State Medicaid Programs Respond to Meet COVID-19 Challenges: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2020 and 2021
Executive Summary
Pub. L. 116-127 (March 18, 2020), https://www.congress.gov/116/plaws/publ127/PLAW-116publ127.pdf.
FMAP = Federal Medicaid Assistance Percentage
MaryBeth Musumeci, Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19 (Washington, DC: KFF, May 4, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-new-increase-in-federal-medicaid-matching-funds-for-covid-19/
US Department of Health and Human Services, Renewal of Determination That A Public Health Emergency Exists (October 2, 2020), https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-2Oct2020.aspx
State fiscal years begin on July 1 except for these states: New York on April 1; Texas on September 1; Alabama, Michigan, and DC on October 1.
The eight states that did not respond by mid-August 2020 are: Delaware, District of Columbia, Illinois, Ohio, New Mexico, New York, Rhode Island, and Utah.
MaryBeth Musumeci, Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19 (Washington, DC: KFF, May 4, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-new-increase-in-federal-medicaid-matching-funds-for-covid-19/
Rachel Dolan, Robin Rudowitz, and Samantha Artiga, Medicaid Maintenance of Eligibility (MOE) Requirements: Issues to Watch When They End (Washington, DC: KFF, September 22, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-maintenance-of-eligibility-requirements-issues-to-watch-when-they-end/
KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Since the time of survey submission, two additional responding states (Connecticut and North Carolina) have received SPA approvals for this group. For an updated count of states with SPA approval to cover the new Uninsured Coronavirus Testing group, see: KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
KFF, “Status of State Medicaid Expansion Decisions”, last updated October 1, 2020, https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
Karyn Schwartz, Jennifer Tolbert, Karen Pollitz, and Tricia Neuman, Update on COVID-19 Funding for Hospitals and Other Providers (Washington, DC: KFF, April 24, 2020), https://www.kff.org/policy-watch/update-on-covid-19-funding-for-hospitals-and-other-providers/
KFF, “Total Medicaid MCO Enrollment,” 2018, https://www.kff.org/other/state-indicator/total-medicaid-mco-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Samantha Artiga and Elizabeth Hinton, Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity (Washington, DC: KFF, May 10, 2018), https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
Molly O’Malley Watts, MaryBeth Musumeci, and Priya Chidambaram, Medicaid Home and Community-Based Services Enrollment and Spending (Washington, DC: KFF, February 4, 2020), https://www.kff.org/report-section/medicaid-home-and-community-based-services-enrollment-and-spending-issue-brief/
MaryBeth Musumeci, Rachel Dolan, and Madeline Guth, State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19 (Washington, DC: KFF, August 26, 2020), https://www.kff.org/medicaid/issue-brief/state-actions-to-sustain-medicaid-long-term-services-and-supports-during-covid-19/
Kathleen Gifford et al., “Benefits and Cost-Sharing,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-benefits-and-cost-sharing/
Introduction
US Department of Health and Human Services, Renewal of Determination That A Public Health Emergency Exists (October 2, 2020), https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-2Oct2020.aspx
KFF, “Health Insurance Coverage of the Total Population,” 2018, https://www.kff.org/other/state-indicator/total-population/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
U.S. Centers for Medicare & Medicaid Services (CMS). National Health Expenditure Data Fact Sheet: Table 4, National Health Expenditures by Source of Funds and Type of Expenditure: Calendar Years 2011-2018 (CMS, March 2020), https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet.html
Pub. L. 116-127 (March 18, 2020), https://www.congress.gov/116/plaws/publ127/PLAW-116publ127.pdf.
Pub. L. 116-136 (March 27, 2020), https://www.congress.gov/116/bills/hr748/BILLS-116hr748enr.pdf.
