State News

Michigan will require insurance providers to cover mental health and substance abuse disorder
treatments at the same level as medical coverage, according to the Detroit Free Press. State-
regulated health plans will be barred from imposing greater deductibles, co-payments, and out-
of-pocket maximums on mental health and substance use disorder treatment than they would
for medical coverage. The legislation mirrors federal parity requirements and aims to limit
loopholes for paying for certain mental health services.

Vermont passed legislation directing the Green Mountain Care Board to explore and create a
plan to regulate the cost of prescription drugs in the state, reports VT Digger. The board will
review of options for cost regulation, including Prescription Drug Affordability Boards (PDABs) in
other states, the Medicare Drug Price Negotiation Program, and other programs. The board
must provide a final plan to the legislature by January 15, 2026.

Vermont has eliminated prior authorization for select primary care services in state-regulated
plans, according to Vermont Public. The legislation allows primary care physicians to order tests
and certain medications for their patients without first seeking prior authorization from insurance
companies.

Connecticut Governor Ned Lamont signed a bill prohibiting health care providers from reporting
medical debt to credit rating agencies, reports the National Law Review. Effective July 1, 2024,
the law updates existing regulations and mandates that health care providers and collection
entities include a clause in their contracts that bans reporting medical debt. This aims to protect
patients' credit scores from being negatively impacted by medical debt.

Oklahoma passed legislation simplifying the prior authorization process, reports KFOR. This
legislation requires prior authorization procedures to be published on websites available to
patients and providers, those with chronic conditions must be notified no less than 60 days prior
to changes that will affect them, appeals must be reviewed by providers of the same or similar
specialties, and insurers must respond to urgent requests within 72 hours and nonurgent
requests within seven days. Moreover, the new law requires hospitals prove compliance with
federal price transparency regulations before pursuing collections. The new law aims to improve
health care efficiency and reduce administrative burdens on health care providers, ultimately
benefiting patient care and accessibility.

Maryland will require health insurance carriers to cover prostheses and hearing aids, reports
WYPR News. State-regulated insurance plans will have to cover prostheses (a custom device to
treat partial or total limb loss) medically necessary hearing aids for adults, effective January 1,
2025.

Iowa will require insurers to cover supplemental and diagnostic breast examinations for state-
regulated plans beginning January 1, 2025, reports the Des Moines Register. Screening
mammograms are covered under law, but supplemental and diagnostic screenings with MRI
and ultrasound, which are often requested during follow-up visits, are not covered, leading to
extra costs for patients and causes some to avoid the screenings.

Wisconsin’s hospital prices are 5th highest in the country, according to Wisconsin Public Radio.
The study found that Wisconsin employers and employees paid over three times (318%) what
Medicare pays for the same service from 2020 to 2022, above the national average of 254
percent. However, he data used in the report is volunteered by employers and insurance
providers and does not capture all outpatient visits and discharges in the state.

Health care costs in Connecticut have risen 4.8 percent annually over the past two decades,
reports the Hartford Business Journal. The Office of Health Strategy Cost Growth Benchmark
released a report, which found that the increase exceeds inflation and wage growth, putting
financial pressure on residents and businesses. The average family premium for employer-
sponsored coverage nearly tripled over the last two decades, rising from $8,781 in 2001 to
$24,746 in 2022.