September 14 Update: CMS and Hurricane Florence; New SHVS State Health Policy Highlights; Medicaid Directors share insights on operations

As southern coastal states prepared for hurricane Florence this week, Health and Human Services Secretary Alex Azar declared public health emergencies in North and South Carolina and Virginia. The Centers for Medicare and Medicaid Services (CMS) announced it is working to keep hospitals and other health care facilities open and running and has also waived certain Medicare, Medicaid and Children’s Health Insurance Program requirements. We are thinking of all those effected by the storm and the folks in state government working hard to ensure the safety of people in their state.

Also this week, CMS announced a new process for hardship exemptions from the Affordable Care Act’s (ACA) individual mandate penalty. New guidance released this week makes it easier for taxpayers to claim a hardship exemption on a federal income tax return without presenting the documentary evidence or written explanation generally required for hardship exemptions. In case you missed it, CMS awarded $10 million in grants to organizations that will serve as Navigators in federally-facilitated exchange states. Updates follow.

  • California – Covered California for Small Business (CCSB) announced the health plan choices and rates for small-business employers and their employees for the upcoming 2019 plan year. The statewide weighted average rate change will be 4.6 percent for employers and their employees, which represents the lowest annual increase in the program’s five-year history.
  • Florida – The Agency for Health Care Administration announced that the 2017 quality scores for Florida’s Medicaid program improved for the third year in a row and are the highest in the Florida Medicaid program’s history. In 2017, Florida’s Medicaid health plans performed as well as or better than the national average on 69 percent of quality measures.
  • Maryland
    • Attorney General Brian E. Frosh announced the filing of a lawsuit in the U.S. District Court for the District of Maryland against the Trump administration, seeking a declaratory judgment that the Affordable Care Act (ACA) is constitutional. The lawsuit follows the Trump Administration’s decision not to defend the ACA in Texas v. Azar.
    • Maryland Health Connection, the state’s official health insurance marketplace, is alerting consumers of a phone scam. A “health care enrollment center” is calling Maryland residents and offering to enroll consumers into affordable health plans. The message offers $199 plans and enrollment with no qualifying life event, outside of open enrollment.
  • New York — The New York State Department of Health announced nine finalists of the Social Determinants of Health ‘Call for Innovations’ Initiative. The solicitation for innovations attracted over 200 applicants from across the country, all of whom have come up with creative and effective ways to address social determinants of health for Medicaid members. The nine finalists represent community-based organizations, health care providers, and technology companies.
  • Oregon – A survey conducted for the Oregon Health Authority (OHA) found that Oregon Health Plan members are highly satisfied with the care they receive and trust the state’s Medicaid program for information about their health. The members who were surveyed also expressed support for policy changes OHA is proposing such as improving access to behavioral health services and containing costs.
  • Washington — The Washington Health Benefit Exchange Board announced the certification of the 2019 Qualified Health Plans and Qualified Dental Plans to be offered through Washington Healthplanfinder during the upcoming open enrollment period which begins November 1.

New SHVS State Health Policy Highlights: Integration Across State Agencies and  Addressing Social Determinants of Health

State Health and Value Strategies (SHVS) is pleased to share two new State Health Policy Highlights that profile existing SHVS resources for states. Service Integration and Joint Accountability Across State Agencies and Programs showcases three SHVS issue briefs that provide states with practical approaches to improve individual and population health and create joint accountability across health care and other sectors. Addressing Social Determinants of Health profiles two issues briefs and a webinar on approaches to addressing social determinants of health (SDOH) within Medicaid. We hope you find these new Highlights useful as a gateway to exploring the SHVS resources on these topics.

Medicaid Director Operations Survey Report

Our friends and partners at the National Association of Medicaid Directors (NAMD) just released their sixth annual Medicaid Director Operations Survey Report. The Report captures data from 45 Medicaid Directors and provides a unique look at state Medicaid agency operations and priorities from the perspective of Medicaid Directors. In this year’s report, NAMD has included a new section on leadership and team development. The findings from the report reveal four main themes that defined Medicaid operations across states in fiscal year 2017, which include continuing to prioritize the transition from volume-based to value-based care in their programs.

Medicaid Expenditures on Home and Community-Based Waiver Programs

The Center for Medicaid and CHIP Services (CMCS) released the 2016 Section 1915 (c) Home and Community-Based Services Waiver Programs Report this week. The nationwide data is broken down by waiver and population, as well as by individual state. Included in the report is spending and target population data for individual waiver programs within each state for federal fiscal (FY) year 2016. The report also compares recent trends to historical patterns and finds that FY 2016 was the second consecutive year that section 1915(c) waiver spending increased more than five percent. Section 1915(c) waiver programs accounted for 29 percent of all Medicaid long-term services and supports and 51 percent of all Medicaid home and community-based services (HCBS).