Templates & Toolkits | Apr 8, 2020

Targeted Options for Increasing Medicaid Payments to Providers During COVID-19 Crisis

Anne Karl, Jocelyn Guyer and Avi Herring, Manatt Health

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.


Expert Perspectives

August 7, 2020

Essential Workers in Challenging Environments: How States Are Working to Protect Farmworkers

While efforts to reduce the spread of COVID-19 have been difficult in all environments, the conditions for those working in agricultural production raise additional challenges. Migrant and seasonal farmworkers, many of whom travel as crops ripen throughout the spring and summer, live and work under conditions that even before COVID-19 posed risks to their safety and wellbeing. This expert perspective  examines approaches to addressing the particular risks of COVID-19 faced by farmworkers, provides a survey of state and local policies and outlines some key themes and recommendations for policymakers as they work to support agricultural workers and stem the spread of COVID-19.

More States Looking to Section 1332 Waivers

In the absence of federal legislation, states are actively seeking tools to reform their health care systems. While 1115 waivers rightly get a lot of attention, because of their ability to reshape state Medicaid programs, the Affordable Care Act’s Section 1332 waivers continue to be a promising avenue for states to stabilize their health insurance marketplace. SHVS is tracking state activity and has many resources, including a template, for states interested in pursuing a Section 1332 waiver.

More information

August 6, 2020

Considerations for State Medicaid and CHIP Agencies As they Prepare to Unwind Eligibility and Enrollment Flexibilities Obtained During the COVID-19 Public Health Emergency

As a condition of receiving enhanced federal funding under the Families First Coronavirus Response Act (FFCRA), states are prohibited from terminating individuals enrolled in Medicaid as of March 18, 2020, or determined eligible on or after that date. These continuous coverage requirements run through the end of the month of the public health emergency (PHE), which was recently extended to October 22, 2020. Absent a further extension of the PHE, states have three months to implement a plan for unwinding the FCCRA continuous coverage requirements which are otherwise set to terminate on October 31, 2020. States will also need to identify which newly obtained eligibility and enrollment flexibilities they would like to make permanent beyond the termination of the PHE–especially in the context of emerging information that suggests that the duration of COVID-19 pandemic may extend well into 2021.