Health Policy News – May 2020

The much-anticipated final Payment Notice and Letter to Issuers in the Federally-facilitated Marketplaces was released early this month, with states’ concerns about the impact of COVID-19 evident in many of the finalized policy changes. The first post this month details the Centers for Medicare and Medicaid Services’ (CMS) final changes and includes an updated fact sheet on the guidance. Both documents clearly delineate the changes made in finalizing the guidance.

In keeping with the trend of our previous two newsletters, this edition also includes two COVID-19-related health policy updates—summarizing the latest federal-level efforts and state action in response to the pandemic.

Many administrators and Medicaid programs are reacting in real time to new, COVID-19-related federal guidance—especially pertaining to how to account for and track federal funds during this pandemic. In this month’s final post, our subject matter experts compiled a guide detailing areas where the federal government has allowed for flexibility in timelines, as well as tips for how to ensure compliance—particularly for costs allocated to COVID-related expenditures.

As in past years, Health Policy News will publish one summer edition in late July; however, we will continue to post updates on the blog in the interim. We encourage you to check back regularly for ongoing coverage of the COVID-19 pandemic—and hopefully other health policy topics—as our country works to contain this public health emergency.

Payment Notice and Letter to Issuers in the Federally-facilitated Marketplaces Finalized for the 2021 Plan Year 

As was the case in recent years, the final Marketplace guidance for Plan Year 2021 includes limited changes from both prior years’ guidance and from the versions proposed earlier this year. To assist states as most prepare to receive and review plan filings, our analysis of CMS’s final guidance flags notable changes from the proposed guidance —including updates specific to the federal COVID-19 pandemic response. To view our full update and final fact sheet, please click here.

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The Federal Administration Continues to Release Guidance and Waivers in Response to the COVID-19 Pandemic

Health Policy News continues tracking federal-level action aimed at addressing the broad impact of the COVID-19 pandemic. This month’s update aggregates the latest developments at the federal level, focusing on funding to support health care providers and flexibility given to providers and states—as well as commercial health plans, plan sponsors and enrollees—via policy changes and waivers. Click here to read it.

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State Mitigation of COVID-19 Related Costs

A piece by one of our editors, entitled “States Should Act Now To Mitigate Commercial Insurance Costs Associated With COVID-19,” was featured on the Health Affairs blog at the end of April. The article examines the impact that COVID-19-related health insurance expenditures in 2020 will have in 2021, and how states can work with health insurers to protect the individual and small group health insurance markets during this turbulent time. To read the full article and review the action items for states outlined in the piece, please click here.

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Guidance for States on How to Properly Document Federal Funding During COVID-19 Response and Recovery

On March 19, 2020, the Office of Management and Budget (OMB) released M-20-17, Administrative Relief for Recipients and Applicants of Federal Financial Assistance Directly Impacted by the Novel Coronavirus (COVID-19) due to Loss of Operations. Although many of the operational impacts and costs of COVID-19 are unknowable at this point, PCG has assembled tips for states related to time-limited administrative flexibilities and best practices to ensure compliance during this public health emergency. To read more, click here.

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