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<p class="MsoNormal"><span style="font-size:10pt;line-height:107%;font-family:'sansserif' , serif;color:#6666ff">I<i>MPORTANT CONFIDENTIALITY & LEGAL NOTICE </i></span></p>
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>>> "Stuart Gordon, J.D." <nasmhpd@memberclicks-mail.net> 1/30/2020 2:18 PM >>><br></span><div>Attached is this week's <em>NASMHPD Weekly Update. </em></div><div><br></div><div>In addition, I have copied below<em> </em>the transmittal issued today by CMS on its new 56-page State Medicaid Director Letter on its Healthy Adult Opportunity (block grant) Demonstrations (too large to attach), on which we will provide additional information next week. The transmittal contains a link to the letter itself, as well as a fact sheet. It is worth noting that both mental health and substance use disorder services will have to be maintained by participating states as essential health benefits, and that special attention will be paid to retaining behavioral health drugs on state fornularies despite the flexibilities being provided in choosing drugs for those formularies. Only non-disabled adults and other expansion beneficiaries can be included in the demonstrations, and enrollment cannot be capped. If the household eligibility level is not at least 133% of the FPL, the enhanced expansion Federal match will not be available to the state. States will be permitted to retain between 25 percent and 50 percent of any state savings, dependent on how successful they've been in achieving a mandated list of measures. That list includes a dozen behavioral health measures and an additional depression screening measure for primary care providers. </div><div><br></div><div>The block grants will be structured either with aggregate caps or per capita caps. The aggregate cap will be based on historical spending with an annual growth rate permitted of CPI-urban consumer plus 0.5 percent.</div><div><br></div><div>Administrator Verma promised in today's in-person roll-out that her PowerPoint presentation will soon be posted on-line.</div><div><h1 class="bulletin_subject" style="margin: 1.5em 0px 5px; padding: 0.5em 0px 0px; text-align: left; color: rgb(34, 34, 34); text-transform: none; text-indent: 0px; letter-spacing: normal; font-family: opensanssemibold, Helvetica, Arial, sans-serif; font-size: 1.25em; font-style: normal; font-weight: bold; word-spacing: 0px; white-space: normal; orphans: 2; widows: 2; background-color: rgb(255, 255, 255); font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial;">Healthy Adult Opportunity Demonstration</h1><span class="dateline rs_skip" style="text-align: left; color: rgb(51, 51, 51); text-transform: none; text-indent: 0px; letter-spacing: normal; font-family: Verdana, arial, Geneva, Helvetica, Century; font-size: 13.6px; font-style: italic; font-weight: 400; word-spacing: 0px; white-space: normal; orphans: 2; widows: 2; background-color: rgb(255, 255, 255); font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial;">Medicaid.gov sent this bulletin at 01/30/2020 09:13 AM EST</span><span style="text-align: left; color: rgb(51, 51, 51); text-transform: none; text-indent: 0px; letter-spacing: normal; font-family: Verdana, arial, Geneva, Helvetica, Century; font-size: 13.6px; font-style: normal; font-weight: 400; word-spacing: 0px; float: none; display: inline !important; white-space: normal; orphans: 2; widows: 2; background-color: rgb(255, 255, 255); font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial;"></span><div class="bulletin_body" id="bulletin_body" style="margin: 0px; padding: 0px; text-align: left; color: rgb(51, 51, 51); text-transform: none; text-indent: 0px; letter-spacing: normal; font-family: Verdana, arial, Geneva, Helvetica, Century; font-size: 13.6px; font-style: normal; font-weight: 400; word-spacing: 0px; white-space: normal; orphans: 2; widows: 2; background-color: inherit; font-variant-ligatures: normal; font-variant-caps: normal; -webkit-text-stroke-width: 0px; text-decoration-style: initial; text-decoration-color: initial;"><table align="center" style="width: 700px; border-collapse: