In This Week’s Update:

• Summarizing CMS’ Proposed Rule for State Directed Payments
• CMS Work Reporting Requirements Outreach Materials
• How Does U.S. Healthcare Compare to Other Developed Nations?
• The Implications of the 2027 NBPP Final Rule
• Translations for Work Requirements’ Core Messages
• State updates: AL, CA, CT, KY, LA, MA, ND, NM, NY, OK, SD, VA, WA, WI, WV & WY

Summarizing CMS’ Proposed Rule for State Directed Payments
The Centers for Medicare & Medicaid Services (CMS) recently released a proposed rule implementing limits on state directed payments (SDPs) enacted under H.R.1. State Health & Value Strategies (SHVS) published a blog that summarizes key provisions of the rule, which clarifies how CMS will implement certain ambiguous provisions and impose new limits on SDPs and Medicaid fee-for-service payments.

CMS Work Reporting Requirements Outreach Materials
CMS published outreach materials states and partners can use to educate individuals enrolled in Medicaid about upcoming work reporting requirements. The materials were informed by qualitative research with Medicaid enrollees, which provides insight into enrollee awareness of the changes and preferred terminology. 

Related resource: SHVS created materials to support states as they communicate to Medicaid enrollees about upcoming Medicaid changes, including a communications workplan, language recommendations, and core messages.

How Does U.S. Healthcare Compare to Other Developed Nations?
A Commonwealth Fund issue brief examines how the U.S. health system compares to 19 other nations in the Organisation for Economic Co-operation and Development (OECD) based on insurance coverage, affordability, care delivery, and health equity. Despite spending nearly double the OECD average on healthcare, the United States has the worst health outcomes among high-income countries and is one of two that has failed to achieve universal health insurance coverage.

The Implications of the 2027 NBPP Final Rule
SHVS published an analysis of CMS’ 2027 Notice of Benefit and Payment Parameters (NBPP) final rule, summarizing the provisions and implications for insurance regulators and state-based Marketplaces.

Translations for Work Requirements’ Core Messages
SHVS published translations of its Part 1 core messages for states to use to talk about Medicaid work reporting requirements. The core messages are now available in Arabic, Chinese, Spanish, and Vietnamese. 

State updates: AL, CA, CT, KY, LA, MA, ND, NM, NY, OK, SD, VA, WA, WI, WV & WY

• Alabama’s Department of Economic and Community Affairs is hosting six workshops explaining its Rural Health Transformation (RHT) Program.
• California requested to renew the Advancing and Innovating Medi-Cal section 1115 demonstration, seeking authority for two new programs that would provide employment services, and home and community-based services for older adults in Medicare who have significant needs and incomes above Medicaid eligibility limits. 
• Connecticut‘s Office of Health Strategy released a notice of funding opportunity to support AI-enabled healthcare and remote patient monitoring in rural communities.
• Kentucky reached four straight years of declines in overdose deaths, and the governor is highlighting programs that led to its success, including Medicaid, the Opioid Response Effort, Narcan distribution, funding to substance-use treatment organizations, Recovery Ready Communities, and other services and efforts to remove dangerous drugs from the state.
• Louisiana launched the Rural Tech Catalyst Fund, an initiative to connect healthcare providers, entrepreneurs, investors, and other stakeholders through its RHT Program to address challenges facing its 1.1 million rural residents.
• Massachusetts’ governor released statewide guidance for interacting with U.S. Immigration and Customs Enforcement (ICE) agents, including for healthcare facilities. The guidance helps organizations protect access to essential services, understand their rights and responsibilities, and prepare staff to respond appropriately if ICE arrives on site. 
• New Mexico‘s governor expanded its Health Professional Loan Repayment Program, increasing annual support and total debt relief available to participating physicians. 
• New York‘s governor is strengthening the state’s healthcare system as a part of the fiscal year 2027 budget by bolstering critical healthcare providers, investing in the Safety Net Transformation Program and youth mental health resources, and implementing technological advancements to improve quality of care and advance health equity. The governor also highlighted provisional figures from the National Vital Statistics System, which show a substantial reduction in overdose deaths in the state from 2022 through 2025.
• North Dakota’s Health and Human Services is launching a $40 million funding opportunity to help rural hospitals upgrade clinical equipment and strengthen emergency and specialty care services through its RHT Program.
• Oklahoma’s Health Care Authority launched an AI system to quickly assist Medicaid enrollees with questions about eligibility, income guidelines, and more.
• South Dakota’s Department of Social Services submitted its provider revalidation strategy to CMS to expand provider categorization and include more frequent renewals and recertifications, along with occasional onsite visits as part of routine oversight. The state also selected three consultant organizations to support implementation and management of RHT Program initiatives.
• Virginia’s governor signed legislation to create a statewide paid sick leave program that requires employers to provide one hour of paid sick leave for every 30 hours worked and extends these protections to full-time and part-time employees. The governor also signed two bills into law to create a peer recovery specialist pathway for people in recovery and ensure that patients being treated for opioid-use disorder can get the medication they need.
• Washington’s Office of the Insurance Commissioner is reviewing a request from 13 health insurance companies for an average rate change of 22.4% for the state’s 2027 individual health insurance market. 
• West Virginia’s governor is making more than $62 million in funding opportunities available through its RHT Program to recruit, train, and retain healthcare professionals while advancing telehealth, healthcare technology, connectivity solutions, and provider support initiatives.
• Wisconsin’s Department of Health Services released its 2025 State Health Assessment, a snapshot of the state’s health and wellbeing that identifies barriers impacting health outcomes and assets to support solutions.
• Wyoming was granted final approval of its year one application for $205 million in federal funding through its RHT Program.