Expert Perspectives

Jan 21, 2022 

Tracking the Data on Medicaid’s Continuous Coverage Unwinding

When the Families First Coronavirus Response Act Medicaid “continuous coverage” requirement is discontinued states will restart eligibility redeterminations, and millions of Medicaid enrollees will be at risk of losing their coverage. A lack of publicly available data on Medicaid enrollment, renewal, and disenrollment makes it difficult to understand exactly who is losing Medicaid coverage and for what reasons. Publishing timely data in an easy-to-digest, visually appealing way would help improve the transparency, accountability, and equity of the Medicaid program. This expert perspective lays out a set of priority measures that states can incorporate over time into a data dashboard to track Medicaid enrollment following the end of the continuous coverage requirement. For a detailed discussion of the current status of Medicaid enrollment and retention data collection and best practices when developing a data dashboard to display this type of information, SHVS has published a companion issue brief.

Jan 14, 2022 

New Requirements to Cover Over-the-Counter COVID Tests: Implications for State Insurance Regulators

On January 15, 2022, health insurers will be subject to new federal requirements to cover and waive cost-sharing for over-the-counter diagnostic tests for COVID-19 for the duration of the federal public health emergency. Past federal guidance required insurers to fully cover COVID-19 tests, but allowed them to require enrollees to first obtain a health professional’s determination that a test is medically necessary. The new requirements, published January 10, enable consumers to obtain the tests directly from pharmacies or online retailers without being seen by a health professional. With case rates surging and the costs of over-the-counter COVID-19 tests ranging from $14 to $34, this new benefit should provide significant financial relief to privately insured individuals. This expert perspective focuses on key provisions of the new coverage requirements as well as health equity considerations and implications for state insurance regulators.

Jan 14, 2022 

New CMS Guidance on Community-Based Mobile Crisis Services

On December 28, 2021, the Centers for Medicare & Medicaid Services (CMS) released a State Health Official letter providing guidance on the scope of and enhanced payments for qualifying community-based mobile crisis intervention services for Medicaid enrollees experiencing a mental health or substance use disorder crisis. The CMS guidance comes as the United States is grappling with staggering need for mental health and SUD services that has grown as a result of the COVID-19 pandemic. This expert perspective provides an overview of the new guidance and reviews the requirements for community mobile crisis services.


Jan 7, 2022 

The Proposed 2023 Notice of Benefit & Payment Parameters: Implications for States

On December 28, 2021, the Centers for Medicare & Medicaid Services released its proposed Notice of Benefit & Payment Parameters for plan year 2023. This annual regulation governs core provisions of the Affordable Care Act, including operation of the health insurance marketplaces, standards for insurers, and the risk adjustment program. This expert perspective focuses on provisions of the proposed rule that are of particular import to the state-based marketplaces and state insurance regulators.

Jan 6, 2022 

Supporting Health Equity and Affordable Health Coverage for Immigrant Populations

Ensuring affordable health coverage and healthcare for immigrant populations in the United States is critical to advancing health equity. In a new series, State Health and Value Strategies (SHVS), with support from the Robert Wood Johnson Foundation, highlights strategies for states to expand affordable health coverage to immigrant populations in the United States. This expert perspective provides an overview of the products included in the series.

Dec 16, 2021 

Notable State Health and Value Strategies Pieces in 2021 That You May Have Missed

2021 was a year like no other in state health policy. Expansions of coverage subsidies, new opportunities in Medicaid, increased federal funding, and a full year of pandemic response. It has been busy for us at SHVS too, and with all of the materials we published this year, we wanted to share a list of what you might have missed.