MaryBeth Musumeci, Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19 (Washington, DC: KFF, May 4, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-new-increase-in-federal-medicaid-matching-funds-for-covid-19/
KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
MaryBeth Musumeci, Rachel Dolan, and Madeline Guth, Appendix to State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19 (Washington, DC: KFF, August 26, 2020), https://www.kff.org/report-section/state-actions-to-sustain-medicaid-long-term-services-and-supports-during-covid-19-appendix/
KFF 50-State Medicaid Budget Survey Archives (Washington, DC: KFF, October 2020), https://www.kff.org/medicaid/report/medicaid-budget-survey-archives/.
The eight states that did not respond by mid-August 2020 are: Delaware, District of Columbia, Illinois, Ohio, New Mexico, New York, Rhode Island, and Utah.
State fiscal years begin on July 1 except for these states: New York on April 1; Texas on September 1; Alabama, Michigan, and DC on October 1.
Eligibility and Enrollment
Pub. L. 116-127 (March 18, 2020), https://www.congress.gov/116/plaws/publ127/PLAW-116publ127.pdf.
Pub. L. 116-136 (March 27, 2020), https://www.congress.gov/116/bills/hr748/BILLS-116hr748enr.pdf.
FMAP = Federal Medicaid Assistance Percentage
MaryBeth Musumeci, Key Questions About the New Increase in Federal Medicaid Matching Funds for COVID-19 (Washington, DC: KFF, May 4, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-new-increase-in-federal-medicaid-matching-funds-for-covid-19/
Rachel Dolan, Robin Rudowitz, and Samantha Artiga, Medicaid Maintenance of Eligibility (MOE) Requirements (Washington, DC: KFF, September 22, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-maintenance-of-eligibility-requirements-issues-to-watch-when-they-end/
Robin Rudowitz, Bradley Corallo, and Samantha Artiga, Analysis of Recent National Trends in Medicaid and CHIP Enrollment: Issues to Watch When They End (Washington, DC: KFF, August 24, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/analysis-of-recent-national-trends-in-medicaid-and-chip-enrollment/
Tricia Brooks, Lauren Roygardner, Samantha Artiga, Olivia Pham, and Rachel Dolan, Medicaid and CHIP Eligibility, Enrollment, and Cost Sharing Policies as of January 2020: Findings from a 50-State Survey (Washington, DC: KFF, March 26, 2020), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2020-findings-from-a-50-state-survey/
Robin Rudowitz and Elizabeth Hinton, Early Look at Medicaid Spending and Enrollment Trends Amid COVID-19 (Washington, DC: KFF, May 15, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/early-look-at-medicaid-spending-and-enrollment-trends-amid-covid-19/
KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
MaryBeth Musumeci, Rachel Dolan, and Madeline Guth, Appendix to State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19 (Washington, DC: KFF, August 26, 2020), https://www.kff.org/report-section/state-actions-to-sustain-medicaid-long-term-services-and-supports-during-covid-19-appendix/
US Department of Health and Human Services, Renewal of Determination That A Public Health Emergency Exists (October 2, 2020), https://www.phe.gov/emergency/news/healthactions/phe/Pages/covid19-2Oct2020.aspx
KFF, “Status of State Medicaid Expansion Decisions”, last updated October 1, 2020, https://www.kff.org/medicaid/issue-brief/status-of-state-medicaid-expansion-decisions-interactive-map/
Calculated based on the 2020 Federal Poverty Level (FPL) of $12,760 per year for an individual in 2020, in the 48 contiguous states and DC. See: U.S. Department of Health & Human Services, Office of the Assistant Secretary for Planning and Evaluation, U.S. Federal Poverty Guidelines Used to Determine Financial Eligibility for Certain Federal Programs (January 2020), https://aspe.hhs.gov/poverty-guidelines
Oklahoma Healthcare Authority, Public Notice: Medicaid Adult Expansion, July 31, 2020, http://www.okhca.org/WorkArea/linkit.aspx?LinkIdentifier=id&ItemID=24995&libID=23981
MaryBeth Musumeci, 3 Key Questions About the Arkansas Medicaid Work and Reporting Requirements Case (Washington, DC: KFF, March 6, 2020), https://www.kff.org/medicaid/issue-brief/3-key-questions-about-the-arkansas-medicaid-work-and-reporting-requirements-case/
For more information on South Carolina’s and other Section 1115 waivers, including the status of work requirements, see: KFF, “Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State”, last updated September 1, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pending-section-1115-waivers-by-state/
Georgia is extending coverage for postpartum women to 6 months and New Jersey is extending this coverage to 180 days.
