March 30 Update

In This Week’s Update:

  • New SHVS Resource Page on COVID-19
  • SHVS COVID-19 Webinar
  • Affordable Care Act Anniversary
  • COVID-19 State Updates: CA, CO, DE, FL, IA, IL, LA, MA, MD, ME, MN, MO, NC, NJ, NV, NY, OR, SC, TX, WA
  • Other State Updates: NE, FL, SC
  • Hospital Readiness for COVID-19
  • Maternal and Infant Mortality in Medicaid

New SHVS Resource Page on COVID-19

Last week, State Health and Value Strategies officially launched the SHVS Resource Page For States on COVID-19. This resource page, developed in partnership with a team of technical assistant experts, serves as an accessible “one-stop” source of COVID-19 information for states. The webpage is designed to support states seeking to make coverage and essential services available to all of their residents, especially high risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available. The latest resource for states includes an expert perspective authored by Manatt Health on CMS guidance for states about the new increased Medicaid and CHIP matching rate and conditions states must meet to qualify for it.

SHVS COVID-19 Webinar

SHVS hosted a webinar for state health officials on the implications of health care provisions for states in the second COVID-19 stimulus bill. The slide deck and a recording of the webinar are posted on the SHVS website.

Affordable Care Act Anniversary

SHVS program director Heather Howard co-authored an op-ed last week reflecting on the tenth anniversary of the Affordable Care Act, how far we’ve come in transforming our health care system, and the work that still remains.  

COVID-19 State Updates

  • Expanding Access to Telehealth Services
    • Maine – The Superintendent of Insurance signed an order that requires insurance companies to provide coverage for clinically appropriate services delivered by telephone, as well as via more commonly used apps, such as FaceTime, WhatsApp, and Skype, as long as they are private.
    • Oregon – The Oregon Department of Consumer and Business Services and the Oregon Health Authority issued guidance to health insurance plans regarding the provisions of health care services to their members through multiple telehealth platforms.
    • South Carolina – The South Carolina Department of Health and Human Services (SCDHHS) announced additional temporary modifications to policies related to telehealth coverage. SCDHHS will reimburse Federally Qualified Health Centers (FQHCs) and Rural Health Clinics (RHCs) for providing telehealth services.
  • Expanding Workforce Capacity
    • Maine – Governor Mills signed an Executive Order allowing licensed physicians, physician assistants, and nurses greater flexibility to contribute to Maine’s response during the state of emergency, including receiving an emergency license to provide health care in person or through telehealth to residents of the state, with no application fee.
  • Grace Periods
    • Oregon — The Oregon Department of Consumer and Business Services issued a temporary emergency order that requires all insurance companies to extend grace periods for premium payments, postpone policy cancellations and nonrenewals, and extend deadlines for reporting claims.
  • Section 1135 Waivers – CMS approved Section 1135 Medicaid waivers requests from 22 states this week, bringing the total number of approved waivers to 34. All Section 1135 approval letters are posted as they are issued on the CMS website.
  • Special Enrollment Periods (SEP)  
    • Colorado and Nevada – The state-based exchanges in these states announced SEPs so uninsured residents can apply for and enroll in health insurance coverage.
  • Major Disaster Declarations
    • California, Florida, Illinois, Iowa, Louisiana, Maryland, Missouri, New Jersey, New York, North Carolina, Texas, and Washington – The Governors of these states requested major disaster declarations, all of which were granted by the President. A major disaster declaration makes federal funding available for Crisis Counseling for affected individuals as well as federal funding to state, tribal, and eligible local governments and certain private nonprofit organizations on a cost-sharing basis for emergency protective measures, including direct federal assistance under Public Assistance, for all areas affected by COVID-19. The federal cost share is 75 percent.
  • Other
    • California – Covered California, the state’s official health insurance marketplace, has developed the first national projection of the pandemic’s potential cost to 200 million Americans in the commercial market—which includes the individual, small-group, and large-group markets. The analysis found that the one-year projected costs in the commercial market range from $34 billion to $251 billion for the testing, treatment, and care specifically related to COVID-19.
    • Delaware – Governor John Carney and the Delaware State Housing Authority announced a new program to provide emergency housing assistance to renters affected by shutdowns, closures, layoffs, reduced work hours, or unpaid leave due to the COVID-19 health crisis. The Delaware Housing Assistance Program will provide eligible households up to $1,500 in assistance, with payments made directly to the property owner or utility company.
    • Massachusetts – To ensure the care and safety of the Boston area’s homeless population during the COVID-19 epidemic, the Baker-Polito Administration announced that a former Boston Medical Center hospital building will be temporarily reopened and used to meet COVID-19-related medical needs of area homeless residents.  
    • Minnesota – Governor Tim Walz announced the Emergency Child Care Grant Program, which will provide financial support to licensed child care providers in greater Minnesota serving families of essential workers needed to respond to the COVID-19 pandemic.
    • North Carolina – In an executive order signed last week, Governor Roy Cooper waived restrictions to increase access to caregivers to provide flexible child care and elder care during the coronavirus emergency.


Other State Updates

  • Florida – Governor DeSantis signed into law a bill that allows advanced nurse practitioners with at least 3,000 hours of experience under the supervision of a physician to qualify to provide services including family medicine, general pediatrics, and general internal medicine without an attending doctor’s supervision.
  • South Carolina – The South Carolina Department of Health and Human Services is implementing changes for select physician-administered drugs. SCDHHS contracts with a designated quality improvement organization, KEPRO, for utilization review and prior authorization services.
  • Nebraska – The Department of Health and Human Services announced that it will hold a public hearing on April 9 to receive comments on the adoption of changes to the Nebraska Alternative Benefit Plans, Medicaid Eligibility and Nebraska Medicaid Managed Care, changes required for the implementation of the state’s Medicaid expansion.


Hospital Readiness for COVID-19: Analysis of Bed Capacity and How it Varies across the Country

A new report by the Urban Institute presents estimates of the number of occupied versus unoccupied beds at the national, state, and county levels, using data from the 2018 American Hospital Association Annual Survey. Across the nation, concerns are mounting that the need for hospital beds will overwhelm national capacity as the COVID-19 outbreak expands, and this report finds just 0.8 unoccupied beds per 1,000 people in the United States. Research has identified many strategies for increasing hospital surge capacity and managing patient flow, and understanding how hospital capacity varies across the country is essential to targeting these strategies appropriately and responding effectively to the pandemic.


Moving the Needle on Maternal and Infant Mortality: A Conversation with New Jersey, Ohio, and Virginia

In the latest Medicaid Leadership Exchange podcast, staff from New Jersey, Ohio, and Virginia Medicaid, and the Association of State and Territorial Health Officials, discuss the many ways that states are working to address the challenges surrounding maternal and infant mortality, specifically the significant disparity experienced by black women. The panelists discuss how universal data dashboards, mandatory perinatal assessments, expansion of coverage to include home visiting and doulas, and shared messaging to the community are showing promising outcomes. The conversation is moderated by Gretchen Hammer, former Colorado Medicaid director and senior strategic advisor at the National Association of Medicaid Directors, and includes insights from Mark Larson, former Vermont Medicaid director and senior vice president of leadership and capacity building at the Center for Health Care Strategies. Those interested in learning more can check out the SHVS publication and companion webinar on Medicaid’s role in combating the maternal morbidity and mortality crisis.