collapse; border-spacing: 0px;" bgcolor="#ffffff" border="0" cellspacing="0" cellpadding="10"><tbody><tr><td style="margin: 0px; padding: 0px;"> <table align="center" style="width: 700px; border-collapse: collapse; border-spacing: 0px;" bgcolor="#ffffff" border="0" cellspacing="0" cellpadding="0"><tbody><tr><td width="700" align="center" style="margin: 0px; padding: 0px; text-align: center; color: rgb(0, 0, 0); background-color: rgb(255, 255, 255);" bgcolor="#ffffff"><div style="margin: 0px; padding-top: 5px; padding-bottom: 5px; font-family: Veranda, Helvetica, sans-serif; font-size: 9pt;"><strong style="font-style: normal; font-weight: bold;"><a title="View in browser" style="color: rgb(0, 0, 0); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBQ-2FcloJlZjnfIpTd11sLeqy55E5WSkX6-2BgWWH-2B2Cj-2FYjU9z9-2BeSYziV-2FzCAELEBuxz5ta08iEAmllOp5lJL-2FL-2Buxognulz8-2FHw12hDW5RB6x_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTnljn-2B4LgIauK8gt-2FGzpd1DSBDTXYttAfLNjJBSgDdxQpLNHZENwKNAh8-2FumjupAYEgoJ3qz05QtLHM0dBSZN2LdD52k5sFwYLbXLiATU0ph7lehsWGYAjJNXciXizdNBWYJDZ-2FxmoiKjl0ksJqseob6lZp-2FX-2Bowg8Xe5DYHLxwTA-3D" target="_blank" rel="noopener">View in browser</a></strong><span> </span>| Distributed by Center for Medicaid and CHIP Services (CMCS)</div></td></tr><tr><td width="700" valign="top" style="margin: 30px 0px 0px; padding: 0px;"><a title="Medicaid.gov" style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=9XVqV0Wf0N4EowdhVjPiPhxCDcCEx8etEsWsIgmRyyE-3D_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTnTERDGU1kfKgi1QUcWnRZInbanWx-2Bfo42rC44tDY1sWO8a7zS0-2FA3eF-2FEN91yFfwtg-2BvDLgISXeSF2wGT-2BW2fu-2BOWDTJ8jMzJU9xNuTMOsHx8qZ57Ao-2BOE670vDzzPrAzdhE7vzL7lFKWpLe7HlJ2Mw-2FEiDOuFtzH8mc-2Fn64lovs-3D" target="_blank" rel="noopener"><img width="700" height="127" style="border: 0px currentColor; border-image: none; vertical-align: middle; display: block;" alt="Medicaid.gov" src="https://public.govdelivery.com/system/images/39825/original/medicaid.gov.jpg" border="0"></a></td></tr></tbody><tbody><tr><td style="margin: 0px; padding: 20px 35px 10px;"><div style="margin: 16px 0px;">Today the Centers for Medicare & Medicaid Services (CMS) is announcing a new opportunity to support states with greater flexibility to improve the health of their Medicaid populations. The Healthy Adult Opportunity (HAO) Demonstration emphasizes the concept of value-based care while granting states with extensive flexibility to administer and design their programs within a defined budget.</div><div style="margin: 16px 0px;">States will have broad flexibility to operate an HAO demonstration project to maximize health outcomes for Medicaid populations in a cost-effective, administratively efficient manner. For the first time, CMS is providing flexibilities currently available to states in a comprehensive suite of pre-packaged waiver authorities.</div><div style="margin: 16px 0px;">To offer states this option, the HAO will involve the use of section 1115(a)(2) authority to provide coverage to individuals not eligible for benefits under the state’s Medicaid state plan, while affording states maximum flexibility in the administration of benefits for such individuals. HAO is available to states for a limited population – adults under age 65 who are not eligible for Medicaid on the basis of disability or need for long term care services and supports, or are not eligible under a state plan.</div><ul style="margin: 0px 0px 0px 3em; padding: 0px;"><li style="margin: 0px; padding: 0px;"><a title="" style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBQH8bmP-2Fvn82bXvGzjvsNuMpowCnPXrlsAjJjs6SBbaPxCZjY5anmFQoKPuBnWFq6sjGRbazIBcMlCyzDsDoM4U2uF4jJd5n0k8hHU9iQ-2BI-2BmxZyHMQH2pojph6eyfZPUg-3D-3D_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTngzPVkxsoIGKg7GF4Yd0o7G-2B6gr2Q9dNwuBuo0BNBOTR5MYbQ-2Bui-2BEQABnPSEt3aDfS49R5zXrTDbLqVK-2FuLelmTngtIYhmFv-2FyWm54lZ3fvNV3dr7hyKUKbFcE8ePIzHyJQe4jwu9vKiZPlEiKmN46MEcVZQqPVNbXpseAjO3uU-3D" target="_blank" rel="noopener">Healthy Adult Opportunity State Medicaid Director Letter</a></li><li style="margin: 0px; padding: 0px;"><a