Durbin, Duckworth Urge CMS to Approve Illinois' Request to Expand Medicaid Coverage, Lift Barriers During COVID-19 Pandemic
WASHINGTON – Amid the COVID-19 pandemic, U.S. Senators Dick Durbin (D-IL) and Tammy Duckworth (D-IL) today urged the Centers for Medicare and Medicaid Services (CMS) to swiftly approve the State of Illinois’ 1115(a) Medicaid waiver request, so the state can expand access to essential health services for nearly 800,000 people and have the flexibility to deliver quality care amid the COVID-19 pandemic.
“Specifically, the 1115(a) demonstration waiver would…remove financial barriers to patients for treatment…and deliver targeted strategies to reduce the risk of COVID-19 transmission for the most at-risk populations,” the Senators wrote in a letter to CMS Administrator Seema Verma. “This 1115(a) waiver will ensure Illinois can properly confront this challenge, and we urge CMS to move expeditiously to approve this waiver for Illinois.”
The 1115(a) Medicaid waiver request submitted by the State of Illinois would build upon the diagnostic coverage provisions in the Families First Coronavirus Response Act to provide coverage at no cost to uninsured patients for COVID-19 treatment, and eliminate out-of-pocket costs for insured patients through secondary payer coverage. The waiver would also address social determinants of health for the most at-risk populations, including by providing temporary housing for individuals experiencing homelessness for the period of quarantine, allowing health services provided on-site to inmates to be reimbursed, and supporting home-delivered meals for low-income beneficiaries in quarantine. Illinois’s 1115(a) request also supports accelerated enrollment, including through expanded presumptive eligibility, extended deadlines for eligibility redetermination, self-attestation of immigration and citizenship status, and easing asset tests for patients in nursing facilities.
Full text of today’s letter is available here and below:
March 30, 2020
Dear Administrator Verma:
Thank you for the actions the Centers for Medicare and Medicaid Services (CMS) has taken to help address the health consequences and challenges posed by the COVID-19 (coronavirus) pandemic, including approving on March 23 the State of Illinois’ Section 1135 waiver request, which we supported. To augment the capacity to meet the growing need across Illinois, the state submitted a Section 1115(a) Medicaid waiver request on March 26. We urge CMS to swiftly approve the 1115(a) waiver request, so Illinois can expand access to health services for nearly 800,000 people and have the flexibility to deliver quality care amid the coronavirus pandemic.
The request submitted by Illinois would waive certain federal Medicaid requirements in order to streamline enrollment, preserve access to coverage, and mitigate the community spread of COVID-19, while maintaining budget neutrality. Specifically, the 1115(a) demonstration waiver would build upon the diagnostic coverage provisions in the Families First Coronavirus Response Act to allow the state to remove financial barriers to patients for treatment, including by providing narrow coverage at no cost to uninsured patients for COVID-19 treatment, and eliminating out-of-pocket costs for insured patients through secondary payer coverage.
The state is also seeking authorities to deliver targeted strategies to reduce the risk of COVID-19 transmission and address social determinants of health for the most at-risk populations, including by providing temporary housing for individuals experiencing homelessness for the period of quarantine, allowing health services provided on-site to inmates to be reimbursed, and supporting home-delivered meals for low-income beneficiaries in quarantine. Illinois’s 1115(a) request also supports accelerated enrollment, including through expanded presumptive eligibility, extended deadlines for eligibility redetermination, self-attestation of immigration and citizenship status, and easing asset tests for patients in nursing facilities. Upon conclusion of the public health emergency, the state will take appropriate measures to verify documentation.
Since March 20, Illinois has been under a stay-at-home order to contain the spread of COVID-19, which so far has resulted in 4,596 cases and 65 deaths. Our state’s health care system is facing unprecedented strains and it is imperative that we provide the resources and flexibility to take care of the most vulnerable patients during this public health emergency. This 1115(a) waiver will ensure Illinois can properly confront this challenge, and we urge CMS to move expeditiously to approve this waiver for Illinois.
Sincerely,
-30-