November 8 Update

In This Week’s Update:

  • Open Enrollment Period Begins
  • Webinars on Managed Care and “No Surprises Act” 
  • State Updates: AZ, MD, MN, MT, NC, OH, OR & SC
  • Consumer Views on Healthcare Affordability
  • Updated Navigator Resource Guide
  • Health Equity Focused Learning Community


Open Enrollment Period Begins

2022 open enrollment period (OEP) launched November 1. This year, has extended OEP by 30 days through January 15 to ensure everyone has enough time to get covered. To help communities with disproportionately high uninsurance rates, CMS also quadrupled its Navigator footprint of people who can assist with the process of getting covered, making assistance available in nearly every county in the nation. Additionally, there are more coverage options this season than last, with the average consumer being able to choose between six and seven insurance companies with plan options. A new fact sheet about the 2022 OEP is available on the CMS website.


Webinars on Managed Care and “No Surprises Act” 

State Health and Value Strategies held two related webinars for states. The first, Promoting Health Equity in Medicaid Managed Care, profiled the recently published Promoting Health Equity in Medicaid Managed Care: A Guide for States, a practical guide that offers a series of concrete actions state Medicaid agencies can implement internally and with their contracted health plans in pursuit of health equity. The second, Enforcement of the No Surprises Act: Considerations for States, provided an overview of federal regulators’ proposed approach to enforcement of the No Surprises Act (NSA) and shared strategies to consider in planning provider and consumer education efforts. 


State Updates

  • Arizona – The Arizona Health Care Cost Containment System (AHCCCS) announced that it received approval from the Centers for Medicare & Medicaid Services (CMS) of a State Plan Amendment extending Medicaid School Based Claiming (MSBC) services to a larger population of Medicaid-enrolled students. While MSBC has long been available to students who have an Individualized Education Plan, this approval allows AHCCCS to cover additional school-based services from specialty providers for even more Medicaid-enrolled students, now including those with Individualized Family Service Plans and other medically necessary plans of care.
  • Maryland – The Maryland Department of Health announced Medicaid rate increases for home and community-based services (HCBS) providers. Increased Medicaid rates will enable HCBS providers to strengthen service delivery. During the most recent legislative session, the Maryland General Assembly passed legislation directing the state’s Medicaid program to spend at least 75 percent of federal American Rescue Plan Act funding reinvestment dollars on a one-time-only provider rate increase.
  • Minnesota
    • The Minnesota Department of Human Services (MDHS) finalized $3.87 billion in managed care contracts to serve approximately 600,000 children, parents and pregnant people in the seven-county metro area in 2022. The contracts with health plans cover MinnesotaCare and a large share of Medical Assistance through the Prepaid Medical Assistance Program. The latest contracting process prioritized efforts to address equity and eliminate health disparities. As a reminder, SHVS recently published a revised version of Medicaid Managed Care Contract Language: Health Disparities and Health Equity, a compendium of health equity language from Medicaid managed care contracts and requests for proposals.
    • MDHS announced the launch of a new accessible, easy-to-use online application, MNbenefits, for nine public assistance programs, with statewide adoption anticipated by early 2022. A 16-county pilot of MNbenefits showed that MDHS clients can complete an application in as little as 12 minutes. The average time to complete the existing online application is 60 minutes.
  • Montana – The Department of Public Health and Human Services released a new report that ranks COVID-19 associated deaths as the third leading cause of death in Montana in 2020 and will likely hold the same ranking for 2021.
  • North Carolina – The North Carolina Department of Health and Human Services released the North Carolina Violent Death Reporting System (NC-VDRS) Data Dashboard, an interactive online dashboard that provides aggregate information on violent deaths for all 100 counties in North Carolina. The NC-VDRS dashboard, funded by the Centers for Disease Control and Prevention, was created to make data more accessible to public health partners to inform the development, implementation and evaluation of prevention efforts around violence and safety. 
  • Ohio – The state submitted a request to amend its Section 1115 demonstration for substance use disorder treatment to prospectively increase the demonstrations per member per month limit for the managed care Medicaid eligibility group to account for changes that occurred in the managed care program. The federal public comment period will be open through November 27, 2021.
  • Oregon – The Oregon Health Authority (OHA) announced the publication of final policy concept papers for the state’s 1115 demonstration waiver renewal. The concept papers outline changes OHA proposes to make to the Oregon Health Plan as part of the state’s effort to advance health equity and will provide the framework for the state’s upcoming application to CMS.
  • South Carolina – The South Carolina Department of Health and Human Services, in partnership with Children’s Trust of South Carolina, launched Community Connections, a free 24/7 online database of resources that connects South Carolinians in need with available social and health care services across the state. Individuals can search for free or low-cost services like medical care; employment and job training opportunities; food and financial assistance; and, education, transportation and child care resources in their communities.


