Congressmen David Trone (D-MD), Jamie Raskin (D-MD), and Brian Fitzpatrick (R-PA) reintroduced the Continuity in Necessary Evaluative Crisis Treatment (CONNECT) Act to connect individuals experiencing a behavioral or mental health crisis with follow-up services. The bill authorizes $30 million to create a new grant program through the Substance Abuse and Mental Health Services Administration (SAMHSA) to support these activities.

Advocates and dentists are hopeful a state House bill will restore dental services for adults with Medicaid coverage in Pennsylvania. The legislation passed the Democratic-controlled state House last month in a bipartisan 153-50 vote. Coverage for many adult dental services was cut in 2011 under the administration of former Gov. Tom Corbett as part of a cost-saving move; the change was estimated to save about $18 million in state funds at the time. Since that time, adults in the state’s Medicaid program have had a very limited set of dental benefits that don’t cover much beyond routine exams, cleanings, and basic fillings. The bill is now in the state Senate before the Human Services Committee. There is also a similar Senate bill, sponsored by Minority Leader Sen. Jay Costa, a Democrat.

From Becker’s

More than 15 million people have been disenrolled from Medicaid since April 2023, surpassing HHS’ original estimates with several months left in the redeterminations process.

According to KFF, as of Jan. 16, 15,015,000 people have been disenrolled from Medicaid during the continuous coverage unwinding process. HHS estimated around 15 million people would lose coverage during the process.

States began the process of redetermining the eligibility of Medicaid recipients for the first time since 2020 in April, after continuous eligibility requirements in place during the COVID-19 pandemic expired.

Here are five things to know about where the unwinding process stands:

1. Around one-third of people who had their coverage up for renewal were disenrolled from Medicaid, while two-thirds were reenrolled in the program, according to KFF.
2. The majority of those disenrolled had their coverage terminated for procedural reasons, rather than being determined ineligible on the basis of income. According to KFF, as of Jan. 16, 71% of disenrollments were due to procedural reasons.
3. Disenrollment rates vary widely by state. In Texas, 61% of those whose coverage was up for renewal were disenrolled, while in Oregon and Maine, 13% of those up for renewal were disenrolled.
4. Children account for around 4 in 10 of those disenrolled from Medicaid, according to KFF. In December, HHS asked nine states with the highest child disenrollment rates to implement more flexibility to keep eligible kids enrolled.
5. States were given 12 months to complete the unwinding process, though in December, HHS said it would extend flexibilities offered to states through the end of 2024. At least two states, Arkansas and Idaho, have already completed the redetermination process.

From Axios

Sixty percent of kids who have lost Medicaid coverage this year came from just nine states, all of which are Republican-led, according to new data from the Biden administration.

Driving the news: And the 10 states refusing the Affordable Care Act’s expansion of Medicaid to low-income adults have disenrolled more kids than all of the expansion states combined, the administration also reported.

Why it matters: The data hints at a partisan divide in reviews of Medicaid eligibility after those checks — which were put on hold during the pandemic — resumed this spring.

• The administration on Monday sent warnings to the nine states with large losses in kids coverage, but federal health officials said they have limited power to require those states to make changes.

Context: At least 2.2 million kids have been removed from Medicaid and its sister program, the Children’s Health Insurance Program, during the so-called “unwinding” of pandemic-era coverage protections as of September, according to data from the Centers for Medicare and Medicaid Services.

• More recent data tracked by outside sources suggest this number is closer to 3 million.
• Many may have been disenrolled because of a procedural issue and not necessarily because they were no longer eligible. States have been restoring coverage for over 500,000 people, many of them children, who were inappropriately booted from Medicaid because of an error in calculating income.

State of play: Health and Human Services Secretary Xavier Becerra sent letters to Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota and Texas on Monday urging them to better protect kids from losing Medicaid.

• The letters note that HHS “will not hesitate to take action to ensure states’ compliance with federal Medicaid requirements,” though they don’t specify what the department might do.
• CMS earlier this month warned it will fine states that don’t properly report data about who’s losing coverage, Modern Healthcare reported.

By the numbers: South Dakota and Idaho recorded the sharpest decreases in Medicaid enrollment among kids between March and September (27%), according to CMS data.

• Kids’ enrollment decreased by more than 10% in most other states receiving warning letters. Enrollment shrank by 9% in Georgia and 6% in Ohio, but those states are among those with the highest number of kids removed from the program.
• Enrollment also decreased by over 10% in New Mexico, Oklahoma and Utah, but those states did not receive warning letters.

States with the smallest decreases in kids’ enrollment were largely blue states. Enrollment actually increased slightly in New York, Oregon, Massachusetts, Rhode Island and Washington, D.C.

