy Youth Survey (HYS), a statewide survey of young people focused on their health behaviors. Data suggest mental health concerns remain with some signs of improved health behaviors, including a decrease in substance use. The findings underscore the importance of a continued focus on efforts in schools, families, and communities to support healthy youth development.
    • Pam MacEwan, CEO of the Washington Health Benefit Exchange, announced that she will be stepping down from guiding the state’s health insurance marketplace, Washington Healthplanfinder, an organization she has served for nearly 10 years. The move will be effective as of June and the Exchange Board will be appointing an interim CEO in the coming weeks. We wish Pam well in her upcoming retirement! 
  • Wisconsin – The Wisconsin Department of Health Services (DHS) released its findings from a series of listening sessions and an online survey conducted in January 2022, which sought input from substance use service providers, family and friends of people with a substance use disorder and people living with a substance use disorder. DHS will use the feedback as it finalizes its plans to invest funds received through national settlements with opioid distributors and manufacturers.