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Initiatives will ensure children in Oregon have continuous Medicaid coverage until the age of six, and expand access to coverage and address nutrition and housing needs in Massachusetts and Oregon
Approvals of the initiatives come during the White House Conference on Hunger, Nutrition, and Health, taking direct action on the Biden-Harris Administration’s National Strategy to end hunger, reduce diet-related diseases, and eliminate health inequities
The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved groundbreaking Medicaid section 1115 demonstration initiatives in Massachusetts and Oregon. Both demonstrations aim to test improvements in coverage, access, and quality with innovative approaches to ensure more eligible people retain their Medicaid coverage, including by approving Oregon’s demonstration to keep children enrolled in Medicaid up to age six — preventing gaps in coverage that can cause children to lose access to needed care in their formative early years.
The initiatives also take steps to address unmet health-related social needs, such as by giving Massachusetts and Oregon new authority to test coverage for evidenced-based nutritional assistance and medically tailored meals, clinically-tailored housing supports, and other interventions for certain beneficiaries where there is a clinical need. These efforts coincide with the White House Conference on Hunger, Nutrition, and Health, where the Biden-Harris Administration released its national strategy to end hunger, improve nutrition and physical activity, and reduce diet-related diseases and disparities – all goals supported by the initiatives approved today.
“This is an historic moment in our nation’s fight to end hunger and improve health equity, particularly in states like Oregon and Massachusetts,” said HHS Secretary Xavier Becerra. “Groundbreaking action in each state will ensure children and youth remain connected to health care, and that we double down on tackling social needs impacting health, such as nutrition. Everyone should get the access to care they need to live safe and healthy lives.”
“I’m proud to partner with Oregon and Massachusetts to improve quality and access, reduce health disparities, and improve health equity, for those who need it most. For the first time ever, children with Medicaid coverage in Oregon will be able to keep their coverage until the age of 6 — ensuring they can get the care they need during their formative years. This is just one aspect of the groundbreaking demonstration initiatives that I’m approving today,” said CMS Administrator Chiquita Brooks-LaSure. “These states are also partnering with community-based providers to address the root social causes of health concerns, like lack of access to nutritious food and housing insecurity. We applaud Massachusetts and Oregon for helping us use every tool available to protect and expand access to high-quality, comprehensive, affordable health care coverage.”
Under the Biden-Harris Administration, thanks to the American Rescue Plan and other Administration efforts, more Americans than ever before have health insurance coverage. Today’s approvals will build on these efforts and support President Biden’s executive orders in April 2022 and January 2021 directing federal agencies to take action to expand affordable, quality health coverage, including by strengthening Medicaid and the Affordable Care Act.
Both demonstrations approved today will work to improve enrollment and continuity of coverage. In Oregon, children determined eligible for Medicaid will be able to stay continuously enrolled until they turn six years old, without their families needing to renew their coverage. This will minimize red tape for both families and the state, and help to ensure access to care throughout this critical period of early childhood. Individuals older than six will be able to keep their coverage for up to two years, even if their household income fluctuates. Massachusetts will provide up to 12 months of continuous coverage for Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries upon release from correctional settings and 24-months of continuous eligibility for beneficiaries with a confirmed status of chronic homelessness, eliminating gaps in coverage for these vulnerable populations.
Evidence indicates that health-related social needs, such as food insecurity and housing instability, are critical drivers of an individual’s health outcomes. With this demonstration, Massachusetts will receive expanded authority to provide certain time-limited housing supports, clinical nutrition education, and medically-tailored food assistance services when medically appropriate. These services will be available to a range of at-risk populations, including postpartum individuals for up to 12 months. Massachusetts will also provide additional meal support for certain households when an eligible beneficiary is a child or pregnant woman with special clinical needs. Oregon will expand health-related social needs coverage for certain food assistance, housing supports, and other interventions that are medically appropriate for individuals experiencing certain life transitions, including individuals who are homeless or at risk of homelessness. In both states, the time-limited housing and nutritional support services provided in the demonstration can be expected to stabilize the housing and nutritional circumstances of these Medicaid enrollees and thus ensure that they will keep receiving and benefiting from the Medicaid-covered services to which they are entitled.
Massachusetts will also be implementing an innovative Hospital Quality and Equity Initiative for private acute hospitals and the Commonwealth’s only non-state-owned public hospital, Cambridge Health Alliance. The initiative is expected to reduce health inequities by improving outcomes in populations that are likely to face barriers to quality health care. As such, the demonstration is likely to help improve the quality of care and is also likely to reduce health disparities through this value-based care approach.
