State Health and Value Strategies (SHVS), in partnership with Manatt Health, Georgetown’s Center on Health Insurance Reforms (CHIR), State Health Access Data Assistance Center (SHADAC), Bailit Health, and GMMB developed this resource page to serve as an accessible “one-stop” source of COVID-19 information for states. This resource is designed to support states seeking to make coverage and essential services available to all of their residents, especially high risk and vulnerable people, during the COVID-19 pandemic. SHVS will update this page frequently with new resources as they become available.
|If you have materials you are willing to share with other states through this page, or if there are topics of particular concern that you would like addressed, please contact SHVS.|
As states face the extraordinary challenges of the COVID-19 crisis, information technology (IT) is an essential tool to support access to health coverage and the safe and effective evaluation, testing, and treatment of patients nationwide. Under the current statutory and regulatory framework, state Medicaid agencies are authorized to receive federal funding for Medicaid IT and associated activities, and much of it at an enhanced federal matching level. This issue brief outlines potential IT investments in responding to COVID-19 and strategies for states to support these investments, as well as secure current and future IT investments that enable Medicaid program operations. The issue brief also highlights the Medicaid authorities and the provisions that may allow states more expeditious access and flexible use of these funds.
On Thursday, May 21, State Health and Value Strategies hosted a webinar that reviewed potential information technology (IT) investments in responding to COVID-19 and strategies for states to support these investments. As states face the extraordinary challenges of the COVID-19 crisis, IT is an essential tool to support access to health coverage and the safe and effective evaluation, testing, and treatment of patients nationwide. The webinar outlined strategies states can employ to secure current and potential IT investments that enable ongoing Medicaid program operations and advance health information exchange.
The COVID-19 pandemic continues to evolve and bring about significant–and rapidly occurring–changes in care delivery. As a result, states are examining their Medicaid managed care incentive arrangements to evaluate the impact of COVID-19 on their health care quality and cost performance requirements. This expert perspective identifies actions federal and state policymakers have taken to address the impact of COVID-19 on their managed care performance incentive programs, and 2020 quality and total cost of care performance. The examples detailed in the expert perspective can be used to inform state decisions on whether and how to modify Medicaid managed care reporting and performance incentives as a result of COVID-19.
According to a new analysis by Families USA, in April and May, states began to experience dramatic increases in Medicaid enrollment. This is important context as Congress considers additional proposals that would increase federal matching rates for Medicaid and other flexible funding to relieve some of the pressure on state budgets
HHS issued a revised FAQ for providers on the Provider Relief Fund with additional information and clarifications on:- The Second $20 Billion Allocation of the $50 Billion General Allocation- $12 Billion Allocation for High Impact Areas- $10 Billion Allocation for Rural Hospitals and Rural Health Clinics
CARES Act Provider Relief Fund General Distribution FAQs
This issue brief provides insights into the current picture of Medicaid spending and enrollment, as Congress considers providing additional fiscal relief through the federal Medicaid match rate. Nearly all states anticipate growing Medicaid enrollment and spending during fiscal years 2020 and 2021.
This Health Affairs blog post highlights states’ policy responses to the COVID-19 pandemic, as well as their proactive approaches to addressing a wide range of health concerns.
This expert perspectives provides an overview of strategies that states can consider to help address gaps in coverage to ensure as many people as possible get access to comprehensive care as the country continues to respond and recover from the COVID-19 health and economic crisis.
The California Department of Health & Human Services (DHCS) conducted a survey to gauge county operations during the public health emergency. Results found that all county offices remain available by phone, 60% are open to the public, 40% are available for in-person application interviews and some have developed inventive ways to ensure customer needs are met.
The guidance document outlines COVID-19 emergency declaration “blanket waivers” for healthcare providers and is regularly updated by CMS. Recent updates include: – Revising the existing “”physical environment”” waivers for hospitals to support activities related to both surge capacity and appropriate quarantining and to clarify that it does not modify hospitals’ obligations under the Americans with Disabilities Act (ADA), to “avoid subjecting persons with disabilities to unjustified institutionalization or segregation
An analysis on national and state-level estimates of coverage changes if unemployment rates rise from precrisis levels (around 3.5 percent nationally) to 15 percent, 20 percent, or 25 percent.
CMCS issued an informational bulletin (CIB) to provide states with guidance about temporarily modifying provider payment methodologies and capitation rates under their Medicaid managed care contracts to address the impacts of the public health emergency. The guidance enumerates several options states could choose to adopt and details example state proposals in an appendix. States may effectuate these actions through managed care contract amendments, rate amendments, and state directed payment preprints and CMS noted it is continuing to prioritize and expedite reviews of these COVID-19 related managed care actions.