Centers for Medicare and Medicaid Services, Letter to Stephanie Muth, Associate Commissioner, Medicaid/CHIP, Texas Health and Human Services Commission, from CMS Administrator, Seema Verma (January 22, 2020), https://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Waivers/1115/downloads/tx/tx-healthy-women-ca.pdf. The HTW Program provides coverage of family planning services to low-income women who are not otherwise eligible for Medicaid coverage.
New Hampshire also reported plans to continue coverage of COVID-19 diagnostic testing, testing-related services, and treatment services for the uninsured but is not counted here as authority for this coverage, created by the Families First Coronavirus Response Act, continues only through the end of the PHE period.
Additionally, Nevada noted that eligibility for the new uninsured COVID-19 group may continue for up to 90 days after the end of the PHE period to allow for prior medical requests to cover testing and diagnostic services. Per the Families First Coronavirus Response Act, authority to cover the uninsured COVID-19 testing group will not extend past the end of the PHE.
Marybeth Musumeci, Key Questions About the New Medicaid Eligibility Pathway for Uninsured Coronavirus Testing (Washington, DC: KFF, May 4, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-new-medicaid-eligibility-pathway-for-uninsured-coronavirus-testing/
U.S. Department of Health & Human Services, Health Resources & Services Administration, “COVID-19 Claims Reimbursement to Health Care Providers and Facilities for Testing and Treatment of the Uninsured,” last updated May 2020, https://www.hrsa.gov/CovidUninsuredClaim
For an updated count of states with SPA approval to cover the new Uninsured Coronavirus Testing group, see: KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Provider Rates and Taxes
Laura Snyder and Robin Rudowitz, Trends in State Medicaid Programs: Looking Back and Looking Ahead (Washington, DC: KFF, June 21, 2016), https://www.kff.org/medicaid/issue-brief/trends-in-state-medicaid-programs-looking-back-and-looking-ahead/
MaryBeth Musumeci, Robin Rudowitz, Elizabeth Hinton, Rachel Dolan, and Olivia Pham, Options to Support Medicaid Providers in Response to COVID-19 (Washington, DC: KFF, June 17, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/options-to-support-medicaid-providers-in-response-to-covid-19/
Elizabeth Hinton and MaryBeth Musumeci, Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic (Washington, DC: KFF, September 9, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-managed-care-rates-and-flexibilities-state-options-to-respond-to-covid-19-pandemic/
CMS has described some of these options in the following two resources:
Centers for Medicare and Medicaid (CMS), “COVID-19 Frequently Asked Questions (FAQs)”, last updated June 30, 2020, https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf
Centers for Medicare and Medicaid (CMS), “Medicaid Managed Care Options in Responding to COVID-19,” last updated May 14, 2020, https://www.medicaid.gov/sites/default/files/Federal-Policy-Guidance/Downloads/cib051420.pdf
Karyn Schwartz, Jennifer Tolbert, Karen Pollitz, and Tricia Neuman, Update on COVID-19 Funding for Hospitals and Other Providers (Washington, DC: KFF, April 24, 2020), https://www.kff.org/policy-watch/update-on-covid-19-funding-for-hospitals-and-other-providers/
U.S. Department of Health & Human Services, “HHS Announces Enhanced Provider Portal, Relief Fund Payments for Safety Net Hospitals, Medicaid & CHIP Providers,” June 9, 2020, https://www.hhs.gov/about/news/2020/06/09/hhs-announces-enhanced-provider-portal-relief-fund-payments-for-safety-net-hospitals-medicaid-chip-providers.html
Robin Rudowitz, Kendal Orgera, and Elizabeth Hinton, Medicaid Financing: The Basics (Washington, DC: KFF, March 21, 2019), https://www.kff.org/report-section/medicaid-financing-the-basics-issue-brief/
Laura Snyder and Robin Rudowitz, Trends in State Medicaid Programs: Looking Back and Looking Ahead (Washington, DC: KFF, June 21, 2016), https://www.kff.org/medicaid/issue-brief/trends-in-state-medicaid-programs-looking-back-and-looking-ahead/
Kathleen Gifford et al., A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/medicaid/report/a-view-from-the-states-key-medicaid-policy-changes-results-from-a-50-state-medicaid-budget-survey-for-state-fiscal-years-2019-and-2020/
These 16 states are: Arizona, California, Colorado, Florida, Georgia, Hawaii, Iowa, Kansas, Massachusetts, Montana, New Jersey, Pennsylvania, South Carolina, South Dakota, West Virginia, and Virginia.
