Action In the House & Senate Accelerating: Director Confirmation Hearings Start Thursday

After a slow few weeks in the House and Senate Health & Human Services Committees action is picking up. There are several bills we’re signed up for and against next week.

Committee Hearings

In Senate Health Agenda we’ve expressed our support for SB1221 which will allow the state health information exchange to capture childhood immunization data – which will help coordinate care. We signed up against SB1293 which would basically outsource inspections of nursing homes and assisted living centers to a 3rd party who the ADHS would contract with. I understand the frustration w/ ADHS after the 2019 and 2022 Auditor General’s reports, but the problem isn’t the statute or system but nonfeasant leadership during the Ducey/Christ administration.

I suggest holding ADHS accountable rather than outsourcing inspections and complaint investigations. See: Auditor General’s Office Produces Scathing Review of ADHS’ Nursing Home Complaint Investigations During the Director Christ Era. We’re neutral on a bill that would allow international medical graduates from a list of 9 countries to get a provisional medical license upon submitting certain documentation about their residency etc. (SB1241).

Over in House Health Agenda we’re signed up against a controversial bill being sold as a solution to homelessness – but the AZ Housing Coalition and others we trust believe the bills would do more harm than good, so we’re signed up against that one (HB2284). We’re signed up neutral on the House mirror bill for international medical graduates (HB2467).

Executive Nominees

In a party line vote the Senate also approved new rules creating a new committee new committee tasked with gathering info and evaluating qualifications on Governor Hobbs’ executive nominees. According to the mission of this new committee they are supposed to ‘recommend a course of action for the Senate to take on each individual.” Historically nominees have been evaluated by the standing committee most closely associated with the job. For example, ADHS and AHCCCS director nominees would be heard by the Senate Health & Human Services committee.

The Committee chair is Hoffman with Kerr as the vice chair. Other members are Shope, Marsh and Burch. Placing Hoffman as the chair could be considered a shot across the bow by Senate President Peterson.

As of this writing, Dr. Cullen (ADHS), Karen Peters (ADEQ) and Angie Rodgers (ADES) are scheduled before the committee on Thursday, February 9 at 2pm. We’ll see if that schedule holds, I doubt it.

Budget Drama

Meanwhile, both chambers have introduced a continuation budget, meaning keeping funding levels largely flat from FY2023 with only required formula changes. The budget has been advancing through the Senate on party-line votes, with Republican leadership asserting that it’s responsible to ensure the state can continue to operate beyond June 30 when the state fiscal year closes.

The Democratic minority is not supportive of the “kick the can down the road” approach and has chastised the majority for their unwillingness to negotiate. The House began their budget hearings Wednesday afternoon, but Governor Hobbs has publicly stated she intends to veto a continuation budget, so even if the budget makes it through both chambers and up to the 9th floor, it won’t become the FY2024 state budget.

Monday marked the final day Senators could introduce new bills without special permission. House members may still introduce bills for a few more weeks, but they are limited to no more than seven bills each. The next important deadline is Friday, Feb. 17, when bills must have advanced through committee in their chamber of origin to continue through the process.

AHCCCS Doing Full Court Press to Prepare for Member Redeterminations

The COVID-19 federal public health emergency gave generous incentives to state Medicaid agencies (AHCCCS) in exchange for not disenrolling people from Medicaid during the federal public health emergency.

The disenrollment suspension had been set to end when the PH emergency expires (now set for May 11, 2023) but the federal budget bill from last December directed states to begin their Medicaid redetermination on April 1, 2023, regardless of when the PH emergency ends, so redetermination will start in about 60 days.

AHCCCS thinks about 600,000 of the 2.5 million currently enrolled AHCCCS members may lose eligibility over the coming year once their year-long redetermination process is finished… and half of those that lose coverage could be for failing to respond to requests from AHCCCS for information to determine eligibility.

AHCCCS has a multi-pronged plan in place to make the redetermination process as smooth and accurate as possible… and to make sure as few people are disenrolled due to a lack of response as possible. Here are the basics of the plan:

AHCCCS will determine eligibility automatically for as many people as possible by coordinating with other federal and state data sources like social security and the Supplemental Nutrition Assistance Program. AHCCCS thinks they can do about 75% of eligibility determination work automatically, meaning members won’t need to do anything.

When members are successfully auto renewed, they’ll will get a summary letter saying: “If the information on the summary is correct, you do not need to do anything. You do not need to call or contact AHCCCS.”

If a member’s eligibility can’t be confirmed automatically, they’ll get a written request from AHCCCS that more information is needed. By rule, the person will need to reply within 30 days, which means having up-to-date contact information like addresses will be super-critical. AHCCCS plans to disenroll folks found to be ineligible before people that didn’t respond to their letter in time.

See AHCCCS’ “End of Continuous Enrollment Toolkit” with fliers, social, & a lot more for stakeholders to use to reach Medicaid audiences.

Note: by federal rule, AHCCCS can’t disenroll a member whose mail is returned undeliverable until making other good-faith attempts to contact the member.

Note 2: AHCCCS members who get kicked off because they’re not eligible anymore qualify for a special open enrollment with the federal marketplace. Marketplace and other sources for coverage options (see www.healthcare.gov).

What’s the Call to Action for AHCCCS Members Right Now?

Make sure AHCCCS has the correct mailing address, phone number, and email address for you! If you moved since March of 2020 – be proactive and make sure to update your contact information in www.healthearizonaplus.gov, or call Health-e-Arizona Plus at 1-855-HEA-PLUS (1-855-432-7587).

If AHCCCS determines that you no longer qualify for Medicaid, they’re supposed to tell you: 1) When your enrollment will end; 2) Information on how to appeal that decision if you believe the disenrollment was in error, and 3) Information about other health care coverage options available from Healthcare.gov.

More Information is Available in AHCCCS’ End of Continuous Enrollment Toolkit, at Preparing for the End of COVID-19: Return to Regular Renewals webpage, and this End of Continuous Enrollment Fact Sheet

What Will Change When the Federal Public Health Emergency Ends May 11?

President Biden announced that HHS will be ending the federal public health emergency on May 11, 2023. What will ending the PH emergency do and how will things change? Here’s my best crack at summarizing what will change once it expires.

The emergency gives the federal government flexibility to change requirements in Medicare, Medicaid, KidsCare, and private health insurance. It also set up a streamlined and separate system for authorizing medical countermeasures and gives some tort liability protection to providers who administer services.

Besides the PH emergency, congress passed the Families First Coronavirus Response Act, the Coronavirus Aid, Relief, and Economic Security (CARES) Act , the American Rescue Plan Act, the Inflation Reduction Act, and the Consolidated Appropriations Act, 2023 – which each had tentacles tied to the declaration…  and some of the provisions in those acts will also expire with the PH emergency.

I found a good table that the Kaiser Family Foundation put together that summarizes the things that will end or change on May 11 including Medicaid match rates, requirements of private health insurance, and a host of other countermeasures like the numerous Emergency Use Authorizations for COVID-19 tests, and treatments like antiviral agents and monoclonal antibodies, and vaccines. Access to those things under EUA may end but I’m not sure whether that means they’ll no longer be available for private purchase.

Anyway- here’s a good chart that summarizes the changes that will happen on May 11 from KFF:

Tomorrow: AHCCCS Doing Full Court Press to Prepare for Member Redeterminations