New legislation in New Jersey will require insurers to reimburse healthcare providers for telehealth and telemedicine services at the same rate as in-person services—originally enacted at the outset of the COVID-19 pandemic— with limited exceptions for the next two years, reports the Governor’s Office. The legislation also charges the state’s Department of Health with conducting an in-depth study of the use of telehealth and telemedicine and the effects on patient outcomes, quality and satisfaction and access to care in order to inform future decisions on payment structure for these services. The extension includes a requirement that audio-only behavioral healthcare services are reimbursed at the same rate as in-person services and prohibits insurance carriers from imposing geographic or technological restrictions on the provision of telehealth services, as long as they meet the same standard of care as if they were delivered in-person.
The Healthcare Value Hub’s Healthcare Affordability State Policy Scorecard ranked Arkansas 30th out of 47 states, plus DC, in healthcare affordability, reports the Arkansas Center for Health Improvement. The scorecard gave Arkansas 29.9 out of 80 possible points and provided several recommendations to improve affordability, such as: enacting stronger price transparency requirements; pursuing coverage options for residents earning too much to qualify for Medicaid; and enacting protections against short-term, limited-duration health plans.
Chandak Ghosh rushed to the Mt. Sinai West emergency room in New York City in 2010 with severe back and stomach pains, according to We The Patients. He was diagnosed with kidney stones, given pain medication, and discharged. In the following days, Mr. Ghosh began to receive separate bills from numerous providers he had seen during his visit. Though he was fully insured, he was told he was responsible for payment until his insurance company paid, and that if he didn't pay by a certain date, the bills would be sent to collections agencies and could hurt his credit. By the time his insurance had fully paid (months later), Mr. Ghosh has received 27 different billing statements.
After Wellstar Health System and UnitedHealthcare insurance did not agree on a new contract, Georgia resident Shelly Azzopardi was left without clear coverage for newly out-of-network follow-up services, according to Georgia Health News. Health care consultants and industry officials say an increasing number of contracts end without a deal, and even when they are resolved, they pressure thousands of patients to choose between higher out-of-pocket costs or leaving a trusted physician or hospital network. A similar dispute is looming involving Anthem Blue Cross and Blue Shield. This trend becomes more pressing as healthcare systems acquire additional hospitals and physician practices, effectively increasing the stakes of negotiation, and with it, the potential for patients to be left out of network if deals collapse.
In 2022, two significant new healthcare laws will be taking effect in Maryland, reports the Associated Press. Firstly, Maryland Senate Bill 923 allows low-income individuals who are pregnant to receive healthcare under Medicaid for up to a year after giving birth, a substantial increase from the current coverage limit of 60 days. In addition, the Maryland Medical Debt Protection Act requires hospitals to relax debt collection practices for patients with lower incomes and may no longer charge interest or additional fees on an incurred debt. Hospitals likewise can’t sue patients over unpaid bills until at least 180 days after the initial charge.
The federal government approved Arkansas’ Medicaid expansion waiver, but will only allow premiums to continue into 2022, reports the Arkansas Times. Arkansas’ new waiver does not include work requirements, which have been blocked by a federal judge, but does impose premium requirements for enrollees above 100 percent of the federal poverty level. The Obama administration originally approved the premium requirements and work requirements were approved under the Trump Administration. The Biden administration approved Arkansas’ Medicaid waiver program to begin in 2022—which purchases private insurance coverage for beneficiaries on the Marketplace—but added an addendum requiring premiums to phase out in 2022. The waiver did not request work requirements after the Biden administration revoked them in 2021.
Legislation capping the cost of insulin in Rhode Island will go into effect on Jan. 1, 2022, reports the Providence Journal. The law prohibits insurers from charging more than a $40 co-pay for a 30-day supply of insulin and prohibits applying a deductible to insulin drugs.
Oregon is preparing to offer free coverage to residents, regardless of immigration status, beginning in 2022, according to the Lund Report. The legislation, “Cover All People,” passed during the 2021 Regular Session and will go into effect in July 2022, providing an avenue for low-income undocumented immigrants to gain access to health insurance coverage. With only $100 million initially allocated, the program will be open to people regardless of immigration status who are between 19 and 25 years old and 55 and older, and will cover primary and preventive care, dental care and behavioral health services. Oregon joins six other states who have extended coverage to undocumented immigrant adults.
New Jersey’s Governor signed an executive order that launched the New Jersey Health Care Cost Benchmark Program that will provide everyone in the state with a shared understanding of how much healthcare costs are growing and factors contributing to high health costs and cost growth, reports ROI-NJ. Over time, the program aims to decrease how much healthcare costs grow each year and to contribute to making healthcare more affordable. The program also offers an important opportunity to implement market-based strategies rooted in broad stakeholder commitment and industrywide collaboration.
Despite having health insurance, Vermont carpenter Rick McDowell incurred more than $7,000 in medical debt following a stroke, according to Vermont Public Radio. Even though about 96% of Vermont residents have health insurance, they often don’t have the means to pay out-of-pocket costs. Vermont hospitals have consistently reported between $62 million and $85 million annually in unforgiven medical debt, which can hurt Vermonters finances and credit scores. Through story gathering, Vermont officials have found that fear of worsening medical debt pushes people to forego care, causing health conditions to worsen and ultimately increase the overall cost of care in Vermont.