State Health Updates

• Arizona – The Arizona Health Care Cost Containment System announced it has met the requirements of the state statute to determine Medicaid eligibility for members who had maintained coverage during the pandemic known as the “COVID Override” group. Within this group, members who were ineligible due to their income represented about half of the total and were prioritized for eligibility redetermination when regular renewal procedures began in April 2023. 
• California
  • The Department of Health Care Services (DHCS) announced a new law allowing adults ages 26 through 49 to qualify for full-scope Medi-Cal, regardless of immigration status beginning January 1. This initiative, called the Ages 26 through 49 Adult Expansion, is modeled after the Young Adult Expansion, which provided full scope Medi-Cal to young adults 19 through 25, and the Older Adult Expansion, which provided full scope Medi-Cal to adults 50 years of age or older.
  • DHCS announced it has received federal approval of its managed care organization (MCO) tax waiver application. The MCO tax is estimated to provide $19.4 billion in net non-federal funding over a 3.75-year tax period. The revenue will allow DHCS to move forward with targeted provider rate increases. Effective January 1, 2024, rates for primary care, maternity care (including OB/GYNs and doulas), and non-specialty mental health services increased to at least 87.5% of Medicare rates.
• Illinois – The Illinois Department of Healthcare and Family Services announced the approval of 11 applications to proceed towards certification in the Supportive Living Program for Dementia Care Settings. The Supportive Living Program is a Medicaid alternative that offers services at a lower cost than a nursing home and can prevent or delay the need for nursing home care. The program operates through a home and community-based services waiver approved by CMS.  
• Maryland – Governor Wes Moore signed an executive order establishing the Longevity Ready Maryland Initiative, directing the Department of Aging to prioritize the wellbeing of older people, people living with disabilities, and caregivers. The Department of Aging is directed to develop a plan that will coordinate and build upon existing state efforts to tackle challenges throughout the lifespan, including a robust care workforce, adequate caregiver support, and equitable healthcare.
• Minnesota – The Minnesota Department of Human Services eliminated the asset limit for Medical Assistance for Employed Persons with Disabilities (MA-EPD). Effective January 1, 2024, people are eligible for MA-EPD with no limit to the amount of assets they own. 
• Missouri – The Missouri HealthNet Division and the St. Louis Integrated Health Network are jointly sponsoring an event to launch Group Prenatal Care on January 12, 2024. Group prenatal care models are designed to improve patient education and include opportunities for social support while maintaining the risk screening and physical assessment of individual prenatal care.
• Nebraska – The Nebraska Department of Health and Human Services will host a public hearing on proposed changes to improve dental care. The proposed changes include removing the annual dental benefit maximum; reimbursement for each step of denture treatment, rather than when the process is complete; covering asymptomatic wisdom tooth extraction; and reimbursement of select services provided by public health dental hygienists. 
• North Carolina
  • The North Carolina Division of Health Benefits released a policy paper outlining the state’s roadmap to expanding access to integrated mental and primary care services. The roadmap outlines seven practical strategies North Carolina has adopted to encourage the collaborative care model, which other states could leverage in their own efforts to increase integrated care.
  • The North Carolina Department of Health and Human Services released a report, “Ensuring Access to Gene Therapies to Address Sickle Cell Disease in Medicaid.” The report details strategies states are taking to expand access to standard treatments for sickle cell disease as well as challenges states grapple with to improve care for this population.
• North Dakota – The North Dakota Department of Health and Human Services announced several state Medicaid plan changes effective January 1, 2024, including a 3.2% inflationary increase for all nursing facility services and a 3% inflationary increase for psychiatric residential treatment facility services. 
• Oregon
  • Governor Tina Kotek announced a $25 million partnership with coordinated care organizations (CCOs) across the state, with a focus on expanding youth behavioral health services. The state and CCOs developed a plan to reinvest surplus Medicaid dollars into Oregon communities, and this partnership will support behavioral health projects that serve youth, meet the greatest need, and are geographically diverse. 
  • The Oregon Health Authority’s Ombuds Program, which serves as the advocate for Oregon Health Plan (OHP) members, released a report detailing top concerns from OHP members specific to child and youth mental health. The report makes recommendations to improve mental health services and supports for children, youth and families across Oregon.
• Pennsylvania – The Pennsylvania Insurance Department announced it will allow insurers to ask applicants to voluntarily provide demographic data on insurance applications in an effort to promote equity initiatives. Insurers will need to inform applicants that the demographic data questions are optional, why the data is being collected, and how the data will support equitable coverage efforts.
• Utah – Effective January 1, 2024, the state of Utah will offer medical and dental benefits for non-U.S. citizen children, called State CHIP. Children of working families may be eligible if they do not have other health insurance and cannot qualify for Medicaid or the traditional CHIP program due to citizenship status. A special open enrollment for State CHIP began on January 1, 2024.