Expert Perspectives

Dec 4, 2020 

Audio-Only Medicaid Telehealth Policies

In response to the COVID-19 crisis, many state Medicaid agencies implemented temporary telehealth service delivery and reimbursement policies that allow for both audio/visual and audio-only telehealth modalities. As states begin to consider their longer-term telehealth policies for the period following the COVID-19 public health emergency, many are looking to continue covering and paying for limited audio-only telehealth. This expert perspective discusses the legal authority that permits states to continue to authorize Medicaid reimbursement for audio-only telehealth after the public health emergency ends.

Nov 6, 2020 

Advances in States’ Reporting of COVID-19 Health Equity Data

This expert perspective provides an update on states’ reporting of health equity data related to cases, mortality, hospitalizations, and testing and new state activity related to data collection, including examples of collecting additional data measures and creating taskforces to advance health equity. The post also provides a summary of CARES Act reporting requirements related to testing.

Nov 2, 2020 

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.

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Oct 30, 2020 

Stable Rates Reflect Strength of ACA Marketplaces

The start of the 2021 rate review process for the Affordable Care Act (ACA) Marketplaces coincided with the initial outbreak of COVID-19 cases, and early forecasts were ominous, with rate increases projected as high as 40 percent. There was also widespread concern about how to set rates when insurers’ COVID-related costs looked anything but predictable. In short, it looked like, after a period of relative stability in Marketplace rates, enrollees might be in for a rollercoaster ride. This expert perspective provides a brief overview of how the rate review process has developed since the first ACA OEP in 2013 and how those developments came together this year to enable regulators and insurers to manage uncertainty and achieve more stable rates for the 2021 plan year.

Oct 30, 2020 

Ensuring Access to the COVID-19 Vaccine for Adult Medicaid Enrollees: A Roadmap for States

This expert perspective provides a roadmap for states to assess their vaccine coverage policies in Medicaid and, if necessary, to close any coverage gaps that might otherwise inhibit vaccine uptake during a crucial period of mass immunization. The concluding section discusses the possibility of congressional action that may alter the federal landscape for Medicaid vaccine coverage.