California’s governor unveiled a proposal to make California the first state to sell its own generic prescription drugs to increase competition in the state's generic drug market, according to Advisory Board. The governor also proposed establishing a single market for drug pricing in California, among other strategies to lower costs. Health policy experts believe that California is ripe for testing these concepts at a government level, but California's Legislature will have to approve the proposals before the state can implement them.
Telehealth giant, Teladoc Health, has announced plans to purchase InTouch Health, a telehealth company that serves the provider market, for $600 million, Crain's New York reports. Through the acquisition, Teladoc plans to create a virtual-care solution that spans provider-to-provider telehealth capabilities for inpatient care, as well as consumer-to-provider applications for outside hospitals. Teladoc has spent millions on acquisitions in recent years, reflecting consolidation that's affecting all of healthcare, including the telehealth sector.
The New Hampshire Insurance Department intends to file a Section 1332 State Relief and Empowerment Waiver application with the federal government to promote stability in the state's individual health insurance market with an expectation that plan year 2021 premiums will be reduced by approximately 15% over whet they would have been otherwise, according to the Office of the Governor. The waiver would create a state-based reinsurance program, allowing New Hampshire to receive what is known as federal "pass-through" funding - the equivalent of what the federal government is estimated to save in premium subsidy payments to New Hampshire residents as a result of the program.
In Colorado, the averae deductible in 2017 was nearly $5,800 for a bronze-level plan, and according to an analysis by the Colorado Center on Law & Policy, 1 in 4 Coloradans wouldn't be able to afford to pay the deductible over the course of a year, according to Kaiser Health News. Rural and lower-income Coloradans are increasingly likely to be unable to afford a high deductible. As such, rural residents who are transferred from smaller, rural hospitals to larger hospitals with a higher level of care may never end up paying their bills at the first hospital. While Colordo has avoided the rural hospital closures that have plagued other states, 22 rural Colorado hospitals have operated in the red in 2019.
The U.S. Supreme Court will hear a case that could decide the validity of at least 38 states’ laws regulating how companies like Express Scripts and CVS Health make money off prescription drugs, reports Bloomberg Law. The justices agreed January 10 to take a case asking whether an Arkansas law regulating pharmacy benefit managers is preempted by the federal Employee Retirement Income Security Act. The Pharmaceutical Care Management Association, a trade group representing PBMs, successfully challenged the law on ERISA preemption grounds in the Eighth Circuit. The court’s decision to hear the case came at the urging of U.S. Solicitor General, who argued that the Arkansas law doesn’t reference ERISA plans or have an impermissible connection with them.
Two of New Hampshire's largest healthcare providers say they need to merge to gain access to more patients, protect the state's only academic medical center and support the state's struggling rural hospitals, according to U.S. News. Dartmouth-Hitchcock Health is seeking to combine with Manchester's Catholic Medical Center. However, concerns over consolidation in the state have been raised.
Americans frequently get slapped with costs for out-of-network services in situations where they weren’t able to shop for an in-network option, but research suggests Kansans may be especially vulnerable, according to KCUR. A Kaiser Family Foundation study put Kansas in the five worst states for how often patients received services from out-of-network providers during emergencies or inpatient care at an in-network hospital in 2017. Half of states — red and blue alike — have passed some level of consumer protections against surprise bills, but Kansas has not. While these protections don’t apply to all patients, they are a first step towards reducing avoidable, and potentially devastating, financial harm.
Many rural Montanans struggle with medical access, reports the Missoulian, with 15 Montana counties having no practicing physicians in 2014. More than a third of Montana's physicians are over the age of 60. As such, the Family Medicine Residency of Western Montana was eastablished to tackle this lack of providers in rural areas of the state, hoping to anchor physicians in Montana and get new doctors into the medical care pipeline as older ones retire.
A Texas law that aims to protect patients from surprise medical bills has taken effect, according to The Texas Tribune. The legislation aims to remove patients from billing disputes between health insurance plans and healthcare providers. The protections apply to Texans with state-regulated health plans, which includes most state employees and public school teachers, people who purchase insurance through the ACA marketplace and some people who receive health insurance through their private employers. The new law bans balance billing for emergency care. In nonemergency situations, there is an exception that allows providers to charge balance bills to patients who intentionally seek out-of-network providers.
Mental health centers in Kansas are forced to rely on out-of-state doctors willing to work remotely due to a shortage of mental health providers in certain areas of the state, according to KCUR. Like many states, Kansas is seeing an increase in patients seeking mental health treatment, but there aren’t enough doctors, nurses and therapists to treat them. Providers say the problem is worse in the state’s least-populated rural areas, where clinic jobs can stay open for years at a time. Only nine of 105 Kansas counties have enough psychiatrists and they are mostly in urban areas.