October 7 Update

In This Week’s Update:

  • Executive Order on Medicare
  • HHS Wellness Project
  • State Updates: CO, ID, NJ, NY, OH, OR, TN & UT
  • Webinar: Medicaid MCOs and Health Equity
  • Strengthening Medicaid’s Access to Care for CSHCN
  • Politico Pulse Check Podcast: Adam Boehler
  • Lessons from CDC’s 6|18 Initiative


Executive Order on Medicare

Last week, President Trump signed an executive order that focuses on the Medicare program. The executive order directs the Department of Health and Human Services (HHS) to develop proposals to address several aspects of Medicare, including plan options for seniors, plan designs and payment models, and the enrollment process for choosing plans. For more information on the executive order, tune into Kaiser’s “What the Health” podcast (segment starts at 1:25).


HHS Wellness Project

Also last week, HHS released a bulletin announcing an application for 10 states to participate in a wellness demonstration project in the individual market. See this Health Affairs blog post for more information on wellness programs, more broadly, the demonstration project bulletin and potential state options.


State Updates: CO, ID, NJ, NY, OH, OR, TN & UT

  • Colorado – The Department of Health Care Policy & Financing announced the Child Health PlanPlus (CHP+) program will begin covering dental services for enrolled prenatal women effective October 1, 2019. This coverage is made possible by HB19-1038, which was signed into law by Governor Polis in April. The dental services available for CHP+ prenatal women will be the same services provided for current CHP+ children. 
  • Idaho – The state submitted an application to the Centers for Medicare & Medicaid Services (CMS) requesting a new five-year Section 1115 demonstration to implement a community engagement requirement for the adult Medicaid expansion population. The federal public comment period is open from October 3, 2019 through November 2, 2019.
  • New Jersey – The New Jersey Department of Banking and Insurance announced that the state will provide up to $2 million in grant funding for state Navigators and other organizations to provide enrollment assistance to New Jersey residents. The Department also announced that it was notified by the Centers for Medicare & Medicaid Services (CMS) that it was authorized to serve as a State-Based Exchange on the Federal Platform (SBE-FP). In June, Governor Phil Murphy signed legislation to establish a State-Based Health Exchange in New Jersey. As part of the transition, the state will operate an SBE-FP for plan year 2020 and a State-Based Exchange for plan year 2021.
  • New York – The First 1,000 Days on Medicaid initiative created the Pediatric Care Clinical Advisory Group (CAG) to provide recommendations of how the state can support children at risk for not achieving their full potential due to individual and community–based disparities in health and available services. The CAG released its final report in which it recommends a pediatric health care model that incorporates behavioral health, addresses social determinants of health, and promotes health equity among all children and families.
  • Ohio – Governor Mike DeWine announced that CMS approved Ohio’s substance use disorder demonstration waiver that allows the state to use federal Medicaid funds for addiction-related treatment of individuals in institutions of mental disease (IMDs).
  • Oregon – The Oregon Health Authority released results from the Oregon Health Insurance Survey, which asks people in 8,000 Oregon households about insurance coverage, access to care, and health care use. The survey, conducted between February and August 2019, found that nearly 3.9 million Oregonians, or 94 percent, have health coverage.
  • Tennessee – The state submitted an amendment to their Section 1115 demonstration, TennCare II, that proposes to establish a “Katie Beckett” program within the TennCare demonstration to provide services and supports to children under age 18 with disabilities and/or complex medical needs who do not currently qualify for TennCare because of their parents’ income or assets. The federal public comment period is open from October 2, 2019 through November 1, 2019.
  • Utah – The Utah Department of Health released for public comment a Medicaid expansion waiver proposal covering individuals up to 138 percent of poverty. The so-called “fallback” waiver, required by the legislature, must be submitted to CMS by March 15, 2020.


Webinar: Medicaid MCOs and Health Equity

State Health and Value Strategies is convening the fifth, and last, webinar in its series SHVS Health Equity Through Managed Care on Tuesday, October 22 from 2:00 to 3:00 p.m. ET. For many states, eliminating disparities in Medicaid managed care programs means working with their MCO contractors, and implementing contractual requirements that advance health equity. The upcoming webinar, The Medicaid MCO Experience in Addressing Health Equity, will profile the work of one MCO, HealthPartners, in addressing equity issues within its Medicaid line of business. We’ll hear from Brian Lloyd, who manages Health Partners’ organization-wide equity initiative, which includes collecting data to eliminate disparities in care, supporting language access, partnering with communities, and building an organizational understanding of equity, diversity, inclusion, and bias. 

Registration (required) at the following link: https://rwjfevents.webex.com/rwjfevents/onstage/g.php?MTID=ee00973dbf7a8247a1e8626da3962c699


Keeping Medicaid’s Promise: Strengthening Access to Services for Children With Special Healthcare Needs

In partnership with the Robert Wood Johnson Foundation and the Lucile Packard Foundation for Children’s Health, Manatt Health released an issue brief focused on how state Medicaid agencies, families, advocates, providers, and other stakeholders can partner to improve access to services for Medicaid-enrolled children with special health care needs. The issue brief identifies a checklist of best practice strategies that states and state Medicaid agencies can implement or have already implemented to improve access to services and health care and to sustain those improvements over time through more effective monitoring, oversight, and collaboration with families and pediatric care teams. The specific access issues vary across states and sometimes within states, and evolve depending on new policies and a changing health care landscape. Taken together, this suite of recommended strategies can address the more common access barriers while creating the systems and accountability needed to ensure that children with special healthcare needs receive the care they require on an ongoing basis. Those interested can also view slides and a recording of an accompanying webinar that highlights the best practices and examples of state initiatives.


One-On-One with Adam Boehler

On the latest episode of Politico’s Pulse Check podcast, Adam Boehler, the departing leader of the Centers for Medicare and Medicaid Services Innovation Center (CMMI) sat down for an exit interview with Politico’s Dan Diamond. During the episode, Boehler discussed why he originally took the job, how he evaluated possible payment reforms, and provided his thoughts on the Trump Administration’s health care agenda. Boehler led CMMI for 18 months and during his tenure he oversaw the rollout of about 16 new payments models, including high profile initiatives focused on kidney and primary care.


Catalyzing Medicaid-Public Health Collaboration to Achieve Mutual Prevention Goals: Lessons from CDC’s 6|18 Initiative

The Center for Health Care Strategies is hosting a webinar, made possible with support from the Robert Wood Johnson Foundation, to describe CDC’s 6|18 Initiative and highlight recent accomplishments from participating Medicaid-public health teams. Medicaid and public health representatives from Kentucky and New Hampshire will discuss their collaborative efforts and successes in improving diabetes care and reducing tobacco use within the 6|18 Initiative. The webinar will also describe a new opportunity for Medicaid-public health teams to receive technical assistance under the 6|18 Initiative to advance prevention in their states. Interested individuals can register for the webinar here. The webinar is October 17.