State News

Gaps in local health partners’ knowledge of available Medicaid services for homeless individuals and underuse of Medicaid reimbursements by qualified homeless individuals exhibit opportunities to reduce the healthcare costs associated with homelessness, according to KTVQ News. The Montana Healthcare Foundation report highlights that by targeting individuals in need of supportive housing intervention and aligning Medicaid funding for critical housing services, communities can realize cost savings and better health outcomes.

A new Maine law requires any private payer to cover any telehealth services that that would cover in person, based on six conditions outlined by the law. According to mHealth Intelligence, the bill also allows reimbursement for healthcare providers who use phone-based telehealth when scheduled telehealth services are technologically unavailable at the time of the scheduled telehealth service for an existing enrollee and the telephonic services are medically appropriate for the corresponding covered health care services. This new piece of legislation opens the door to more remote patient monitoring programs. 

State regulators approved two major hospital mergers and acquisitions under the condition that the organizations agreed to healthcare cost price caps tied to the Consumer Price Index, reports the Hartford Business Journal. This type of agreement is a first for Connecticut and one of the most stringent cost controls ever placed on hospital combinations in the state. Compared to states like Massachusetts and Rhode Island, Connecticut’s caps are relatively modest. Nevertheless, they are an important protection against rising healthcare costs, which have historically increased with consolidation

Alaska placed 30^th on The Commonwealth Fund’s 2019 health system scorecard, ranking states on access to care, cost of care and overall health outcomes, reports State of Reform. The state performed favorably in the areas of “healthcare disparities” and “avoidable hospital use and cost” – 14^th and 8^th in the nation, respectively. Alaska performed less favorably in “prevention and treatment” (38^th), “healthy lives measurements” (36^th) and “access and affordability” (39^th).

Minnesota lawmakers have extended to 2023 a moratorium that blocks the state’s nonprofit HMOs from being sold to for-profit companies, according to The Star Tribune. The measure was first adopted two years ago as a temporary measure to block conversion transactions, as lawmakers were concerned that nonprofit assets could wrongly be shifted to investor-owned carriers in a merger or acquisition.

The Colorado legislature passed numerous bills in the healthcare space that primarily focused on reducing the cost of care for consumers and improving accountability for quality care, according to the National Law Review. Some of these laws include HB 19-1174, which requires insurance carriers, providers and facilities to begin providing patients with information on the potential impact of receiving services from an out-of-network provider, prohibits “balance billing” patients who receive covered services from out-of-network providers at an in-network facility or emergency services from out-of-network providers or facilities, and establishes the reimbursement amount insurance carriers must pay to out-of-network providers that provide health care services to covered persons at an in-network facility or out-of-network providers for emergency services. HB 19-1131 requires that manufacturers and their representatives provide information about the wholesale acquisition cost of a prescription drug when providing information to a health care provider licensed to prescribe controlled substances or prescription drugs, and that when providing wholesale prescription drug price information, the manufacturer and representatives must also provide a list of at least three generic prescription drugs from the same therapeutic class and their wholesale acquisition costs. HB 19-1320 requires certain hospitals to complete an annual community health needs assessment and annual community benefit implementation plan.

Florida has enacted several healthcare laws geared towards affordability. One such law would allow health insurance companies to work with providers — like hospitals — to setup a website with lists of shoppable, non-emergency services such as lab work or outpatient surgical procedures, according to Florida Voices for Health. Another bill would establish a Canadian drug-import program for state healthcare coverage, which includes 3.8 million Medicaid recipients and 100,000 state prisoners. 

A 10-year project of the University of Wisconsin-Madison Population Health Institute and the Robert Wood Johnson Foundation shows the health disparities among populations in Wisconsin, according to The Milwaukee Independent. The interactive tool displays different health measures for the different counties in Wisconsin, from air pollution-particular matter to income inequality to ratio of population to primary care physicians.

Florida has passed legislation authorizing the state to import prescription drugs from Canada and other countries, potentially lowering the cost of lifesaving medicines that millions of people take every day, according to AARP. The law creates two prescription drug importation programs: The Canadian Drug Importation Program focuses on bringing down the cost of drugs to state-funded programs, such as Medicaid and the state prison system; and The International Prescription Drug Importation Program allows medicines to be imported from Canada and other countries, and then purchased by consumers through wholesale distributors and pharmacies. In order to implement these programs, states need approval from the U.S. Department of Health and Human Services (HHS) to begin their programs.