Introduction
Health Policy News had planned content for the month of March, but given the unprecedented times we are all living through, we thought it best to dedicate this month’s entire edition to recent federal and state efforts to support consumers, providers, and health insurance carriers in combating COVID-19. Just in the past week, a flurry of activity at the federal and state level has been aimed at expanding testing for COVID-19, bolstering hospitals and provider capacity, and stopping the spread of the disease.
Our articles detail select breaking federal and state responses to COVID-19, including H.R. 6201, Families First Coronavirus Response Act, and recent guidance from the Centers for Medicare and Medicaid Services (CMS) that highlight the flexibility afforded to state Medicaid departments, other public programs, and private insurers during the present state of emergency. Lastly, we make readers and state policymakers aware of waiver opportunities and efforts at the state level to insure the uninsured maintain enrollment and allow access to health care providers via non-traditional methods like telehealth. We hope this will assist your state as you seek to best serve your residents and address the needs of the healthy, as well as those struggling with illness during this global pandemic.
CMS Provides Flexibility to Public Healthcare Programs During the COVID-19 Pandemic via Medicaid Waivers
By virtue of the declaration of a public health emergency by the U.S. Department of Health and Human Services on January 31st and the President’s declaration of a national state of emergency on March 13th, states now have new Medicaid waiver authority available to them—which many quickly sought to tap. To read more about flexibilities recently afforded to states via Section 1135 Waivers, as well as new opportunities under Section 1115 and Section 1915(c) Waivers, click here.
Congress and CMS Issues Guidance and Requirements Relative to Public Health Care Programs and COVID-19
CMS has regularly issued guidance relative to Medicare, as well as state Medicaid and Children’s Health Insurance programs, since the start of the pandemic. This guidance, paired with targeted legislation passed at the federal level, puts forth and outlines flexibility and requirements aimed at addressing the broad impact of the COVID-19 pandemic via public programs. New flexibilities and expectations for public programs were also included in the Families First Coronavirus Response Act and other bills passed quickly by Congress to address the pandemic. To read more about flexibility included in federal guidance and legislation, click here.
Congress and CMS Action Relative to Employers and Private Insurance Coverage and COVID-19
As of March 25th, the Center for Consumer Information and Insurance Oversight had published several pieces of guidance detailing flexibilities and expectations for private insurance during the pandemic, covering topics such as co-payments for COVID-19 testing and treatment, service delivery, and enrollment. These issues have also been addressed by recent legislation. To read more about provisions specific to private insurance and employers, click here.
State-Level Responses to COVID-19
States have taken action to increase residents’ access to health insurance, as well as clarify for consumers the costs associated with COVID-19 testing and treatment. Many states are urging consumers to utilize telehealth during this period of social distancing and quarantine and avoid hospitals or medical facilities unless absolutely necessary. To assist regulators and policymakers seeking to provide stability, expand coverage options, and ensure health care access for consumers, we compiled a round-up of some recent state action on these topics, with more details available here.
We encourage state regulators and other readers to stay updated on guidance coming out from the federal level—in particular, by regularly checking CMS’s updates. Stay safe, stay at home if you can and as always, HPN is available at healthpolicynews@pcgus.com if you have any questions.
Image credit: NIAID-RML
