State officials are awaiting more details on what's next after the president declared the opioid epidemic a national emergency.
The emergency response could be declared through the Stafford Act or the Public Health Service Act. Each statute has different implications, but here’s what the declaration could mean:
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— Accelerating HHS waivers to remove the "IMD exclusion" — several states have criticized a provision in federal law that prohibits federal Medicaid funds from reimbursing services at an inpatient mental health facility that has more than 16 beds.
— The White House’s opioid commission, led by New Jersey Gov. Chris Christie, raised the possibility that HHS could negotiate lower prices for naloxone, the drug that reverses opioid overdoses.
— Freeing up money in the Public Health Emergency Fund, although there isn’t much in there to begin with. The fund is authorized to have only $45 million.
With information lacking so far, officials still have more questions than answers. "Although the White House and HHS have both issued statements, we do not have any additional information on what this means,” said Jay Butler, the chief medical officer in Alaska’s HHS.
With help from Victoria Colliver and Renuka Rayasam
OKLAHOMA — The state Supreme Court struck down a $1.50 per pack cigarette fee the Legislature passed earlier this year, putting a budget squeeze on several state health agencies. The court found the fee violates the state constitution's ban on passing revenue-raising measures in the last five days of a legislative session and without securing 75 percent supermajority support, according to the AP. Republican Gov. Mary Fallin said the decision would cause a $215 million shortfall for Oklahoma’s Department of Human Services, Department of Mental Health Substance Abuse Services and the Oklahoma Health Care Authority, which oversees the state’s Medicaid program. Fallin said the state will likely need a special legislative session to deal with the budget gap.
CALIFORNIA — Health advocates for low-income Californians sued the state agency overseeing Medicaid, accusing the state Department of Health Care Services of illegally pushing patients with complex medical conditions into managed care plans. State rules allow Medi-Cal recipients to request a temporary exemption from enrolling in managed care and stay with their fee-for-service providers if their doctor determines their health would suffer. The lawsuit, filed Tuesday by Neighborhood Legal Services of Los Angeles County and the Western Center on Law and Poverty, accuses the state of failing to follow its own standards by going against medical opinion and a neutral arbiter’s orders.
TEXAS — As state lawmakers head into the final week of the special session, a number of health care-related measures sought by Gov. Greg Abbott are advancing. That includes a measure that would boost requirements around “do-not-resuscitate” orders. The bill, which has the support of anti-abortion activists, adds a number of steps that a doctor must take before carrying out such an order, including the requirement that a patient or legal guardian provide written or oral consent in the presence of two witnesses. Medical groups worry that it would boost liability on doctors and invade patient privacy. The bill has already made it through the state Senate and is headed to the House floor for a vote.
OREGON — Oregon Health Authority director Lynne Saxton resigned this week after a local newspaper reported that she considered waging a smear campaign against a local health care provider that’s been critical of the state health agency. The scheme, revealed by the Portland Tribune through a public records act request, was never implemented. The provider, FamilyCare, and the state have been duking it out in court over the health agency’s reimbursement levels, and FamilyCare had accused state health officials of incompetence. Saxton publicly apologized for the never-realized “communication plan” on Monday. Saxton’s resignation on Tuesday reportedly came at the request of Gov. Kate Brown. No successor has been named.
In other Oregon news: The state became the fifth to raise its tobacco age to 21. The new law, which will take effect Jan. 1, primarily targets vendors who sell tobacco to underage individuals. The other four states that raised the tobacco age to 21 are California, Hawaii, Maine and New Jersey.
NORTH CAROLINA — The state has released more details on a planned statewide Medicaid managed care program that is set to launch in 2019 and be fully implemented in 2023. Officials are aiming to better integrate physical, behavioral health and substance use disorder services for enrollees and use value-based payment strategies, among other goals. The state estimates that the managed care program will cover roughly 1.8 million people in six years, but would be potentially much higher if Democratic Gov. Roy Cooper successfully expands Medicaid under the Affordable Care Act. The GOP-controlled Legislature still opposes expansion.
STATE HIGHLIGHTS OF THE WEEK
How the Trump administration is spending millions to shore up Obamacare
Health officials wary of Trump’s rhetoric on opioid crisis
2018 rate filing deadline extended to Sept. 5
States ponder what to do if Obamacare subsidies disappear
POLITICO Pro Q&A: Tennessee Insurance Commissioner Julie Mix McPeak
Study: Appalachia plagued with lower life expectancy
Florida legislators told that LIP money should be used to combat opioid crisis