State News

Delaware state legislature easily passed a measure to establish the Interagency Pharmaceuticals Purchasing Study Group, according to the National Academy for State Health Policy. The group is tasked with an ambitious agenda, expected to submit recommendations to leverage bulk purchasing of pharmaceuticals to meaningfully lower drug prices by the end of 2019. The strategies to leverage the state’s combined purchasing power will hopefully help bring down the cost of health care in the state, where health care spending traditionally grows faster than the state’s economic growth and currently exceeds the national average.

The Arizona Health Care Cost Containment System (AHCCCS) announced a policy change, effective May 1, 2019, that allows transportation network companies (a.k.a. “rideshare” companies) to register as non-emergency medical transportation providers, according to a press release. Under the new AHCCCS provider category, rideshare companies are eligible to serve Medicaid members who do not require personal assistance during medically necessary transportation. Adding rideshare companies as providers of non-emergency medical transportation can add flexibility to the health care delivery system and increase transportation options for Medicaid members. 

An analysis of New York's 2014 surprise medical bill law found that insurer, provider, and consumer stakeholders generally agree that the implementation of the law went smoothly, and that consumer complaints declines dramatically, according to a report from the Georgetown University Health Policy Institute, Center on Health Insurance Reforms. However, there continue to be significant gaps within the law concerning surprise balance bills due to patient misinformation about a provider's network status and use of out-of-network facilities during emergencies. The law protects consumers from charges for out-of-network services not paid by an insurance plan in cases of emergency or circumstances in which the patient did not have a reasonable choice between an in-network and out-of-network provider. 

A study by AARP North Carolina found that more than 80 percent of family caregivers in North Carolina support expanded roles for advanced-practice registered nurses (APRNs). The survey, in response to the SAVE Act currently under consideration in the North Carolina legislature, also found that 90 percent of NC residents rated care they received from APRNs as “excellent” or “good.” The bill would allow APRNs to offer primary care services without physician oversight. Expanding the role of APRNs would help address doctor shortages in the state as well as increase access to care in the state’s rural communities, according to Public News Service.

Consumers in Illinois have been bogged down with steep price increases when buying health insurance on the Affordable Care Act (ACA) marketplace. According to the Chicago Tribune, new proposed legislation would give the Illinois Department of Insurance the power to say “no” to certain sky-high price increases proposed by insurance companies for plans sold to individuals and small businesses. The bill wouldn’t apply to plans offered by large employers. Opponents of the bill say it does nothing to address the rising prices of healthcare that can lead to higher insurance prices, and it could limit the types of plans insurers are able to offer.

The Medical Society of Delaware has announced a new partnership with Pennsylvania’s medical society, PAMED, reports Delaware Public Media. The goal of the partnership is for the two medical societies to negotiate with medical providers to achieve value-based contracts that will also financially benefit physicians. The medical societies are also partnering with Health EC, a data mining company, to track patient data as well as monitor for unmet need and/or duplication of effort.

The Medical Society of Delaware has announced a new partnership with Pennsylvania’s medical society, PAMED, reports Delaware Public Media. The goal of the partnership is for the two medical societies to negotiate with medical providers to achieve value-based contracts that will also financially benefit physicians. The medical societies are also partnering with Health EC, a data mining company, to track patient data as well as monitor for unmet need and/or duplication of effort.

A new North Dakota law establishes a reinsurance pool for the individual health insurance market, reports the Insurance Journal. The bill, backed by the North Dakota Department of Insurance, creates a reinsurance mechanism called “invisible” reinsurance. A study conducted by the department in 2018 shows that the invisible reinsurance pool would reduce premiums and provide a low-cost alternative for healthier individuals. This would result in more individuals with health insurance, a more stable individual market and protection for health insurance companies from unpredictable high cost claims.

In South Carolina, a law originally written to help state and local governments collect debts is being used by private companies to seize tax refunds from people with past-due medical bills, according to The Post and Courier. In 2017 alone, healthcare organizations took approximately $92.9 million in more than 172,000 seizures to pay off medical debt. The program makes big money for the state—the Department of Revenue earned $12.6 million in 2017 through the fees for its collection programs. Tragically, about a third of the state’s population under 65 has past-due medical bills. This debt collection program is especially harmful for low-income individuals who rely on their tax refund. This program is also troublesome because a reviewof five years of Medicare’s investigations of hospitals showed 30 percent of claims have errors. It is often difficult for consumers to get their money back even if they were billed incorrectly.