On August 19, the federal government issued a new final rule to further implement the federal independent dispute resolution process under the No Surprises Act (NSA). This expert perspective reviews the final rule and discusses its implications for state balance billing protections and oversight.
State updates as of August 19, 2022.
On August 16, President Biden signed the Inflation Reduction Act (IRA), a $740 billion reconciliation package, into law. This expert perspective describes the healthcare provisions included in the IRA, such as provisions to improve the affordability of healthcare for Medicare and Affordable Care Act (ACA) Marketplace enrollees. The expert perspective also describes several significant healthcare policies included in the House-passed Build Back Better Act that were left out of the IRA.
State updates as of August 12, 2022.
The unwinding related section 1902(e)(14) strategies newly available to Medicaid and CHIP agencies can provide significant relief to states facing pending eligibility and enrollment actions and processing delays, workforce and systems limitations, and other operational challenges. Ensuring eligible individuals do not lose coverage for procedural or administrative reasons and supporting those who are ineligible for Medicaid/CHIP transition to Marketplace coverage will be paramount for all states as they begin to resume normal operations when the federal public health emergency (PHE) ends. This expert perspective outlines the time-limited targeted enrollment flexibilities that CMS has availed to states through section 1902(e)(14) waiver authority and discusses considerations beyond the strategies described in federal guidance and supplemental resources. This expert perspective has been updated as of August 5, 2022 to include reference to additional guidance released by the Centers for Medicare & Medicaid Services.
State updates as of August 5, 2022.
This expert perspective focuses on strengthening communications to enrollees during the unwinding of the Medicaid continuous coverage requirement to ensure that those who are eligible maintain their coverage, and those who are ineligible are transitioned to a marketplace plan or other insurance. The intention is to help states develop a timeline within their communications plans to coordinate and sequence outreach to these consumer groups. Critical in this effort to reduce churn will be effective coordination with stakeholders. This expert perspective outlines outreach strategies and tactics state Medicaid agencies and state-based marketplaces can implement to effectively inform enrollees what is happening and what actions they may need to take to stay insured. This expert perspective has been updated to reflect the passage of the Consolidated Appropriations Act, an omnibus funding package that separates the Medicaid continuous coverage provision from the COVID-19 public health emergency that provides a fixed end date for the Medicaid continuous coverage guarantee of March 31, 2023.
State updates as of July 29, 2022.
This expert perspective reviews the focus on health equity in California’s final Medi-Cal Managed Care Plans Request for Proposals (RFP) which the state issued in February 2022. This expert perspective is a companion to the latest version of State Health and Value Strategies’ Medicaid Managed Care Contract Language: Health Disparities and Health Equity which has been updated to incorporate new details from California’s RFP.
State updates as of July 22, 2022.