Upcoming SHVS Webinar – Save the Date!

 Policy, Operational, and IT System Strategies to Prepare for PHE Unwinding

Wednesday, November 10 from 2:00 to 3:00 p.m. ET.

State Health and Value Strategies is hosting a webinar that will provide an overview of strategies for states seeking to ensure that eligible enrollees are able to keep or transition to new affordable health coverage when the public health emergency (PHE) continuous coverage requirement ends. Following the expiration of the PHE, states will resume eligibility and enrollment activities for all enrollees in Medicaid and the Children’s Health Insurance Program (CHIP). As part of their planning for resuming eligibility and enrollment operations, states have an opportunity to retain coverage gains experienced over the pandemic period by taking steps to ensure that eligible enrollees are able to keep Medicaid/CHIP coverage, and those who are eligible for subsidized Marketplace coverage are transitioned and enrolled. Experts from Manatt Health and McKinsey & Company will discuss how states can prepare now by deploying strategies to update enrollee contact information, and make other eligibility and enrollment technology changes to better serve their residents.   

Registration (required) at the following link:


Healthcare Affordability: Majority of Adults Support Significant Changes to the Health System

Healthcare costs continue to rise putting access to high-quality health services out of reach for too many individuals and families, especially those with lower incomes who are disproportionately people of color. Findings from a Robert Wood Johnson Foundation national survey of adults helps illuminate respondents’ experiences with healthcare costs, perceptions of who is to blame, appetite for change, and feelings about a range of policy reforms. There is widespread support for policies to lower healthcare costs as consumers continue to make sacrifices such as delaying or forgoing care. More than half (52 percent) of respondents want big fundamental changes to the health system to bring costs down. Additionally, those with lower incomes, who are disproportionately people of color, report feeling the strain of high healthcare costs more than others, illustrating that lowering costs can help advance health equity.


Navigator Resource Guide

The Georgetown University Center on Health Insurance Reforms released an updated Navigator Resource Guide. This guide is focused on the private insurance reforms of ACA, including the health insurance marketplaces, benefit and cost structures, and premium tax credits. It is organized into four sections that address how individuals may present themselves to Navigators based on their insurance status and coverage options. The questions and answers in the guide have been developed in collaboration with the staff at the Center on Budget and Policy Priorities, the Georgetown University Center for Children and Families, and the Kaiser Family Foundation.


Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative

Based on an unprecedented increase in public health funding and an extraordinary focus on the health equity divide during the COVID-19 pandemic, governmental public health and its partners have an opportunity to amplify a vision for vibrant communities where everyone can lead their healthiest life. With support by the Robert Wood Johnson Foundation, the CDC Foundation, the Association of State and Territorial Health Officials and the Michigan Public Health Institute released a request for applications for the Strategies to Repair Equity and Transform Community Health (STRETCH) Initiative. This initiative will convene state health agencies and their partners to establish a learning community that will combine virtual engagements with tailored technical assistance to support state health agencies. A virtual informational session is scheduled for Tuesday, November 9 at 3:00 p.m. ET to learn more. Responses to the request for applications are due November 19.