title="" style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBQH8bmP-2Fvn82bXvGzjvsNuN4R6oEfcaoZvWW2TB5TaPk66ToQX3C0sAU5Nq10SCcdjwgwwS88ypzTrMBr-2BNMq9H5wf9Jmo2-2BmYNXWWpNhd1ZqdK3cR0qFmGxQ0nYAJbyM1TyVVwuS7YUlUk3jv-2B4epE-3D_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTn0bQJtdFpYnd4Aqa-2FY8TIyQdSeAWpAfRnzzFH-2F9jzvXDqh2KogdFbP0wqkntK6el7MnN0N9u2981TVoKU9NxuaSEK0afcZXAH9YSzz7I0l2MM3uJXtgSeAa2ph6W0LEefeHHM6u3LLJsXK3ua-2F2ro4hXzkWabZ4RQeIgtjbqxu-2Fg-3D" target="_blank" rel="noopener">Health Adult Opportunity 1115 Application Template</a></li><li style="margin: 0px; padding: 0px;"><a title="" style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBS2lbbFK4BwPzpuxW01k3pOtIxiOZ2Q6Wp-2FiDBh4MNKJljogvkdSIF-2FHPEQTeX0h8zh0QApvNyRyz-2BSBGPT6KFE-2FbxzA3kfFQ5O9y50R5HBQfPOI1jH4vLBbMSwB-2BG69aM4gP6N6sm5yaHv36vBZmv4HM0S8fTUve6jvKpEHivKf_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTnmLAub0bm7mI1UgKzxY-2FWZ-2Fizb4JAEcEImYMK16A1tucUfG5Iw4HXii75WMCTheHRbMbhQzGkuRe9V-2BP2bnQJ8beIqAL3QcBPN3JpzsyC5UgiPTmHs3-2F-2FTvzSeiCGT4hJ-2BSVw55O2F21Ey5RorItIQvVqL3LigS1BrAIJyZny4n0-3D" target="_blank" rel="noopener">Healthy Adult Opportunity Press Release</a></li><li style="margin: 0px; padding: 0px;"><a title="" style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBS2lbbFK4BwPzpuxW01k3pOxHqFhgtWIngK2o2MRBMLarc-2FpfR8dO9iylHfcUakRoXt1eNgRXdTvAJMR5NbUp6M-3D_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTn5JQtU3uCCx3JJAys8xpIs3UDFY0Eqp-2Ff-2BuZy2g8LMZ1JwH6lMGUforjRabfCH8o-2B-2FEKdRI0h8oe9crAJ14cveYhZLzJ6XrkYAQMpF56u9Sx3khZFCIIuflhIKr9WJoZlfo3T6ad-2B4I6dYq7rSU4J-2BRIWXrlm9XDVyMGty646o0Q-3D" target="_blank" rel="noopener">Healthy Adult Opportunity Fact Sheet</a></li><li style="margin: 0px; padding: 0px;"><a style="color: rgb(33, 118, 174); text-decoration: none;" href="http://clicks.memberclicks-mail.net/wf/click?upn=TSwnpu9eSYNmwFssKAkzBS2lbbFK4BwPzpuxW01k3pOxHqFhgtWIngK2o2MRBMLaU5Orcjfg5Ol9-2BDekFePSqYrPKFqJZ48CrDWGlMfximM-3D_r-2B6rBVPyGmD0fdN9orXYpXwFd73jK0fMzyzfqAuJv6VhYZrm3-2BR44l4-2BM-2F00LhCP1OAt3cVU-2FHsdFzx1U47ICJsQi53879t89XPWkPxBJMDXqQajIRVGn2AKk0C6wfP19UYiie6HhVXSvo-2Ba-2BK1yqu8mKNLxvOnH57yXPp3qoejifHAdPQlAD7h2QIyNcJTnMzmUH6cm-2BYAe3Exd0wj0yFpwLPePDceFO4vPPRSI8kKCnQoG7JKQUSClS8AebN3um0Io45p0kFa0gYmfJX-2Bjw-2Fpq-2F5lYdMXm9CAoB-2Fr-2B6Ju97qr0V-2BEgCvt6SCEOcR6cjh-2B7erNWMo3WKfqij3lxdQUBO3xcw9oJr6p6grRuKMg-3D" target="_blank" rel="noopener">Medicaid Facts and Figures</a></li></ul><div style="margin: 16px 0px; text-align: left; color: rgb(0, 0, 0); font-family: Veranda, Helvetica, sans-serif; font-size: 14px;"><span style="font-family: verdana, geneva;"> </span></div></td></tr></tbody></table></td></tr></tbody></table></div><br></div><br>
<div class="MsoNormal"><span style='color: rgb(102, 102, 255); line-height: 107%; font-family: "sansserif" , serif; font-size: 10pt;'>I<i>MPORTANT CONFIDENTIALITY & LEGAL NOTICE </i></span></div>
<div class="MsoNormal"><i><span style='color: rgb(102, 102, 255); line-height: 107%; font-family: "sansserif" , serif; font-size: 10pt;'>This e-mail and any attachments from NASMHPD, Inc. may contain information that may be confidential or legally privileged. These documents are intended only for the use of the individuals or entities to which it is addressed. If you or your firm are not the intended recipient and have received this transmission mistakenly, you are hereby notified that reading, copying, disclosing, or distributing these documents, or taking any action based on the information contained within them, is strictly prohibited and may be unlawful. If you have received this e-mail in error, please notify us by calling 703.739.9333 immediately and permanently delete the original e-mail and destroy any copies or printouts of this e-mail as well as any attachments.</span></i><span style='color: rgb(53, 56, 56); line-height: 107%; font-family: "segoe ui" , sans-serif; font-size: 10pt;'> </span><i><span style='color: rgb(102, 102, 255); line-height: 107%; font-family: "segoe ui" , sans-serif; font-size: 9pt;'>This email is not a substitute for legal advice, and NASMHPD does not provide legal advice.</span></i><i><span style="color: rgb(102, 102, 255); line-height: 107%; font-size: 9pt;"></span></i></div>
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