State News

New Jersey | May 16, 2019 | News Story

Questions About NJ's Surprise Billing Law, and One Call for Changes

Though many advocates believe New Jersey’s surprise-billing law is working as intended, some doctors claim that they have been forced to take lower payments from insurance carriers, threatening their practices. According to NJ Spotlight, hospitals similarly argue that the law has reduced their leverage in contract negotiations with insurers over in-network payment rates. Signed in 2018, New Jersey’s surprise-billing law required greater disclosure from both insurance companies and providers and ensured that patients weren’t responsible for excess costs.


New York | May 16, 2019 | News Story

NYS Medicare ACOs Generated Savings in 2017 After Large Losses in Prior Two Years, But CMS Program Still Lost Money

A new United Hospital Fund report reveals that New York accountable care organizations (ACOs) participating in CMS programs meant to reduce Medicare spending reduced spending by $11.5 million in 2017, after increasing spending by roughly $60 million in each of the two prior years. According to the United Hospital Fund, CMS still ended up about $40 million in the red after accounting for the ACOs that reported losses and distributing incentive payments to those that saved money. CMS started the Medicare Shared Savings Program six years ago to offer healthcare providers the opportunity to create an ACO that would be held accountable for the quality and cost of care of Medicare patients, in return for a share of any savings generated 


Nevada | May 15, 2019 | News Story

Gov. Sisolak Signs Bills to Expand Patient Protections in Nevada

A new Nevada law limits the amount insured patients can be charged for emergency services when they receive care from an out-of-network provider, according to KTVN. The law will end surprise billing practices “that can leave patients on the hook for unexpected bills for emergency care that can run up to $10,000 or more." The Governor also signed Assembly Bill 170, which codifies the Affordable Care Act’s protections for people with pre-existing conditions into Nevada state law, providing Nevadans assurance that they won’t be denied healthcare based on a pre-existing condition regardless of what happens at the federal level. 


Iowa | May 15, 2019 | News Story

Gov. Reynolds Creates First Statewide Children’s Mental Health System

Iowa’s Governor signed a bill to create and fund the nation’s first statewide children’s mental health system, according to a press release. HF690 establishes required core services for children, regional crisis stabilization, mobile response teams, 24-hour hotline access to services and $1.2 million for home and community-based children’s mental health services to eliminate the waiting list that currently exists. This legislation supports the governor’s Executive Order, signed in 2018.


Oregon | May 15, 2019 | Report

Medicaid Investments to Address Social Needs in Oregon and California

Healthcare organizations across the U.S. are developing new approaches to address patients’ social needs. Medicaid programs are uniquely placed to support these activities, given their central role in supporting low-income Americans, yet little evidence is available to guide Medicaid initiatives in this area. A study in Health Affairs examined how Medicaid funding was used to support social interventions in sites involved in California and Oregon’s payment reforms. Investments were made in direct services—including care coordination, housing services, food insecurity programs and legal supports—as well as capacity-building programs for healthcare and community-based organizations. Several factors influenced program implementation, including the local health system context and wider community factors. These findings offer insights to healthcare leaders and policymakers as they develop new approaches to improve population health.


California | May 15, 2019 | Report

Medicaid Investments to Address Social Needs in Oregon and California

Healthcare organizations across the U.S. are developing new approaches to address patients’ social needs. Medicaid programs are uniquely placed to support these activities, given their central role in supporting low-income Americans, yet little evidence is available to guide Medicaid initiatives in this area. A study in Health Affairs examined how Medicaid funding was used to support social interventions in sites involved in California and Oregon’s payment reforms. Investments were made in direct services—including care coordination, housing services, food insecurity programs and legal supports—as well as capacity-building programs for healthcare and community-based organizations. Several factors influenced program implementation, including the local health system context and wider community factors. These findings offer insights to healthcare leaders and policymakers as they develop new approaches to improve population health.


District of Columbia | May 14, 2019 | News Story

The District’s Racial and Income Divide is Cutting Short the Lives of Black Residents

The District’s latest “health equity” maps show a city divided by race and income – how well you live, or sometimes whether you live at all, can depend on what side of the line you are on, reports The Washington Post. Average life expectancy in Woodley Park, a wealthy and predominantly white neighborhood, is 21 years higher than in the St. Elizabeths neighborhood, which is poor and predominantly black. Additionally, infant mortality for babies with black mothers is three times higher than for babies with white mothers. Mothers’ hypertension is a factor in these premature deaths, and stress from continued exposure to racism and discrimination – in addition to structural and institutional factors that perpetuate persistent inequities – exerts a great toll both on physical and mental health. The D.C. Health Department’s report recommends engaging a broad spectrum of the community in efforts to address these stressors and focusing on “changing community conditions, not on blaming individuals or groups for their disadvantaged status.”


Minnesota | May 14, 2019 | Report

Health Costs Surge for Minnesota Employers, Employees

Health care spending for Minnesota businesses and their workers jumped 9.6% last year - nearly triple the national growth rate. According to the Star Tribune, Minnesota was an early user of strategies such as moving workers to high-deductible health plans and enticing them to pick cheaper generic prescription drugs. The Minnesota Health Action Group reported the results of it's annual survey of employers regarding workplace benefits. The survey showed that for the first time, the number of businesses offering high-deductible plans exceeded those offering classic preferred provider plans and that cost-sharing by workers increased by 3 percentage points from last year. 


Kansas | May 13, 2019 | News Story

Lawsuit: Sick People in Missouri, Kansas Paid Higher Prices for Generic Drugs Due to Price-Fixing

Missouri and Kansas have joined 41 other states and Puerto Rico in a lawsuit accusing generic drug makers of conspiring to manipulate and drive up prices for more than 100 generic drugs, reports KCUR. The lawsuit, filed in federal court in Connecticut, alleges that generic drug giant Teva Pharmaceuticals significantly raised prices on more than 100 generic drugs beginning in July 2013 and colluded with competing companies to carve up markets and raise prices on at least 86 of those drugs. Missouri’s Attorney General called the alleged conspiracy “one of the most damaging and far-reaching price fixing schemes in modern history, with certain companies inflating prices by nearly 1,000%.”


Missouri | May 13, 2019 | News Story

Lawsuit: Sick People in Missouri, Kansas Paid Higher Prices for Generic Drugs Due to Price-Fixing

Missouri and Kansas have joined 41 other states and Puerto Rico in a lawsuit accusing generic drug makers of conspiring to manipulate and drive up prices for more than 100 generic drugs, reports KCUR. The lawsuit, filed in federal court in Connecticut, alleges that generic drug giant Teva Pharmaceuticals significantly raised prices on more than 100 generic drugs beginning in July 2013 and colluded with competing companies to carve up markets and raise prices on at least 86 of those drugs. Missouri’s Attorney General called the alleged conspiracy “one of the most damaging and far-reaching price fixing schemes in modern history, with certain companies inflating prices by nearly 1,000%.”