These 19 states are: California, Colorado, Connecticut, Florida, Georgia, Indiana, Iowa, Kentucky, Louisiana, Maine, Michigan, Montana, North Carolina, Oregon, South Carolina, Texas, Virginia, West Virginia, and Wyoming.
Delivery Systems
Kathleen Gifford et al., “Delivery Systems,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-delivery-systems/
KFF, “Total Medicaid MCO Enrollment,” 2018, https://www.kff.org/other/state-indicator/total-medicaid-mco-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
Elizabeth Hinton and MaryBeth Musumeci, Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic (Washington, DC: KFF, September 9, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-managed-care-rates-and-flexibilities-state-options-to-respond-to-covid-19-pandemic/
Centers for Medicare and Medicaid (CMS), “COVID-19 Medicaid & CHIP All State Call,” April 10, 2020, https://www.cms.gov/files/zip/covid19allstatecall04102020.zip
Centers for Medicare and Medicaid (CMS), “Medicaid Managed Care Options in Responding to COVID-19,” last updated May 14, 2020, https://www.medicaid.gov/sites/default/files/Federal-Policy-Guidance/Downloads/cib051420.pdf
“Other” carve-ins reported include chiropractic, “treat-no transport” ambulance services, and diabetes prevention services (Missouri), doula services (New Jersey), and adult podiatry services (South Carolina).
“Other” carve-outs reported were lens fabrications from selected plans (California) and elective C-sections (New Jersey).
Elizabeth Hinton and MaryBeth Musumeci, Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic (Washington, DC: KFF, September 9, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-managed-care-rates-and-flexibilities-state-options-to-respond-to-covid-19-pandemic/
The survey did not ask states to specify whether MCO contract or rate adjustments were made to FY 2020 MCO contracts so we are unable to report this information comprehensively.
Elizabeth Hinton and MaryBeth Musumeci, Medicaid Managed Care Rates and Flexibilities: State Options to Respond to COVID-19 Pandemic (Washington, DC: KFF, September 9, 2020), https://www.kff.org/medicaid/issue-brief/medicaid-managed-care-rates-and-flexibilities-state-options-to-respond-to-covid-19-pandemic/
MassHealth Managed Care Entity Bulletin 36, “Community Support Program for Homeless Individuals Residing in Department of Housing and Community Development-Funded New Temporary Shelters,” July 2020, https://www.mass.gov/doc/managed-care-entity-bulletin-36-community-support-program-for-homeless-individuals-residing-0/download
The 11 MCO states that reported food assistance or home delivered meal initiatives are: Hawaii, Indiana, Kansas, Massachusetts, Michigan, Missouri, Nebraska, New Jersey, South Carolina, Virginia, and Wisconsin.
The eight MCO states that reported enhanced MCO care management and outreach efforts often targeting persons at high risk for COVID-19 are: California, Colorado, Indiana, Kentucky, Missouri, Nebraska, Pennsylvania, and West Virginia.
The four MCO states that reported provisions of PPE are: Arizona, Kansas, Kentucky, and Pennsylvania.
The three MCO states that expanded telehealth and remote support are: Nebraska, Wisconsin, and West Virginia.