• As of June, more than 20% of children who lost coverage had been re-enrolled in Medicaid or CHIP, federal data shows. It’s unclear how many may have found coverage elsewhere, such as through the ACA insurance marketplaces or a parent’s employer.

The other side: States contacted by Axios defended the coverage losses and said they had followed federal requirements for the unwinding process.

Read more.

The U.S. Department of Agriculture (USDA) is accepting applications for grants to help agricultural producers maximize the value of their products and venture into new and better markets.

USDA is making the grants available under the Value-Added Producer Grants program. The grants help farmers and ranchers generate new products, create marketing opportunities, and increase their incomes through value-added activities.

Eligible applicants include independent producers, agricultural producer groups, farmer or rancher cooperatives, and majority-controlled producer-based business ventures.

USDA may award up to $75,000 for planning activities or up to $250,000 for working capital expenses related to producing and marketing a value-added agricultural product.

Planning activities may include conducting feasibility studies and developing business plans. Working capital expenses may include costs associated with processing, marketing, advertising, inventory and salaries.

USDA is particularly interested in applications that will advance Biden-Harris Administration priorities to:

• Reduce climate pollution and increase resilience to the impacts of climate change through economic support to rural communities.
• Ensure all rural residents have equitable access to Rural Development (RD) programs and benefits from RD-funded projects; and
• Help rural communities recover economically through more and better market opportunities and through improved infrastructure.

Paper applications must be postmarked and delivered by mail, email or in person to the state office where the project is proposed by close of business on April 16, 2024. Electronic applications will be accepted via Grants.gov until 11:59 p.m. Eastern Time on April 11, 2024.

Additional information is available on page 2919 of the Jan. 17 Federal Register.

If you’d like to subscribe to USDA Rural Development updates, visit our GovDelivery subscriber page.

Contact information in Pennsylvania: If you are in Pennsylvania and have questions about this program, please contact Karen Kuhns, area specialist for the Rural Business and Cooperative programs, at 724-261-3893 or karen.kuhns@usda.gov.

The Centers for Medicare & Medicaid Services (CMS) will issue a final rule that places new requirements on Medicare Advantage (MA) organizations, Medicaid managed care plans, Children’s Health Insurance Program (CHIP) managed care entities, state Medicaid and CHIP Fee-for-Service (FFS) programs, and Qualified Health Plan (QHP) issuers on the Federally Facilitated Exchanges (FFEs) to improve the electronic exchange of healthcare data and streamline processes related to prior authorization. This final rule will also add a new measure for eligible hospitals and critical access hospitals (CAHs) under the Medicare Promoting Interoperability Program and for Merit-based Incentive Payment System (MIPS) eligible clinicians under the Promoting Interoperability performance category of MIPS.

Weblinks

• Press Release: https://www.cms.gov/newsroom/press-releases/cms-finalizes-rule-expand-access-health-information-and-improve-prior-authorization-process
• Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/cms-interoperability-and-prior-authorization-final-rule-cms-0057-f
• Final Rule: https://www.cms.gov/files/document/cms-0057-f.pdf

The U.S. Department of Health and Human Services, through the Centers for Medicare & Medicaid Services (CMS), announced a new model to test approaches for addressing the behavioral and physical health, as well as health-related social needs, of people with Medicaid and Medicare. The Innovation in Behavioral Health (IBH) Model’s goal is to improve the overall quality of care and outcomes for adults with mental health conditions and/or substance use disorder by connecting them with the physical, behavioral, and social supports needed to manage their care.  The model will also promote health information technology (health IT) capacity building through infrastructure payments and other activities.

The IBH Model will be tested by the Center for Medicare and Medicaid Innovation (CMS Innovation Center). Under IBH, community-based behavioral health practices will form interprofessional care teams consisting of behavioral and physical health providers, as well as community-based supports. This new model supports the President’s mental health strategy and implements an action item in the HHS Roadmap for BH integration.

Read more.

Among fourteen categories that can be searched by state, topic, keyword, and year, the resource includes legislative topics on newborn screening, women’s health, childhood obesity and nutrition, maternal and infant mortality, maternal and child mental health and the impacts of substance use on the MCH population. The database goes back to 2017 and is kept up to date by the National Conference of State Legislatures (NCSL).

Read the full article here.

HRSA relies on grant reviewers to select the best programs from a competitive group of applicants. Over the coming months, the Federal Office of Rural Health Policy will be competing a number of programs, including among other things: substance use disorders and opioid use disorder, rural workforce, and rural hospitals. Having reviewers with expertise in rural health greatly benefits the review process and is also an opportunity to learn about the review process itself. Reviews are typically held remotely over a period of a few days and reviewers who participate and complete their assigned duties receive an honorarium. Registration is easy and does not commit you to serving as a reviewer. Please consider lending your expertise to these important initiatives.

Read the full article here.