Public Health Emergency
The Public Health Emergency (PHE) was extended through April 16th.
CMS published a letter on March 3rd extending the timeframe to wind down Medicaid renewals from 12 months to 14 months, but they did not extend the 60-day notice. According to this letter, the PHE will not begin winding down any earlier than July 2022.
Healthcare.gov Special Enrollment Period
CMS is extending the enrollment period through the rest of the year for those at or below 150% of the federal poverty level.
This is required for states who are a Federally Facilitated Marketplace through Healthcare.gov which includes: AL, AK, AZ, FL, GA, HI, IN, KS, LA, MI, MO, MA, MS, NC, OK, SC, TN, TX, UT, VA, WV, WI, WY, DE, IL, IA, NE, ND, OH and SD.
The extension is optional for states who are a State Based Marketplace which includes: AR, CA, CO, CT, ID, KY, NV, NM, OR, WA, DC, ME, MD, MA, MI, MN, NJ, NY, PA, RI and VT.
This does not include those eligible for Medicaid, Medicare Part A or most employer-sponsored health insurance plans.
Medicaid State of the Union
Governor Mike Dunleavy prepared an executive order that will separate the current health department into two divisions. The Department of Health division will manage public health, behavioral health, healthcare services and senior and disability services. The Department of Family and Community service will include juvenile justice, children services and several other sub-departments.
In February, Alaska’s legislature legal team reviewed the executive order and identified several issues, and they held an in-depth hearing later that month. No outcome of that hearing has been published yet.
The Indiana Department of Administration announced they would be awarding managed Medicaid contracts to Anthem/Blue Cross Blue Shield, Care Source Indiana, MDWISE and Centene/Managed Health Services. These managed care organizations will provide the Hoosier Healthwise and Healthy Indiana Plan programs, which cover adults, pregnant women and children for the Indiana Family and Social Services Administration.
Additionally, on March 3rd Governor Holcomb signed an executive order to end the Public Health Emergency. However, since Medicaid is managed by CMS, this change will not include the Medicaid flexibilities and redeterminations.
On April 4th the Kansas Medical Assistance Program (KMAP) will be moving to a new processing and payment system called Kansas Modular Medicaid System (KMMS). This system will replace many key functions impacting Kansas Medicaid providers.
Additionally, Blue Cross Blue Shield of Kansas City and Blue Cross Blue Shield of Kansas are partnering to submit a proposal on the new KenCare contract. The goal is for the new alliance to be called Healthy Blue and serve the managed Medicaid population within the state.
Although CMS opposes work requirements to be eligible for Medicaid, the state has developed a bill that would put Medicaid work requirements on the ballot for voters to decide in the November election. If approved, it would still need final approval by CMS via the 1115 waiver.
Effective April 1st, North Carolina Medicaid coverage for postpartum mothers will extend from 2 months to 12 months after birth.
Additionally, the state has flipped from a fee-for-service model to managed Medicaid, and this change is the foundation for the Health Opportunities Pilots Program. This program is an innovative approach that integrates a standardized screening process, referral and feedback system, care management and enhanced programming within Medicaid, and it builds on existing infrastructure in coordinated care and social services.
When fully implemented, this program will provide whole care and coverage for at risk recipients which includes services spanning from food, housing, transportation and medical needs. The approach is designed to create lasting change on all social determinants of health through the Medicaid program. Read more here.
Although the state has attempted or discussed Medicaid expansion multiple times, it does appear to have a larger backing than in the past. With bi-partisan support and many organizations promoting the change, it is a possibility the state could move forward with expanding their Medicaid program.
Governor Lee is proposing $25.5 million for dental benefits for over 600,000 qualifying residents, and his proposal also includes a commitment to retain dental providers. This investment in dental health is in response to a disproportionate amount of funds that have been used to treat dental health issues at hospitals. In 2019, Tennessee spent $10 million on patients showing up to the hospital because of tooth pain or another oral health crisis.
The rest of the medical-related budget proposed will be used to attract more medical residents to the state and for substance abuse treatment.