CMS will require both states to systematically monitor the demonstrations and conduct rigorous independent evaluations to determine the outcomes and impacts.
For additional information about the Massachusetts’ MassHealth Section 1115 Demonstration, please visit: https://www.medicaid.gov/medicaid/section-1115-demo/demonstration-and-waiver-list/82006.
The Centers for Medicare & Medicaid Services (CMS) released the 2023 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs, and the 2023 Medicare Part D income-related monthly adjustment amounts.
Please review the Fact Sheet at https://www.cms.gov/newsroom/fact-sheets/2023-medicare-parts-b-premiums-and-deductibles-2023-medicare-part-d-income-related-monthly. For more information on the 2023 Medicare Parts A and B premiums and deductibles (CMS-8077-N, CMS-8078-N, CMS-8079-N), please visit https://www.federalregister.gov/public-inspection/current.
The Rural Health Information Hub collaborated with NORC Walsh Center for Rural Health Analysis to create resources for developing, implementing, evaluating, and sustaining rural health literacy programs.
The Federal Communications Commission provides easy-to-understand material – flyers, social media content, videos, audio PSAs – in English and Spanish to help consumers understand the federal program that helps households pay for internet service.
This report from the Center for Economic Analysis of Rural Health explores the relationship between health care and local economies, as well as the economic implications associated with COVID-19.
Last week, the U.S. Department of Health & Human Services (HHS) introduced the Roadmap for Behavioral Health Integration, to advance the White House Strategy to Address our National Mental Health Crisis announced earlier this year. The HHS paper explains policy and programs that will build three pillars of the national strategy: 1) Strengthen System Capacity by developing a diverse workforce; 2) Connect Americans to Care through health financing; and 3) Support Americans by Creating Healthy Environments with investments in behavioral health, upstream prevention, and recovery. The Roadmap includes rural communities as part of its cross-cutting equity priority, but does not cover all of the behavioral health initiatives across the Department; important efforts already underway include the HHS Overdose Prevention Strategy and the new three-digit 988 Suicide and Crisis Lifeline.
NIH has released a new Funding Opportunity for research into the implementation of effective non-opioid interventions for chronic pain management in rural and remote populations. The NIH’s Helping to End Addiction Long-term (HEAL) initiative to speed scientific solutions to the national opioid public health crisis, is intending to commit $5.7M in FY2023 to this effort, which will result in five to six awards. The FOA requires partnerships with health care systems or organizations and community partners and encourages links to key rural partners such as State Offices of Rural Health, State Rural Health Associations, and Area Health Education Centers.
The nonprofit Rural Health Redesign Center has been tapped to provide technical assistance to hospitals through the process of becoming newly designated Rural Emergency Hospitals (REH). The REH is a federal policy response to the growing number of rural hospital closures and it allows Critical Access Hospitals and certain hospitals of no more than 50 beds to convert to a facility with essential services – emergency department, observation care, and additional outpatient services. The REH Technical Assistance Center announced today will help these transitioning hospitals through the conversion process. More resources and information will be available in the coming weeks and months but the Center is ready to answer questions today. On Wednesday, October 12 at 3:00 pm ET FORHP will host a webinar to explain the Rural Emergency Hospital, the new Technical Assistance Center, and other FORHP-funded activities to support hospitals exploring the REH option.
The Pennsylvania Department of Human Services issued an annual update Medical Assistance Bulletin regarding the EPSDT Program Periodicity Schedule and Coding Matrix. There are several content updates including:
- Psychosocial/Behavioral Assessment has been updated to “Behavioral/Social/Emotional Screening” (annually from newborn to 21 years) to align with AAP policy, the ACOG Women’s Preventive Services Initiative recommendations, and the AACAP guidelines.
- Risk assessment for hepatitis B virus infection has been added to occur once between the ages of newborn and 21 years, with appropriate action to follow, if positive.
- Risk assessment for sudden cardiac arrest and sudden cardiac death has been added to occur once between the ages of 11 and 21 years, with appropriate action to follow, if positive.
There are also several footnote updates. For full details click here. Additionally, a Medical Assistance Bulletin was issued regarding vaccine counseling-only visits for beneficiaries under 21. This bulletin announced the Medical Assistance program will cover vaccine counseling visits for beneficiaries under age 21 for vaccines provided through the EPSDT benefit when no vaccines are administered. For details click here.
The U.S. Department of Human Services (HHS) Office for Civil Rights and the Department of Justice’s Civil Rights Division recently released guidance on how various federal laws require making telehealth accessible by people with disabilities and limited English proficient persons.