- CMS has approved Washington state's request to expand its Medicaid program to combat COVID-19, the disease caused by the novel coronavirus that has slammed the state in recent weeks.
- With Thursday's OK, CMS is waiving requirements that doctors get prior authorization from insurers for prescriptions or treatment, and allowing Washington to move more quickly to expand Medicaid payments and services related to the virus. CMS did not approve a request to expand Medicaid to a greater number of uninsured Washingtonians.
- Washington, which submitted its request Sunday, is the second state to receive a federal greenlight and has been the hardest state hit to date, with at least 74 deaths, according to a Johns Hopkins University tracker. CMS approved a similar waiver from Florida on Monday.
A handful of states have signaled interest in the expanded flexibility, which allows them to curtail typical Medicaid requirements to free up resources during a national emergency. CMS has said it expects to review and approve many more waivers in the coming days as the Trump administration looks to accelerate its response to the fast-moving disease that has killed at least 150 people in the U.S. so far. That figure is likely low due to lags in Centers for Disease Control reporting and testing.
With its nod, CMS is making it easier for Washington to let out-of-state providers practice in the state. Gov. Jay Inslee, a Democrat, declared a state of emergency Feb. 29, and said Thursday ambulatory surgery centers and dental, orthodontic and endodontic offices would not be allowed to perform non-emergency medical and dental procedures to free up personnel and equipment for the COVID-19 response.
"The trajectory of the COVID-19 outbreak in Washington State is critical," Washington's waiver request reads. "We are concerned that the healthcare system may quickly became overwhelmed."
Washington asked CMS to expand federal match for additional public health services in light of the outbreak, including expanding Medicaid eligibility to uninsured people who are above 135% to 200% of the federal poverty line.
The Trump administration, which has rolled back safety net coverage for low-income Americans for the past three years, including promoting Medicaid block grants, did not approve the expansion. CMS said it was continuing to work on the request to "review and adjudicate as quickly as possible."
Like in Florida, Washington is allowed to eschew prior authorization and is also now allowed to expedite enrollment of out-of-state providers for the duration of the emergency. CMS is also letting Washington temporarily delay Medicaid fair hearings and their decisions, trials a Medicaid beneficiary can ask for if they don't agree with a change or denial in their coverage following their health plan's complaint and appeal process, and use alternative sites of care to a hospital for treatment.
Unlike Florida, Washington requested CMS waive public notice for state plan amendments, meaning the state can change its Medicaid payment rates, premiums and cost-sharing or alternative benefit plans without telling the public a day in advance.
That flexibility, though, is only for temporary changes to Washington's Medicaid program that increases beneficiary's access to COVID-19 treatment, such as cost sharing waivers, payment rate increases or adding services or providers to alternative benefit plans.