The three MCO states that reported expanded pharmacy home deliveries are: Kansas, Nebraska, and West Virginia.
The two MCO states that reported MCO-provided gift cards are: Kentucky and Virginia.
Samantha Artiga and Elizabeth Hinton, Beyond Health Care: The Role of Social Determinants in Promoting Health and Health Equity (Washington, DC: KFF, May 10, 2018), https://www.kff.org/racial-equity-and-health-policy/issue-brief/beyond-health-care-the-role-of-social-determinants-in-promoting-health-and-health-equity/
In June 2015, CMS issued an Informational Bulletin to clarify when and how Medicaid reimburses for certain housing-related activities, including individual housing transition services, individual housing and tenancy sustaining services, and state-level housing related collaborative activities. In January 2018, CMS issued a State Medicaid Director Letter providing guidance on state Section 1115 waiver proposals to condition Medicaid on meeting a work requirement. CMS explicitly stated the demonstration opportunity does not provide states with the authority to use Medicaid funding to finance employment support services. Predating this guidance, a few states implemented voluntary work referral programs. Federal Medicaid funds also cannot be used to finance work referral programs.
Centers for Medicare and Medicaid (CMS), “Coverage of Housing-Related Activities and Services for Individuals with Disabilities,” June 26, 2015, https://www.medicaid.gov/federal-policy-guidance/downloads/cib-06-26-2015.pdf
Centers for Medicare and Medicaid (CMS), “RE: Opportunities to Promote Work and Community Engagement Among Medicaid Beneficiaries,” January 11, 2018,, https://www.medicaid.gov/federal-policy-guidance/downloads/cib-06-26-2015.pdf
Under federal Medicaid managed care rules, Medicaid MCOs may have flexibility to pay for non-medical services through “in-lieu-of” authority and/or “value-added” services. “In-lieu-of” services are a substitute for covered services and may qualify as a covered service for the purposes of capitation rate setting. “Value-added” services are extra services outside of covered contract services and do not qualify as a covered service for the purposes of capitation rate setting.
Samantha Artiga, Bradley Corallo, and Olivia Pham, Racial Disparities in COVID-19: Key Findings from Available Data and Analysis (Washington, DC: KFF, August 17, 2020), https://www.kff.org/racial-equity-and-health-policy/issue-brief/racial-disparities-covid-19-key-findings-available-data-analysis/
Cornelia Hall, Samantha Artiga, Kendal Orgera, and Rachel Garfield, Food Insecurity and Health: Addressing Food Needs for Medicaid Enrollees as Part of COVID-19 Response Efforts (Washington, DC: KFF, August 14, 2020), https://www.kff.org/report-section/food-insecurity-and-health-addressing-food-needs-for-medicaid-enrollees-as-part-of-covid-19-response-efforts-issue-brief/
Oklahoma and Missouri responded that “yes” the COVID-19 emergency caused the state to implement, expand, or reform a program or initiative to address enrollees’ social determinants of health but did not describe specific related actions and are therefore not included in Exhibit 4, but are included in count of 27 states.
Minnesota Governor Walz directed more the 75 billion dollars in Coronavirus Relief funding toward food security.
The area median income (AMI) is the household income for the median, or middle, household in a region and is calculated annually by the Department of Housing and Urban Development for every metropolitan region in the country. See: Brian McCabe, “The Area Medium Income (AMI), Explained,” (Washington, DC: Greater Greater Washington: September 1, 2016), https://ggwash.org/view/42671/the-area-median-income-ami-explained
California Department of Social Services, “Project Roomkey: Emergency Housing for Immediate Protection Fact Sheet,” https://www.cdss.ca.gov/Portals/9/FEMA/Project-Roomkey-Fact-Sheet.pdf
North Carolina implemented NCCARE360 six months ahead of schedule.
