State Health Updates

• Alaska – CMS approved a postpartum coverage extension state plan amendment (SPA) for Alaska. This SPA approval will extend comprehensive coverage after pregnancy through Medicaid and CHIP for a full 12 months. Alaska is the 44th state, including D.C. and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year. As a reminder, SHVS published an issue brief on the American Rescue Plan option to extend postpartum coverage.
• Arkansas – Arkansas submitted a request for a new Medicaid section 1115 demonstration which would provide coverage of all medically necessary services for the first 90 days at the beginning of incarceration or admission to an Institution for Mental Disease (IMD) and the 90 days immediately prior to release from either setting. The state will also provide a pre-release benefit package of case management and care coordination services, medication-assisted treatment services, and a 30-day supply of prescription drugs to individuals leaving carceral settings.
• Colorado
  • Governor Jared Polis and the Colorado Department of Health Care Policy & Financing announced the submission of an amended application to the FDA to import lower-cost prescription drugs from Canada. This submission is an amendment to the initial application and if the FDA approves Colorado’s Canadian Drug Importation Program, the state can start the process of bringing lower-cost prescription drugs into the state.
  • The Office of Saving People Money on Health Care has released its second annual report on Long COVID in Colorado. The report synthesizes state-specific data, highlights recent work, outlines next steps, and shares first-hand accounts from Coloradans living with Long COVID.
• Maine
  • Responding to a pharmacy vendor network disruption, the Department of Health and Human Services (DHHS) Office of MaineCare Services announced that it has authorized pharmacies to provide prescriptions for up to 30 days to help MaineCare members access needed medications. This is in response to the national issue with Change Healthcare, the out-of-state vendor that operates the pharmacy claims system for Maine’s Medicaid program. DHHS asks pharmacies to neither turn away nor ask enrollees to pay out-of-pocket for prescriptions that are covered by MaineCare and DHHS will pay all eligible claims submitted once the system is operational again.
  • CoverMe.gov, the state’s official health insurance Marketplace, released its 2024 Open Enrollment Overview report. The report provides an overview of enrollment trends, affordability of health insurance coverage through the Marketplace and key operational and marketing changes that took place during the 2024 open enrollment. 
• Massachusetts – The Massachusetts Health Connector, the state’s official health insurance Marketplace, released its Strategic Plan for 2024 through 2028. The strategic plan is intended to serve as a roadmap for the Health Connector, providing a framework to organize agency initiatives, infrastructure, policies, and practices to ensure continued success and maximum public impact.
• Michigan – The Michigan Department of Health and Human Services has awarded a three-year contract for a technical assistance program for up to 24 county jails seeking to implement or expand medications for opioid-use disorder (MOUD) programs. Participating counties will receive grants up to $25,000 to cover associated costs. This project is funded through opioid settlement dollars and is designed to address significant overdose risks in incarcerated populations during and following incarceration by increasing access to MOUD programs.
• Minnesota – Minnesota submitted a request to extend the Medicaid section 1115 demonstration entitled “Minnesota Substance Use Disorder (SUD) System Reform” for an additional five years. This demonstration provides federal Medicaid funds for enrollees receiving SUD treatment in facilities that meet the federal definition of an IMD.
• Montana – Governor Greg Gianforte and Department of Public Health and Human Services (DPHHS) Director Charlie Brereton announced an expansion of behavioral health services for Montanans. The announcement comes after CMS approved a waiver for DPHHS to provide three new Medicaid-funded services as part of the state’s Healing and Ending Addiction through Recovery and Treatment (HEART) program. The new services will help Montanans struggling with substance-use and mental health conditions find and keep stable housing, provide incentives to those meeting treatment goals, and provide services to incarcerated individuals in the 30 days before their release from the state prison system.
• New Mexico – The New Mexico Human Services Department announced the appointment of Dana Flannery as the new director of the New Mexico Medicaid program. Congrats Dana!
• New York – Governor Kathy Hochul announced $20 million in start-up funding for school-based mental health clinics and launched a rolling application, which will make it easier for interested schools to access state funding. Governor Hochul also announced that her Youth Mental Health Advisory Board will begin accepting applications from interested children and teenagers.
• North Carolina – The North Carolina Department of Health and Human Services will pursue participation in the new CMS Cell and Gene Therapy (CGT) Access Model, which will first focus on access to recently approved gene therapies for Medicaid enrollees living with sickle cell disease, a genetic blood disorder that disproportionately impacts Black Americans. The CGT Access Model aims to improve health outcomes for people by supporting outcomes-based agreements that will provide for treatments within a framework that lowers prices for states and ties payment to outcomes.
• North Dakota – North Dakota Health and Human Services has received approval from CMS to expand access and add services to the state’s Medicaid autism spectrum disorder waiver. The approved waiver adds 195 slots and increases the qualifying age of children who can be served from age 15 through age 17. Waiver changes include an enhanced reimbursement rate to provide case management in rural areas and provider rate increases. 
• Oregon – CMS approved a new section 1115 demonstration for Oregon which will enable the state to receive federal financial participation to provide a limited set of home and community-based services to older adults or adults with disabilities. CMS is also authorizing continuous eligibility for individuals enrolled in the demonstration to support consistent coverage and continuity of care by keeping individuals enrolled for 24 months regardless of income fluctuations or other changes. 
• Wisconsin – The Wisconsin Office of Children’s Mental Health released an infant and toddler mental health fact sheet. The fact sheet is aimed at parents and caregivers, early childhood educators and policymakers.