November 15 Update

In This Week’s Update:

  • Medicaid Continuous Coverage Unwinding: IT Strategies
  • State Updates: AR, AZ, CA, CO, CT, GA, MN, NJ, NY, NV, OK, OR & WA
  • Patient-Centered Addiction Care
  • Healthcare for People Experiencing Homelessness
  • Partnering with Healthcare to Build a Stronger Child Care System


IT Strategies to Keep Medicaid Enrollees Covered 

State Health and Value Strategies hosted a webinar that provided an overview of strategies for states to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the Medicaid continuous coverage requirement ends. During the webinar, experts discussed how states can prepare now for the end of the continuous coverage requirement by deploying strategies to update enrollee contact information and make other eligibility and enrollment technology changes to better serve their residents. The slide deck and recording are available now. As a reminder, SHVS has created a resource page to serve as an accessible one-stop source of information for states in unwinding when the Medicaid continuous coverage requirement ends.




State Updates


  • Arkansas – In an effort to amplify client voices and increase feedback from Medicaid enrollees, the Arkansas Department of Human Services (DHS) is launching a Medicaid Client Voice Council. The council will meet every other month with the goal of improving the quality and delivery of Medicaid services for all Arkansans by learning from the experiences and hearing the ideas of the people DHS serves.  
  • Arizona  
    • The Arizona Health Care Cost Containment System (AHCCCS) awarded a contract to begin the strategic planning and modular road mapping of a full system overhaul of the Prepaid Medicaid Management Information System (PMMIS), a 30-year old mainframe computer system that manages the Medicaid business functions for Arizona. The awarded contractor, NTT Data, LLC, will create a roadmap of technological, budgetary, staffing, and business process challenges that Arizona will face as it converts from a single mainframe system into the modular approach preferred by the Centers for Medicare & Medicaid Services (CMS). The contract award is contingent upon CMS approval.  
    • Governor Doug Ducey announced $40.7 million to provide transitional housing for Arizonans, including members of the American Indian community and those with special needs. The Department of Housing, advocates, and the legislature identified organizations across Arizona to receive the funds, as a proactive way to combat homelessness.  
  • Connecticut – AccessHealthCT, the state-based marketplace, announced that in addition to on-site locations, it will offer three in-person enrollment fairs during November, giving Connecticut residents more time to shop, compare and enroll in quality health insurance plans. 
  • Georgia – CMS is opening a new 60-day federal comment period on the state’s proposed Section 1332 waiver application for the Georgia Access Model. The comment period runs from November 9, 2021 through January 9, 2022. 
  • Minnesota – Governor Tim Walz announced that the Minnesota Department of Health has hosted more than 1,000 community COVID-19 vaccination events since February in partnership with Minnesota community organizations and providers. The state has worked with trusted community institutions and hosted clinics in convenient locations and has seen a steady reduction in the gap in first dose vaccination rates between Black, Indigenous, and people of color and the statewide average. 
  • New Jersey – Governor Phil Murphy and other executive branch leaders announced the “Governor’s Challenge to Prevent Suicide Among Service Members, Veterans, and Their Families.” The initiative will bring together state and federal agencies to combat suicide among members of the military and their families. This work will build on existing suicide prevention efforts across the state and assist with further implementation of best policies and practices using a comprehensive public health approach.
  • Nevada
    • Governor Steve Sisolak announced the resignation of Heather Korbulic, the Executive Director of the Silver State Health Insurance Exchange, the state-based marketplace. Her last day is December 3, 2021. Heather has served as Executive Director of the Exchange since 2016 and has been a long-standing thought partner for the SHVS program. 
    • Nevada Medicaid announced the addition of a new fourth option when choosing a managed care organization (MCO) health plan starting January 1, 2022. With this addition, the new contracts require Nevada Medicaid to distribute members equally among all the MCOs. Members will have 90 days from January 1 to review the benefits provided by each MCO and may choose to switch to a different plan. 
  • Oklahoma – The Oklahoma Health Care Authority announced it has enrolled more than 200,000 Oklahomans approved for SoonerCare benefits through Medicaid expansion. Nearly 60 percent of these Oklahomans are new applicants. The remainder were qualifying members from existing programs, such as Insure Oklahoma and low-income adults (parent caretakers) who were transitioned to the expansion population.
  • Oregon – The Oregon Department of Consumer and Business Services is seeking public input before its third annual public hearing on prescription drug prices. The hearing is scheduled for December 8. The department set up a brief survey for consumers to ask questions and share their stories about rising prescription drug prices. 
  • Washington – The Washington Health Benefit Exchange, the state-based marketplace, reports over 208,000 customers in Washington have already secured health coverage for 2022 through Washington Healthplanfinder, the state’s online insurance marketplace. 
  • California and Colorado – Both states announced that COVID-19 booster shots are now available for all adults 18 and up residing in those states.  
  • Minnesota and New York – CMS announced additional funding in 2022 to the two states to support their respective Basic Health Programs as well as added funds for 2020 and 2021. The agency also released revised funding methodologies for program years 2020-2021 as well as a Q & A for states.


Strengthening Patient-Centered Addiction Care in the United States

The American Society of Addiction Medicine (ASAM) and Well Being Trust published a new resource designed to assist states looking to establish a strong, consistent framework, such as The ASAM Criteria®, for patient-centered, evidence-based addiction care. By helping providers, payers, and patients “speak the same language” when it comes to addiction care, this new Toolkit authored by Manatt Health is designed to support continuity and consistency in substance use disorder (SUD) treatment delivery and coverage. The Toolkit is designed to assist interested states in establishing a common framework across all payers, providers, and patients in describing addiction care and ensuring that care remains focused on the individualized needs of those living with SUD. It includes a comprehensive list of strategies that interested states can pursue, examples from current state efforts, and model legislative, regulatory, and contractual language from which interested states can draw. As a reminder, SHVS published an issue brief Implementing the ASAM Criteria for SUD Treatment through Medicaid Managed Care that draws from the experiences of states that were among the first to implement their SUD waivers to profile how The ASAM Criteria® is used within the context of managed care and utilization review, and the challenges and best practices associated with its use.


Improving Healthcare for People Experiencing Homelessness

The Alliance for Health Policy is hosting a panel of experts on Wednesday, November 17 to discuss policy options for improving the health of people experiencing homelessness. As of January 2020, over 580,000 individuals were experiencing homelessness in the United States. In August of 2021, the Supreme Court issued a majority opinion that ended the national eviction moratorium put in place at the beginning of the pandemic. As COVID continues to present new and evolving challenges for the nation’s health care system, it is important to understand how to best serve one of the country’s most disproportionately affected populations and increase access to health care services equitably and sustainably. The panel will provide an overview of the specific health and access challenges faced by people experiencing homelessness and highlight insights on how to deliver effective health care to this population.


Partnering with Healthcare to Build a Stronger Child Care System

PolicyLab at Children’s Hospital of Philadelphia (CHOP) is hosting a virtual conversation with child care and health care providers and policy and research experts that will explore the role health care systems can play in supporting early childhood education. Panelists will discuss the challenges to facilitating coordination between the health care and early childhood sectors and what policy changes can further support the health and well-being of children, caregivers and child care providers. The conversation will draw on a new issue brief published by PolicyLab that highlights policy changes that are needed to ensure a robust, quality child care system including how to support child care providers with behavioral interventions and policies to improve the quality of care for children with medical complexity.