This expert perspective includes recommended communication strategies—and some examples—for how states can elevate coverage options and help ensure that more residents can access health insurance during these uncertain times.
Providers and Workforce
(e.g., licensure/certification, enrollment)
|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.|
SHVS/Manatt Health. Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis State Health & Value Strategies hosted a webinar in 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.
STATE TEMPLATES AND TOOLKITS
SHVS/GMMB. Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis This toolkit identifies more immediately available tools that can help ensure payments continue flowing to providers despite substantial utilization changes.
CMS. Section 1135 Waiver Flexibilities This page includes federal background information on Section 1135 waivers and a CMS-developed template for states and territories.
CMS. Federal Disaster Resources This page catalogs CMS’s approved COVID-19 State Section 1135 waivers.
CMS. 1115 Application Process This page includes guidance and a template for COVID-19 1115 waiver demonstrations.
CMS. State Plan Flexibilities This page includes guidance and templates for the Medicaid State Plan Disaster Relief SPA and CHIP Disaster Relief SPA.
Kaiser Family Foundation. Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19 This page includes details on Section 1135 waivers and 1915 (c) Waiver Appendix K strategies.
FEDERAL STATUTE AND GUIDANCE
CMS/CMCS. COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Children’s Health Insurance Program (CHIP) Agencies These updated FAQs for state Medicaid and CHIP agencies address available resources for emergency preparedness and response efforts, and flexibilities related to eligibility and enrollment, benefits, cost-sharing, financing, and workforce.
CMS. Medicare and Medicaid Programs; Policy and Regulatory Revisions in Response to the COVID-19 Public Health Emergency CMS released an interim final rule with comment period that proposes several changes to the Medicaid and Medicare programs. For the Medicaid program, the rule amends health home regulations by allowing other licensed practitioners to order home health services, without physician sign-off.
CMS. CMS Announces Relief for Clinicians, Providers, Hospitals and Facilities Participating in Quality Reporting Programs in Response to COVID-19 CMS announced it is granting exceptions from reporting requirements and extensions for clinicians and providers participating in Medicare quality reporting programs.
CMS. COVID-19 Emergency Declaration Blanket Waivers for Health Care Providers This broad-sweeping guidance outlines a host of blanket waivers and flexibilities that the Administration is affording to health care providers.
Drug Enforcement Administration (DEA). Exception to Regulations Emergency Oral CII Prescription This guidance allows prescribers and practitoners to issue time limited prescriptions of schedule II drugs via oral communication (e.g., telephone) under limited circumstances.
Drug Enforcement Administration (DEA). Exception to Separate Registration Requirements Across State Lines This guidance allows practitioners to dispense schedule II-IV drugs (including methadone, buprenorphine and opioids) not only in their home states but also in states with which their home stateshave reciprocity.
Drug Enforcement Administration (DEA). Exemption Allowing Alternate Delivery Methods for OTPs This guidance allows OTPs to make “door stop” deliveries for medications for opioid use disorder in a lock-box for patients under quarantine.
Substance Abuse and Mental health Services Administration (SAMHSA). FAQs: Provision of Methadone and Buprenorphine for the Treatment of Opioid Use Disorder in the COVID-19 Emergency This FAQ clarifies that OTPs may initiate new patients on buprenorphine via telehealth and without an in-person visit, but maintains the face to face requirement for initiation with methadone.
CMS. Fact Sheet: Expansion Of The Accelerated And Advance Payments Program For Providers And Suppliers During COVID-19 Emergency CMS expands Accelerated and Advance Payments to all Medicare FFS providers and suppliers.
CMS. Trump Administration Engages America’s Hospitals in Unprecedented Data Sharing This letter requests that hospitals report testing data to HHS and bed capacity and supplies to CDC’s National Healthcare Safety Network on a daily basis.
CMS. The Center for Consumer Information & Insurance Oversight Fact Sheets & Frequently Asked Questions (FAQs) Compilation of COVID-19 FAQs on private insurance issues
CMS. COVID-19 Resources for States Compilation of resources for state on Medicare, Medicaid, and CHIP, including transcripts and recordings of all-state calls.
CMS. Coronavirus Waivers and Flexibilities Resources on waivers and flexibilities available to states and providers.
Internal Revenue Service (IRS). Cornonavirus Tax Relief Information on federal tax provisions, guidance, and operational changes responding to COVID-19.
CMS. Podcasts and Transcripts: COVID-19 Stakeholder Calls Recordings and transcripts of CMS calls on COVID-19 with states and other stakeholders.
Substance Abuse and Mental health Services Administration (SAMHSA). Considerations for Crisis Centers and Clinicians in Managing the Treatment of Alcohol or Benzodiazepine Withdrawal during the COVID-19 Epidemic
Substance Abuse and Mental health Services Administration (SAMHSA). Considerations for the Care and Treatment of Mental and Substance Use Disorders in the COVID-19 Epidemic This guidance advises outpatient providers to utilize telehealth, whenever possible, reschedule non-urgent appointments, reach out to high risk patients for COVID-19, eliminate cancellation/no show fees.
Substance Abuse and Mental health Services Administration (SAMHSA). Frequently Asked Questions (FAQs) Related to COVID-19 for SAMHSA Grant Recipients This FAQ addresses general questions associated with award and management of SAMHSA discretionary grants that may arise in relation to COVID-19.
Substance Abuse and Mental health Services Administration (SAMHSA). Interim Considerations for State Psychiatric Hospitals This guidance details infection control and social distancing recommendations for state psychiatric hospitals.
Substance Abuse and Mental health Services Administration (SAMHSA). OTP Guidance for Patients Quarantined at Home with the Coronavirus This guidance advises that Opioid Treatment Programs on providing medications to patients who are quarantined with COVID-19.
Substance Abuse and Mental health Services Administration (SAMHSA). COVID-19 Public Health Emergency Response and 42 CFR Part 2 Guidance This guidance clarifies that medical emergency exception to Part 2 applies during COVID-19.
American Medical Association (AMA). Special Coding Advice During COVID-19 Public Health Emergency
STATE EXAMPLES AND MODELS
Alaska. Insurance Coverage for Telehealth AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
California. DHCS COVID‑19 Response CA developed a robust, centralized COVID-19 resource page that provides guidance related to providers, HCBS, and federal requests/waivers.
Massachusetts. Coverage Provided Via Hospital-Determined Presumptive Eligibility MA developed an All Provider Bulletin that summarizes the State’s Hospital-Determined Presumptive Eligibility process.
Massachusetts. MassHealth Coverage and Reimbursement Policy for Services Related to Coronavirus Disease 2019 MA developed a managed care plan bulletin that outlines requirement’s for coverage and billing related to COVID-19.
Massachusetts. March 15 2020 Telehealth Order 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.
Minnesota. CHAPTER 70–S.F.No. 4334 AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
Mississippi. Amended Proclamation MS Mississippi State Board of Medical Licensure has waived state licensure restrictions to allow out-of-state physicians who already have a pre-existing doctor-patient relationship to treat patients in Mississippi through telemedicine.
New Jersey. Governor Murphy Signs Legislation to Expand Telehealth Access and Expedite Licensure of Out-of-State Professionals AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
New York. Comprehensive Guidance Regarding Use of Telehealth including Telephonic Services During the COVID-19 State of Emergency NY established telehealth reimbursement parity in Medicaid programs during the state of emergency.
Vermont. Vermont House Passes Telehealth Bill Amid Coronavirus Concerns AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.
West Virginia. House Bill 4003 AK, MN, NJ, VT, and WV introduced or enacted telehealth legislation to increase telehealth access and coverage during the month of March.