Kathleen Gifford et al., “Long-Term Services and Supports,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-long-term-services-and-supports/
Centers for Medicare and Medicaid (CMS), “Financial Alignment Initiative (FAI),” last updated September 28, 2020, https://www.cms.gov/Medicare-Medicaid-Coordination/Medicare-and-Medicaid-Coordination/Medicare-Medicaid-Coordination-Office/FinancialAlignmentInitiative/FinancialModelstoSupportStatesEffortsinCareCoordination
Arizona Department of Economic Security, “DDD Health Plans,” website, https://des.az.gov/services/disabilities/developmental-disabilities/new-ddd-health-plans
Wisconsin Department of Health services, “Family Care Partnership Program,” last updated January 28, 2020, https://www.dhs.wisconsin.gov/familycare/fcp-index.htm
Long-Term Services and Supports
Molly O’Malley Watts, MaryBeth Musumeci, and Priya Chidambaram, Medicaid Home and Community-Based Services Enrollment and Spending (Washington, DC: KFF, February 4, 2020), https://www.kff.org/report-section/medicaid-home-and-community-based-services-enrollment-and-spending-issue-brief/
MaryBeth Musumeci, Molly O’Malley Watts, and Priya Chidambaram, Key State Policy Choices About Medicaid Home and Community-Based Services (Washington, DC: KFF, February 4, 2020), https://www.kff.org/medicaid/issue-brief/key-state-policy-choices-about-medicaid-home-and-community-based-services/
Sarah True et al., COVID-19 and Workers at Risk: Examining the Long-Term Care Workforce (Washington, DC: KFF, April 23, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/covid-19-and-workers-at-risk-examining-the-long-term-care-workforce/
Priya Chidambaram, Key Questions About the Impact of Coronavirus on Long-Term Care Facilities Over Time (Washington, DC: KFF, September 1, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/key-questions-about-the-impact-of-coronavirus-on-long-term-care-facilities-over-time/
Priya Chidambaram, Rising Cases in Long-term Care Facilities Are Cause for Concern (Washington, DC: KFF, July 21, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/rising-cases-in-long-term-care-facilities-are-cause-for-concern/
KFF, COVID-19: Long-Term Care Facilities from “State Data and Policy Actions to Address Coronavirus,” last updated October 8, 2020, https://www.kff.org/coronavirus-covid-19/issue-brief/state-data-and-policy-actions-to-address-coronavirus/
Centers for Medicare and Medicaid (CMS), “COVID-19 Frequently Asked Questions (FAQs)”, last updated June 30, 2020, https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf
MaryBeth Musumeci, Rachel Dolan, and Madeline Guth, State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19 (Washington, DC: KFF, August 26, 2020), https://www.kff.org/medicaid/issue-brief/state-actions-to-sustain-medicaid-long-term-services-and-supports-during-covid-19/
Kathleen Gifford et al., “Long-Term Services and Supports,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-long-term-services-and-supports/
For updated counts of states taking this action using Medicaid emergency authorities, see: KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Examples of congregate settings include assisted living facilities for seniors and group homes for individuals with disabilities.
MaryBeth Musumeci, Rachel Dolan, and Madeline Guth, State Actions to Sustain Medicaid Long-Term Services and Supports During COVID-19 (Washington, DC: KFF, August 26, 2020), https://www.kff.org/medicaid/issue-brief/state-actions-to-sustain-medicaid-long-term-services-and-supports-during-covid-19/
Maine reported plans to increase access to its shared living model, in which a family member can serve as a live-in paid caretaker.
