The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources.
COVID-19 Resources for States
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.|
Please click on the links below to access topic-specific resources.
(e.g., tracking dashboards, equity task forces)
|Reopening/Recovery||COVID-19 Testing and Care
(e.g., coverage and access, provider and plan reimbursement)
(e.g. equitable disbursement, payment issues, communications strategies)
|Medicaid Coverage and Access
(e.g., eligibility and enrollment (including appeals), benefits and cost-sharing (prior authorization, refills))
|Health System Considerations
(e.g. Telehealth/Telemedicine, Providers and Workforce, Substance Use Disorder & Mental Health)
|Commercial Insurance Coverage and Access
(e.g. individual market coverage, regulatory options, surprise billing, Employee Retirement Income Security Act (ERISA) flexibilities)
|Funding and Coverage for the Uninsured||Social Risk Factors and COVID-19
(e.g., housing, food insecurity, justice-involved individuals, interpersonal violence)
|Home and Community-Based Services (HCBS) and Long-Term Care (LTC)|
|Federal Authorities and Funding Opportunities
(i.e., Section 1135 Waivers, Section 1115 Waivers, 1915(c) Waiver Appendix K, Medicaid State Plan Amendments (SPAs))
(e.g. messaging and communications strategies for COVID-19 response, best practices across agencies, leveraging digital platforms)