CMS Allows 5 States to Adopt Multiyear Continuous Medicaid Eligibility for Children

HealthCare Dive / By Emily Olsen

Continuous enrollment ensures beneficiaries don’t suddenly lose access to care if their financial circumstances change, while reducing administrative burden for states, according to the CMS. 

Under the latest waivers, Colorado and Pennsylvania will also provide a year of continuous eligibility for some people ages 19 through 64 who were recently incarcerated. Hawaii will offer two years of ongoing enrollment for children ages six through 19, while Minnesota will provide a year of continuous eligibility for people ages 19 through 21.

It’s the latest move from the Biden administration to expand continuous eligibility for Medicaid. Though all states are required to continuously cover children in Medicaid and CHIP for one year, the CMS has approved nine other state requests to expand continuous eligibility for specific groups.

Continuous enrollment policies could also help avert disenrollments for administrative reasons — a significant challenge during Medicaid redeterminations, according to Elisabeth Wright Burak, a senior fellow at Georgetown’s CCF. 

States began rechecking enrollees’ eligibility for Medicaid last year after a period of continuous enrollment during the COVID-19 pandemic. Millions of Americans have been removed from the program since.

Nearly 70% of disenrollments during the unwinding period were for procedural or paperwork reasons, suggesting some of the beneficiaries who were cut from Medicaid might still be eligible, according to health policy research firm KFF.

Children were also inappropriately disenrolled due to a systems error during redeterminations last year, forcing federal regulators to pause enrollment checks in 30 states.

Further turbulence for Medicaid could be on the horizon after President-elect Donald Trump assumes office early next year. The Republican-controlled government could implement Medicaid work requirements to narrow eligibility or use block grants to limit funding.

DEA and Telehealth

NAHC

At 4:15 p.m. [ET last Friday], the U.S. Department of Health and Human Services (HHS) jointly with the Drug Enforcement Administration (DEA) issued a rule, titled 'Third Temporary Extension of COVID-19 Telemedicine Flexibilities for Prescription of Controlled Medications'. This Third Temporary Rule extends the telemedicine flexibilities for prescribing controlled medications, originally set to expire on December 31, 2024, through December 31, 2025. These flexibilities have been in effect since March 2020.

The rule provides the following in pertinent part:

With the deadline of December 31, 2024, granted by the Second Temporary Rule quickly approaching, DEA, jointly with HHS, is now issuing a third temporary extension (Third Temporary Rule) to ensure a smooth transition for patients and practitioners that have come to rely on the availability of telemedicine for controlled medication prescriptions. This additional time will allow DEA (and also HHS, for rules that must be issued jointly) to promulgate proposed and final regulations that are consistent with public health and safety, and that also effectively mitigate the risk of possible diversion. Furthermore, this Third Temporary Rule will allow adequate time for providers to come into compliance with any new standards or safeguards eventually adopted in a final set of regulations.  

This Third Temporary Rule, like the First and Second Temporary Rules, covers the portions of the March 2023 NPRMs related to extensions of the telemedicine flexibilities in place during the COVID-19 PHE, and it extends, through December 31, 2025, the telemedicine flexibilities that have been in place since March 2020 for prescribing controlled medications via the practice of telemedicine.

The DEA and HHS anticipate releasing a final set of regulations in the future, but no specific timeframe has been provided. In implementing this extension, the DEA and HHS considered stakeholder feedback from E.O. 12866 meetings-of which the Alliance took part- along with the impending expiration of existing flexibilities and input from Telemedicine Listening Sessions and Tribal Consultations. 

Judge Overturns DoL OT Rule

[Last] Friday, November 15, 2024, U.S. District Judge Sean Jordan for the Eastern District of Texas issued a ruling overturning the Department of Labor’s Overtime Rule. The DOL rule was previously under injunction only in Texas and began to be enforced in July, was rescinded in its entirety nationwide and no longer applies anywhere in the country. Though the federal government would usually appeal a ruling such as this, the timing of the Presidential Transition, coupled with the likelihood that President Trump’s administration would cease to defend the rule in court, raises questions about what strategy DOL will take moving forward.

We anticipate that DOL will issue guidance and updates on the implications of today’s ruling shortly.

The DOL Rule is here: https://www.federalregister.gov/documents/2024/04/26/2024-08038/defining-and-delimiting-the-exemptions-for-executive-administrative-professional-outside-sales-and.

The ruling from Judge Jordan is here: https://nahc.org/wp-content/uploads/2024/11/Judge-Jordan-Ruling-Overturns-DoL-OT-Rule.pdf.

Trump Nominates RFK Jr. to Lead HHS

Healthcare Dive / By Sydney Halleman

President-elect Donald Trump has nominated vaccine skeptic and lawyer Robert F. Kennedy Jr. to lead the HHS in a controversial decision that’s expected to draw ire from some public health experts.

Trump announced the appointment on social media platform Truth Social.

“For too long, Americans have been crushed by the industrial food complex and drug companies who have engaged in deception, misinformation, and disinformation when it comes to Public Health,” Trump wrote Thursday.

His role as secretary of the HHS would give him oversight over a budget of nearly $2 billion and agencies including the Food and Drug Administration and the CMS, which is responsible for administering federal healthcare programs like Medicare and Medicaid.

Kennedy has previously promised to overhaul the federal public health industry. “FDA’s war on public health is about to end,” Kennedy wrote in October in a post on X.

Most recently, Kennedy stated he wanted to eliminate fluoride in the country’s water supply, a decision that would upend one of the nation’s largest public health initiatives. Over social media, Kennedy has also criticized what he calls an epidemic of “chronic disease,” including autism, obesity and diabetes.

Originally a candidate for president, Kennedy endorsed Trump after dropping out of the race in August. On the campaign trail, Trump promised to let Kennedy “go wild” on healthcare.

If confirmed by the Senate, Kennedy would succeed the Biden administration’s Secretary Xavier Becerra.