April 28, 2020

Around the nation: Oklahoma becomes 1st state to submit waiver seeking Medicaid block grant

Daily Briefing

    Oklahoma Gov. Kevin Stitt (R) last week submitted a waiver request seeking CMS' permission to expand the state's Medicaid program and transition the federal portion of the state's Medicaid funding to a type of block grant, making Oklahoma the first state to submit such a waiver under guidance the Trump administration released earlier this year, in today's bite-sized hospital and health industry news from California, New York, and Oklahoma.

    • District of Columbia: The Supreme Court on Monday issued an 8-1 ruling stating that the federal government must pay health care insurers billions of dollars in payments owed to the health plans under the Affordable Care Act's (ACA) risk corridors program. The ACA's risk corridors provision called for federal payments to health insurers to help offset the costs they might incur by enrolling a higher-than-expected number of sick people through the insurance exchanges. However, the program has faced a significant funding shortfall, and Congress has prohibited HHS from using general funds to cover risk corridors payments. As a result, CMS has not been able to reimburse some insurers in full, and insurers sued the agency over the missing payments. The high court in the ruling issued Monday said CMS is obligated to make the payments under the risk corridors provision, because the ACA "created [a federal] obligation neither contingent on nor limited by the availability of appropriations or other funds" (Minemyer, FierceHealthcare, 4/27).

    • New York: The Naval hospital ship USNS Comfort is set to return to its home port from New York, after treating and discharging all of its patients there, according to Northwell Health. The vessel was sent to New York City to assist hospitals that were overwhelmed with patients due to the country's new coronavirus epidemic. Medical personnel on the ship treated 182 patients overall and was down to one final patient as of Saturday. Department of Defense spokesperson Jonathan Hoffman said the ship's departure is "a sure sign of modest progress in mitigating the [new coronavirus] in the nation's hardest hit city and is a welcome sign" (Budryk, The Hill, 4/26; Lungariello, USA Today, 4/23).

    • Oklahoma: Gov. Kevin Stitt (R) last week submitted a waiver request seeking CMS' permission to expand the state's Medicaid program and transition the federal portion of the state's Medicaid funding to a type of block grant. The move makes Oklahoma the first state to request a Healthy Adult Opportunity demonstration waiver under guidance the Trump administration released earlier this year. Under the waiver, the state would use the capped funding to expand Medicaid to about 220,000 adults with annual incomes less than 133% of the federal poverty level, implement Medicaid work and premium requirements for certain beneficiaries, and implement value-based Medicaid reimbursements for providers (Pifer, Healthcare Dive, 4/21; LaPointe, HealthPayerIntelligence, 4/22; Forman, The Oklahoman, 4/21).
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