On Thursday, April 9 at 2:00 p.m. ET, State Health and Value Strategies hosted a webinar during which experts from Manatt Health walked through tools states can use to increase payments to providers through both fee-for-service and Medicaid managed care, despite COVID-19 driven changes to utilization. As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government has acknowledged the financial challenges facing providers through supplemental funding included in the three federal stimulus bills enacted to date and several states have submitted Section 1115 waivers requesting CMS approval to establish “disaster relief funds,” paid for with Medicaid dollars, to further assist providers. States are increasingly seeking innovative strategies to leverage Medicaid authorities to support the essential and vulnerable providers on the frontlines of the pandemic.
On Wednesday, April 29 State Health and Value Strategies hosted a webinar, State Strategies to Support Medicaid/CHIP Eligibility and Enrollment in Response to COVID-19. Many states are experiencing an increase in the volume of Medicaid applications due to the COVID-19 pandemic and the resulting economic crisis. During the webinar experts from Manatt Health reviewed strategies states can use to manage and process an increased number of Medicaid applications, and the federal authorities that permit states to do so. Communications experts from GMMB reviewed strategies for messaging to new and existing enrollees.
This webpage, developed by the Pennsylvania Department of Insurance highlights FAQs and provides coverage information to consumers who have lost their jobs.
The Pathways to Coverage for COVID-19 Testing and Treatment for Adults toolkit provides an overview for states of various coverage pathways for individuals, including those who are uninsured, in need of COVID-19 testing and treatment. The toolkit provides varying pathways for Medicaid expansion and non-expansion states.
A recent analysis by the Urban Institute estimates eight different FMAP increase approaches and how they would affect the amount of fiscal relief states would receive.
As the COVID-19 pandemic continues to progress, providers across the continuum of care are experiencing significant changes in utilization resulting in declining revenue and jeopardizing access to care. The federal government has acknowledged the financial challenges facing providers through supplemental funding included in the three federal stimulus bills enacted to date. In addition, several states have submitted Section 1115 waivers requesting CMS approval to establish “disaster relief funds,” paid for with Medicaid dollars, to further assist providers. While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, more immediately available tools can help ensure payments continue flowing to providers despite substantial utilization changes. This Q&A provides a moment-in-time update in response to questions SHVS has received regarding the April 9 Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis Webinar and corresponding Toolkit.
CMS is implementing modifications to the Medicare Shared Savings Program (MSSP), including to the calculation of shared losses, quality reporting requirements, timelines for increasing financial risk, and the financial methodology for determining benchmark year and performance year expenditures.
As the coronavirus (COVID-19) crisis continues, state Medicaid and Children Health Insurance Program (CHIP) agencies are rapidly pursuing multiple financing strategies to support their responses. CHIP Health Services Initiatives (HSIs) can provide additional financial support to states and local communities serving low-income children. This issue brief provides an overview of CHIP HSIs and identifies ways that states can leverage them as part of their targeted response to the COVID-19 pandemic.
The COVID-19 pandemic is causing dramatic changes in utilization that threaten the financial stability of providers and may jeopardize access to care during and after the national emergency. With elective cases generally cancelled, hospitals have sharply lower utilization and revenue. Some hospitals in hotspots are seeing a surge in COVID-19 related usage, which may offset some or all of the revenue decline and in some cases increase their costs. In addition, many other providers that rely on face-to-face visits—including primary care, behavioral health, and providers of long-term services and supports—are seeing large utilization declines due to social distancing requirements. Federal and state governments have acknowledged and responded to the financial challenges facing providers in several different ways. While it will take some time for waiver requests to be reviewed and for the new federal funds to be released, this toolkit identifies more immediately available tools that can help ensure payments continue flowing to providers despite substantial utilization changes.
The University of Minnesota COVID-19 Health Insurance Model (MN-HIM) estimates the number of people at who lost employer-sponsored health insurance (ESI) during the four-week period ending on April 11, 2020. In developing this model SHADAC aimed to create both national and state-level estimates as well as provide a further breakdown between policyholders (age 18-64) and their dependents (adults and children).
This expert perspective considers the policy implications and challenges for states and discusses potential state measures to address sensitive implementation challenges given interactions with eligibility for health care programs and CARES Act unemployment insurance expansion and stimulus payments.
Manatt Health’s analysis of CMS’ guidance for states about new increased Medicaid and CHIP matching rate.
