October 24 Update

In This Week’s Update:

  • Maternal Health Compendium
  • CMS Proposed Rule on Medicaid and CHIP E&E
  • State Access to Behavioral Health Services
  • Strategies in Behavioral Health Integration
  • State updates: CO, DE, IL, KY, MD, MI, NE, NH, PA & SC


Maternal Health Compendium

Last week, State Health and Value Strategies published a compendium that provides information on state strategies to improve maternal health outcomes. The compendium synthesizes research about the national state-of-play across four domains: maternal health models, quality improvement, workforce and benefits, and eligibility and enrollment/coverage expansion. 


CMS Proposed Rule on Medicaid and CHIP E&E

On Monday, October 17, State Health and Value Strategies hosted a webinar that provided an overview of the proposed rule that seeks to strengthen existing eligibility, enrollment, and renewal operational processes. During the webinar experts from Manatt Health highlighted the intersection with unwinding and the end of the public health emergency, discussed key considerations related to the new policy, IT systems, and operational process changes, and reviewed opportunities for state policymakers to provide comment. The webinar drew on the expert perspective CMS Proposed Rule on Medicaid and CHIP Eligibility, Enrollment, and Renewal that summarizes the proposed rule. Both the slide deck and a recording of the webinar are now avaliable. Comments on the proposed rule are due no later than November 7, 2022. If your state is interested in TA to support the submission of comments on the proposed rule, please be in touch.


State Access to Behavioral Health Services

The United States is in a behavioral health crisis exacerbated by the pandemic. As more individuals and families need behavioral healthcare, they face significant barriers to treatment. The Mental Health Parity and Addiction Equity Act (MHPAEA) was enacted to remove insurance-related obstacles to mental health and substance use disorder treatment, but inadequate compliance has raised questions about health plan enrollees’ ability to access these crucial services. In a new issue brief supported by the Robert Wood Johnson Foundation, experts from the Georgetown Center on Health Insurance Reforms review MHPAEA oversight and enforcement in five states—Arizona, Nebraska, Pennsylvania, Virginia, and Washington—to understand the challenges states face and identify opportunities for improvement. The brief focuses on enforcement of parity requirements for “non-quantitative” treatment limits that insurers impose on enrollees, such as prior authorization requirements and medical necessity determinations.


Strategies in Behavioral Health Integration

The need and demand for behavioral health services continues to rise across the country, and the ability for families, providers, and payers to connect to the full range of care and respond effectively is critical. A fully integrated model that includes behavioral and physical health coverage can empower states, managed care organizations (MCOs) and providers to holistically meet the needs of enrollees. On October 24, the National Opinion Research Center (NORC) at the University of Chicago will host Part V of the Medicaid Managed Care Webinar Series highlighting the state of Washington’s framework to integrate behavioral health from the policy, payer, and provider perspectives. Speakers will share key strategies to address operational and structural challenges for integration, how partnerships between the state, MCOs and providers can be leveraged to implement the model and the benefits of “carving in” behavioral health services. The webinar will also provide an overview of the programs and services launched as a result of integrating behavioral health services and lessons learned. Registration information is available here.


  • Colorado – The Department of Health Care Policy and Financing announced an informational webinar on preparing for the end of the PHE, geared toward partners such as advocacy organizations, providers, and community organizations who may provide other assistance to Health First Colorado (Medicaid) or Child Health Plan Plus members. The webinar will include an overview of communication resources for partners to assist members in preparing for and taking part in the renewal process.
  • Delaware – As part of its strategic plan to improve access for Delawareans across the state, the Department of Health and Social Services is launching a community engagement phase to hear from the community about their experiences navigating and receiving state services such as food benefits, Temporary Assistance for Needy Families (TANF), emergency housing and Medicaid, and potential solutions to make those services more effective for all.
  • Illinois – Governor JB Pritzker and the Illinois Department of Public Health (IDPH) announced that the state is awarding up to $3.7 million to 18 different organizations across Illinois to address systemic health disparities that have been highlighted by the COVID-19 pandemic. The program, Activating Relationships In Illinois for Systemic Equity (ARISE), is a joint initiative of IDPH’s Center for Minority Health Services and the Center for Rural Health. The goal of the ARISE program is to work with trusted, community-based partners to take significant strides towards closing health equity gaps.
  • Kentucky
    • Governor Andy Beshear announced a new initiative to support workforce participation by expanding Medicaid coverage of dental, vision, and hearing services. The initiative will reach more than 900,000 adults enrolled in the state Medicaid program and includes 1) expanding dental benefits to cover fillings, root canals, and two cleanings per year; 2) adding a set of glasses or contacts to vision coverage; and 3) covering hearing aids and fittings.
    • The Kentucky Department for Medicaid Services submitted a request to extend the KY HEALTH section 1115 waiver demonstration for a five year period. The demonstration increases access to substance use disorder treatment for individuals who are Medicaid eligible, and provides coverage to former foster care youth under age 26 who were in foster care under the responsibility of another state when they turned 18 and were enrolled in Medicaid at that time or at some point while in foster care. The federal comment period will be open from October 14, 2022 through November 13, 2022.
  • Maryland – The Maryland Department of Health announced $80 million in additional funding to support hospitals and skilled nursing facilities in the state. Governor Larry Hogan has dedicated $50 million in funding to be distributed across both the hospital and skilled nursing facility industries ($25 million each), which have been affected by the COVID-19 pandemic and related workforce challenges.
  • Michigan –  Governor Gretchen Whitmer and the Michigan Department of Health and Human Services announced they are seeking CMS approval for an amendment to the Medicaid State Plan to create an initiative called “Plan First!” that would expand access to family planning services. The initiative would offer 25,000 Michiganders free contraception, cancer screenings, STI/STD testing, and more, saving them up to $2,000 a year.
  • Nebraska – The Nebraska Department of Health and Human Services has opened the applications for two grant programs, both funded under American Rescue Plan Act appropriations, that will provide $25 million total to support rural emergency services. The $5 million Emergency Medical Services (EMS) Equipment grant is intended to provide funding for the one-time purchase of emergency medical equipment. The $20 million Rural Ambulance Replacement grant is intended to assist EMS across Nebraska in replacing aging ambulance fleets.
  • New Hampshire – The Department of Health and Human Services submitted an application to extend its existing Substance Use Disorder, Serious Mental Illness, and Serious Emotional Disturbance Treatment Recovery and Access section 1115 demonstration. The extension application seeks authority to continue the demonstration with the addition of a new community reentry program. The federal public comment period will be open through November 16, 2022.
  • Pennsylvania – Governor Tom Wolf announced that Pennsylvania is proposing to enter a new profit-sharing agreement with its Medical Assistance physical health (PH) managed care organizations (MCOs). Under the proposed agreement, PH-MCOs will be limited to 3% profits annually with the requirement to invest additional profits in approved projects and initiatives that directly benefit the health and well-being of Pennsylvanians. The agreement would take effect for the 2023 contract year.

South Carolina – The South Carolina Department of Health and Human Services announced the implementation of three changes to the Medically Complex Children Waiver (MCCW) program, which serves children who meet hospital level-of-care and have chronic physical/health conditions that are expected to last longer than 12 months. The changes include an increase of the maximum age for MCCW participation to age 21, implementation of environmental modification services (physical adaptions to the private residence of the participant or the participant’s family), and recruitment of respite service providers.