Health Policy News – April 2020

Last month, Health Policy News brought you breaking news about the legislation and guidance aimed at providing greater flexibility to states and providers as they struggle to meet health and service demands during this global pandemic; requirements relative to COVID-19-related health coverage; and examples of action at the state level to address local need. As the pandemic continues, so does the federal and state response. This month, amid continuing developments on these topics at the federal and state level, we report on the latest updates to keep you informed about policy changes—particularly those getting less coverage nationally.

This month’s piece on the federal-level response details updates from both Congress and the Centers for Medicare and Medicaid Services (CMS). In addition to the recent passage of a fourth legislative change, directed at providing relief funds relative to COVID-19, CMS continues to release a significant amount of guidance. We provide an overview of key provisions in this latest legislative package and the guidance released in the last month—with a particular focus on coverage requirements, funding and flexibility for states and providers—as well as links to where you can find more information.

Our second article brings you updates from the state level. In addition to widespread telehealth advocacy during this pandemic, states are acting to ensure consumers have access to testing and treatment, and remain insured during these uncertain times.

Finally, we provide insight into the role of critical incident management systems during the pandemic. Having these systems in place to address the inevitable service strains and challenges during this time allows states to quickly and appropriately investigate and remedy incidents, as well as gain more insight into any specific challenges facing the state. Our piece gives suggestions for ways states can prepare for and manage the current pandemic, along with a variety of COVID-19-related solutions PCG offers for state Medicaid programs.

Updates on the Federal Response to COVID-19

As the pandemic continues to impact the country, Congress and CMS continue to advance temporary funding, policy changes, and waivers to support states, providers, and the public in their efforts to fight COVID-19. This article outlines key provisions in the most recent stimulus package, as well as guidance and waivers coming out of CMS relative to providers, public programs, and private insurance coverage. Given the high volume of media coverage on the topics of clinical guidance and stimulus funding more broadly and clinical guidance, this article focuses on funding for providers, new flexibility for states and providers, and requirements for health coverage—all aimed at supporting the fight against COVID-19. For more information on the policy developments at the federal level, click here.

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Updates on the State Level Responses to COVID-19

In addition to expanding telehealth availability, states have enacted policy mandates and taken action to ensure patient access to medications, healthcare, and COVID-19 testing and treatment with minimal barriers.. This article details the latest state approaches to ensuring consumer protections, continuity of coverage and access to treatment and testing. For more information about recently released state-level, COVID-19-related guidance and bulletins directed at both Medicaid and commercial insurance carriers—including examples from key states—click here.

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Care During A Crisis

Leveraging Your Critical Incident Management System to Ensure Health and Welfare When It Matters Most   

State Medicaid agencies have been hit hard during the COVID-19 crisis. Over the last several weeks, these programs have seen an unprecedented increase in member enrollments, as well as significant disruptions to care delivery as a result of the impact of stay-at-home orders on a provider capacity. This article highlights the importance of implementing critical incident management policies to ensure continuity of service, mitigate the spread of COVID-19 within high risk populations, and gain insights into how to properly manage critical incidents on a routine basis. For more information about the role and value of critical incident management systems during the pandemic, click here.

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