Massachusetts: New Law Places Tighter Control on Opioids

Governor Charlie Baker (R) signed landmark legislation aimed at addressing the State's opioid epidemic, which claims four lives per day in Massachusetts, according to the Governor's press release. The law is the first in the nation to limit first-time adult opioid prescriptions and all opiate prescriptions for minors to a seven day supply, with some exceptions. The new law also requires schools to provide education and awareness on opioid abuse, requires physicians to cross reference a prescription database before writing certain opioid prescriptions, and provides for ongoing education for providers. The bill was passed unanimously in both legislative chambers.

New Hampshire: New Division to Unify Response to Mental Health and Substance Abuse Challenges

Governor Maggie Hassan (D) announced the new Division of Behavioral Health within the State's Department of Health and Human Services (DHHS), established to promote the integration of behavioral health and medical care and to provide a unified response to the mental health and substance abuse challenges facing the State. The new division complements the recently-approved Delivery System Reform Incentive Payment (DSRIP) waiver, which promotes integrated care addressing the full range of beneficiaries' needs. It also aligns with implementation of New Hampshire's mental health class action settlement agreement, which significantly expands and enhances mental health service capacity in integrated community settings. Katja Fox, who has been serving as the Director of Strategic Integration for Behavioral Health and Substance Use Services, now serves as the director of the new division.

Vermont: Green Mountain State Seeks 1332 Waiver to Forego Online SHOP Platform

Vermont filed the first 1332 Waiver for State Innovation with CMS, seeking to waive the ACA requirement to establish an online infrastructure for the State's SHOP. The State aims instead to preserve its current system, which allows small employers direct enrollment through qualified health plan (QHP) issuers and choice among any available QHP. If approved, the waiver would become effective January 1, 2017. There are currently over 4,000 employers, representing more than 44,000 covered lives, enrolled in Vermont's SHOP.

HHS Releases Three-Year Evaluation of Community First Choice

HHS released its final report to Congress on the ACA's Community First Choice (CFC) benefit, which allowed states to provide long-term services and supports (LTSS) to eligible Medicaid enrollees in their homes or communities through their State Plans. The CFC benefit increases states' federal matching rate by six percentage points for covered services. The report presents findings as of March 2015—three years after CMS's final rule—including key factors impacting states' decisions whether to pursue CFC, the demographics of the approximately 300,000 individuals served by the program, states' LTSS expenditures and variation across programs. The report highlights recommendations from implementing states, which noted the importance of developing robust inter-agency communications among the "patchwork" of programs that serve individuals with physical or development disabilities. States also highlighted that local, state and federal funding and collaboration is critical for providing effective and accessible home and community based services. Four states (California, Maryland, Montana and Oregon) have implemented CFC; three others (Connecticut, Texas and Washington) have received approval to do so and two (Minnesota and New York) remain under review.