A number of states allowed legally responsible relatives to be paid providers prior to the COVID-19 pandemic. For more on this and other pre-pandemic HCBS policies, see: MaryBeth Musumeci, Molly O’Malley Watts, and Priya Chidambaram, Key State Policy Choices About Medicaid Home and Community-Based Services (Washington, DC: KFF, February 4, 2020), https://www.kff.org/medicaid/issue-brief/key-state-policy-choices-about-medicaid-home-and-community-based-services/
Benefits, Cost-Sharing, and Telehealth
Kathleen Gifford et al., “Benefits and Cost-Sharing,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-benefits-and-cost-sharing/
KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Madeline Guth and Elizabeth Hinton, State Efforts to Expand Medicaid Coverage & Access to Telehealth in Response to COVID-19 (Washington, DC: KFF, June 22, 2020), https://www.kff.org/coronavirus-covid-19/issue-brief/state-efforts-to-expand-medicaid-coverage-access-to-telehealth-in-response-to-covid-19/
State Telehealth Laws & Reimbursement Policies (Center for Connected Health Policy, Spring 2020), https://www.cchpca.org/sites/default/files/2020-05/CCHP_%2050_STATE_REPORT_SPRING_2020_FINAL.pdf
KFF, “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Centers for Medicare and Medicaid (CMS), “State Medicaid & CHIP Telehealth Toolkit,” last updated April 23, 2020, https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf
Kathleen Gifford et al., “Benefits and Cost-Sharing,” A View from the States: Key Medicaid Policy Changes (Washington, DC: KFF, October 18, 2019), https://www.kff.org/report-section/a-view-from-the-states-key-medicaid-policy-changes-benefits-and-cost-sharing/
For more information on this emergency authority, see KFF, Table: Approved Section 1915 (c) Waiver Appendix K Strategies to Address COVID-19 from “Medicaid Emergency Authority Tracker: Approved State Actions to Address COVID-19,” last updated October 7, 2020, https://www.kff.org/medicaid/issue-brief/medicaid-emergency-authority-tracker-approved-state-actions-to-address-covid-19/
Gabriela Weigel et al., Opportunities and Barriers for Telemedicine in the U.S. During the COVID-19 Emergency and Beyond (Washington, DC: KFF, May 11, 2020), https://www.kff.org/womens-health-policy/issue-brief/opportunities-and-barriers-for-telemedicine-in-the-u-s-during-the-covid-19-emergency-and-beyond/
Because 100% of Tennessee’s Medicaid beneficiaries are enrolled in managed care, the state has no fee-for-service telehealth policies and thus is not included elsewhere in this write-up of emergency telehealth policies.
For more information on how states can implement or update Medicaid managed care telehealth policies, see: Centers for Medicare and Medicaid (CMS), “COVID-19 Frequently Asked Questions (FAQs)”, question V.A.1, last updated June 30, 2020, https://www.medicaid.gov/state-resource-center/downloads/covid-19-faqs.pdf
Pharmacy Cost Containment Actions
Kathleen Gifford et al., How State Medicaid Programs are Managing Prescription Drug Costs (Washington, DC: KFF, April 29, 2020), https://www.kff.org/report-section/how-state-medicaid-programs-are-managing-prescription-drug-costs-introduction/
The 11 states that expanded PDLs are: Alaska, California, Colorado, Connecticut, Louisiana, Massachusetts, Missouri, Mississippi, Nebraska, New Hampshire, and Washington.
The 11 states that had new or expanded value-based purchasing arrangements are: Alaska, Arizona, Colorado, Indiana, Massachusetts, Michigan, Nevada, North Carolina, Texas, Virginia, and Vermont.
The seven states that had targeted reforms to address transparency and other PBM concerns are: Arizona, Kentucky, Maryland, Massachusetts, Mississippi, South Carolina, and Virginia.
Challenges and Priorities in FY 2021 and Beyond Reported by Medicaid Directors and Conclusion
Health Homes (created under Section 2703 of the ACA) target beneficiaries who have at least two chronic conditions (or one and risk of a second, or a serious and persistent mental health condition), and provide a person-centered system of care that facilitates access to and coordination of the full array of primary and acute physical health services, behavioral health care, and social and long-term services and supports.
Methods
KFF, 50-State Medicaid Budget Survey Archives, (Washington, DC: KFF, October 2020), https://www.kff.org/medicaid/report/medicaid-budget-survey-archives/.
State fiscal years begin on July 1 except for these states: New York on April 1; Texas on September 1; Alabama, Michigan, and DC on October 1.
- The eight states that did not respond by mid-August 2020 are: Delaware, District of Columbia, Illinois, Ohio, New Mexico, New York, Rhode Island, and Utah.