On December 10, 2024, the Centers for Medicare & Medicaid Services released an updated CMCS Informational Bulletin (CIB) that refines CMS’ descriptions of opportunities for states to cover clinically appropriate and evidence-based services and supports that address health-related social needs (HRSN) in Medicaid and the Children’s Health Insurance Program. This expert perspective summarizes the CIB.
On November 14, 2024, CMS released its second installment in its series of Medicaid and CHIP guidance intended to support state efforts to verify eligibility and conduct renewals in compliance with federal Medicaid and CHIP requirements. A new expert perspective summarizes the latest CMCS Informational Bulletin and accompanying slide deck which address the continued use of unwinding-related section 1902(e)(14) waivers beyond the previously established expiration date of June 30, 2025.
On September 26, 2024, the Centers for Medicare & Medicaid Services (CMS) released comprehensive guidance, accompanied by a summary slide deck, reinforcing and clarifying federal Medicaid requirements regarding Early and Periodic Screening, Diagnostic, and Treatment (EPSDT). This expert perspective provides an overview of CMS’ new EPSDT guidance, which represents CMS’ most comprehensive discussion of EPSDT requirements in over a decade.
On September 9, the Centers for Medicare & Medicaid Services (CMS) released a new collection of federal Medicaid and CHIP reporting templates designed to assist states in monitoring Mental Health Parity and Addiction Equity Act (MHPAEA) compliance in Medicaid and CHIP. Informal public comment is requested by December 2, 2024. This expert perspective reviews the reporting templates to highlight considerations for states and support the formulation of comment submissions.
In today’s dynamic digital landscape, state Medicaid agencies and Marketplaces have various tools to reach their audiences efficiently and effectively with important information. WhatsApp, a globally adopted direct messaging platform, has risen in popularity with users in the U.S. and shown increased potential for reaching specific populations. While WhatsApp is commonly used as a direct-to-consumer tactic, this expert perspective explores strategies and best practices for states that are interested in using WhatsApp in their member outreach and support efforts.
On July 23, 2024, the Centers for Medicare & Medicaid Services released a State Health Official letter, “Provisions of Medicaid and CHIP Services to Incarcerated Youth.” The letter provides implementation guidance on the Consolidated Appropriations Act, 2023 requirements that states provide specific services for children and youth eligible for Medicaid and CHIP and involved in the juvenile justice system. The SHO letter also offers states the option to provide full scope Medicaid and CHIP services to justice-involved eligible children and youth. The effective date for the provisions in the SHO letter is January 1, 2025. This expert perspective reviews the SHO letter in detail and highlights key considerations for states.
On June 26, 2024 the Centers for Medicare & Medicaid Services (CMS) released the Notice of Funding Opportunity (NOFO) for the Transforming Maternal Health (TMaH). This expert perspective summarizes the key takeaways pertaining to the model. CMS recommends that states submit a letter of intent to apply for the TMaH model and these optional letters of intent are due on August 8, 2024. Applications to participate in the model are due on September 20, 2024.
The final Access Rule published on April 22, 2024 establishes new requirements for states regarding the engagement of people enrolled in Medicaid to inform policy and program design. Under the rule, states will need to create and support a Beneficiary Advisory Council (BAC) composed solely of current and former Medicaid enrollees, their family members, and paid and unpaid caregivers and a Medicaid Advisory Committee, comprising a diverse array of stakeholders, including members drawn from the BAC. The new requirements provide states with the opportunity to engage community members in a way that builds and maintains trust and strengthens the Medicaid program.
State Health and Value Strategies’ States of Innovation series profiles the latest health news at the state level, highlighting what states are working on to achieve better, more affordable, and more equitable health for all. This States of Innovation highlights state activity in May 2024 which includes state efforts to address affordability, increase access to children’s coverage and care, engage the community and advance health equity. States also took action on maternal and reproductive health, access to mental and behavioral health, and coverage for justice-involved populations. This States of Innovation features updates from Alabama, Arizona, Arkansas, California, Connecticut, Delaware, Georgia, Hawai’i, Iowa, Kentucky, Massachusetts, Michigan, Minnesota, Nebraska, New Jersey, New Mexico, Nevada, North Carolina, Oregon, Pennsylvania, Rhode Island and Tennessee.
On April 26, the U.S. Department of Health and Human Services Office for Civil Rights released a final rule interpreting section 1557 of the Affordable Care Act , which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability. This expert perspective reviews the implications of the rule for state policymakers.