Ensuring Access to LTSS During COVID-19: Exploring a State Resource Guide Produced by Manatt Health and The SCAN Foundation
Manatt Health
On Friday, July 10, State Health and Value Strategies hosted a webinar during which experts from Manatt Health presented key findings from a new COVID-19 state resource guide, funded by The SCAN Foundation. People who use long-term services and supports (LTSS), including individuals dually-eligible for Medicare and Medicaid, are particularly vulnerable to contracting COVID-19 and experiencing severe symptoms. We have seen COVID-19 have a devastating impact on people with complex care needs receiving care in nursing homes and other congregate care settings, in particular. To date, over 50,000 nursing home residents have died from COVID-19, representing up to 40 percent of U.S. COVID-19 deaths. Although there is less transparency on the impact of COVID-19 on people receiving LTSS in the community, we know that care has been disrupted due to caregivers being subject to stay-at-home orders, having no access to child care, lacking access to PPE to provide care safely, or quarantining after being sick or exposed to COVID-19.
In the resource guide, Manatt Health identifies federal and state Medicaid flexibilities available to state officials and other stakeholders and how those flexibilities are being deployed during COVID-19 to help ensure access to LTSS. The resource guide highlights examples of how states are ensuring continued access to LTSS by expanding the types of settings in which services can be delivered, bolstering pay and other supports for LTSS providers, and addressing barriers to care created by the COVID-19 pandemic. Several states are turning their attention to considering which flexibilities they want to “unwind,” which they want to retain to respond to future COVID-19 outbreaks or other public health emergencies, and which they want to make permanent to strengthen and improve LTSS care delivery. The webinar provided examples of how states are approaching answering these questions.
On November 15, 2023, the Centers for Medicare & Medicaid Services released its proposed 2025 Notice of Benefit and Payment Parameters, the annual regulation which governs core provisions of the Affordable Care Act. This expert perspective focuses on aspects of the proposed rule likely to be of interest to state officials, including requirements for State-Based Marketplaces to align with the standards of the Federally Facilitated Marketplace, proposals for states to update essential health benefits, and initiatives to ease the eligibility and enrollment process for consumers.
This expert perspective summarizes CMS’ new Informational Bulletin and accompanying framework which together detail Medicaid coverage options for services that address the health-related social needs (HRSN) of Medicaid enrollees. The new guidance reiterates the importance of addressing HRSNs to improve access to care and health outcomes, and summarizes (and in some cases updates) multiple previous sources of CMS guidance on how HRSN services may be covered in Medicaid, including guidance on in lieu of services authority and on HRSN coverage in section 1115 waivers.