In response to the COVID-19 pandemic, the federal government is moving rapidly to help states and health care providers respond to mounting needs for new sources of funding and flexibility. Congress has passed three COVID-19 stimulus bills, and the U.S. Department of Health and Human Services has issued guidance outlining new flexibilities available to states and providers, and is working to approve additional requests from states, to award funds appropriated by Congress, and to issue more guidance about such funding. This Q&A provides a moment-in-time update in response to questions SHVS has received about the federal government’s response.
Webinar recording and slide deck from webinar hosted on March 18, 2020.
In addition to prohibiting new eligibility restrictions, the Families First MOE prevents states from terminating people’s coverage during the public health emergency. This “continuous coverage” provision not only guarantees that people will be able to access needed care during the pandemic, but also allows state agencies operating with reduced capacity to prioritize enrolling people who lose their jobs and job-based coverage over requiring people to prove they remain eligible.
The COVID-19 pandemic is causing considerable stress on state budgets because of both increasing expenditures and declining revenues. Unlike the federal government, states cannot incur deficits. In this paper, we estimate the fiscal impacts of several approaches for increasing federal Medicaid matching rates, providing state-level estimates for each approach.
An article by CBPP that examines how expanding Medicaid in the public health crisis could allow people to enroll in Medicaid coverage as early as June or July. In addition, retroactive coverage for people signing up this summer and found to be eligible could cover medical costs — including COVID-19 treatment — incurred up to three months prior to actual enrollment.
Webinar slides and recording that explores the key health care provisions in the second COVID-19 stimulus bill.
Medicaid memo to providers summarizing changes to program requirements, including expansion of telehealth coverage, provider licensure, and prior authorization for services, during the COVID-19 crisis. Content on behavioral health was updated in a subsequent memo.
TennCare Guidance on EPSDT/Well Child Visits during COVID-19
This memo clarifies a section of the earlier Medicaid provider memo on flexibilities offered to providers of behavioral health and addiction and recovery treatment.
CMCS issued new Medicaid FAQs regarding the new optional COVID-19 testing Medicaid eligibility group, benefits and cost-sharing for COVID-19-related testing and diagnostic services, the increased FMAP available under Section 6008 of the FFCRA, and other FAQs
This expert perspective, written by experts at Manatt Health, discusses strategies state Medicaid and CHIP agencies can pursue as part of their response to COVID-19.
CMS issued a revised FAQ for state Medicaid and CHIP agencies, initially issued on March 12. The May 5-issued FAQ provides additional guidance on available waiver and state plan amendment authorities during the COVID-19 public health emergency, the Basic Health Plan program, presumptive eligibility categories for Medicaid plans, member enrollment flexibilities during the public health emergency, terms for states receiving the previously announced 6.2 percentage point FMAP increase, and other topics.
This guidance allows practitioners further flexibility in prescribing and dispensing buprenorphine to new and existing patients with opioid use disorder via telephone without examination in person or via telemedicine.
In light of the growing number and diversity of approved 1135 waivers, this Q&A document provides a general primer on Section 1135 to help healthcare stakeholders understand the scope of what HHS and CMS can and cannot do under this emergency authority.
Plain-Language Information about Coverage Options, Eligibility, and COVID-Related Benefits
NCQA has made modifications to HEDIS and accreditation requirements for Medicaid and Commercial plans related to COVID19.
CMS released guidance for rural health care and Medicaid agencies on telehealth flexibilities provided by the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment (SUPPORT) Act.
Recordings and transcripts of CMS calls on COVID-19 with states and other stakeholders
This bulletin summarizes flexibilities to New York’s Medicaid eligibility and enrollment system–including for new Medicaid applications and eligibility renewals.
MA developed an All Provider Bulletin that summarizes the State’s Hospital-Determined Presumptive Eligibility process.
MA developed a managed care plan bulletin that outlines requirement’s for coverage and billing related to COVID-19.
Summary of Key Healthcare Provisions in the Second COVID-19 Stimulus Bill.
This FAQ includes guidance for behavioral health providers, partners, and the greater community to develop coordinated prevention and response plans for COVID-19.
NY allowed out-of-state providers and providers in New York that are not currently registered to provide telehealth services.
NY waived cost-sharing for telehealth visits with in-network providers.
MS Division of Medicaid is allowing beneficiaries to access telehealth services from home; promoting the use of personal cellular device, computer, tablet, or other web camera-enabled device to seek and receive medical care; and waiving limitation of the use of audio-only telephonic conversations until April 30, 2020.
AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
In MA, through executive order, Governor Baker expanded access to telehealth services in all commercial insurers and MassHealth programs, waived all cost-sharing for any medically necessary treatment delivered via telehealth related to COVID-19 at in-network providers, waived any prior authorization barriers needed to obtain medically necessary telehealth services, and established a 24-hour process to allow medical professionals to receive a license to practice in Massachusetts