State News

Chandak Ghosh rushed to the Mt. Sinai West emergency room in New York City in 2010 with severe back and stomach pains, according to We The Patients. He was diagnosed with kidney stones, given pain medication, and discharged. In the following days, Mr. Ghosh began to receive separate bills from numerous providers he had seen during his visit. Though he was fully insured, he was told he was responsible for payment until his insurance company paid, and that if he didn't pay by a certain date, the bills would be sent to collections agencies and could hurt his credit. By the time his insurance had fully paid (months later), Mr. Ghosh has received 27 different billing statements. 

After Wellstar Health System and UnitedHealthcare insurance did not agree on a new contract, Georgia resident Shelly Azzopardi was left without clear coverage for newly out-of-network follow-up services, according to Georgia Health News. Health care consultants and industry officials say an increasing number of contracts end without a deal, and even when they are resolved, they pressure thousands of patients to choose between higher out-of-pocket costs or leaving a trusted physician or hospital network. A similar dispute is looming involving Anthem Blue Cross and Blue Shield. This trend becomes more pressing as healthcare systems acquire additional hospitals and physician practices, effectively increasing the stakes of negotiation, and with it, the potential for patients to be left out of network if deals collapse.

Saint Francis Hospital and Medical Center has sued Hartford HealthCare and its subsidiaries, reports the CT Mirror, claiming that it is trying to create a monopoly on hospital services by acquiring physician networks, particularly cardiologists, and demanding that they refer their patients only to Hartford HealthCare. The lawsuit alleges "a campaign of exclusion, acquisition and intimidation," and claims that Hartford HealthCare executives have stated in meetings that their plan was to "crush" or "bury" Saint Francis. The lawsuit also claims that as Hartford HealthCare acquired physician practices, it threatened and intimidated physicians who don't comply with its dictates. Hartford HealthCare has been cornering the market on lucrative operations such as cardiac and orthopedic surgeries by forcng doctors to send their patients only to Hartford HealthCare hospitals or by obtaining exclusive rights to robotic equipment. 

Saint Francis Hospital and Medical Center has sued Hartford HealthCare and its subsidiaries, including Hartford Hospital, reports CT Mirror. Saint Francis claims that Hartford HealthCare is trying to create a monopoly on hospital services by acquiring physician networks, particularly cardiologists, and demanding that they refer patients only to Hartford HealthCare. The lawsuit claims that as Hartford HealthCare acquired physician practices, they threatened and intimidated physicians who don’t comply with its “dictates.” The lawsuit also claims that other hospitals in the region suffer due to Hartford HealthCare’s “anticompetitive conduct.” 

Medicaid expansion in Louisiana was associated with decreased travel distance to healthcare providers, according to a study in Health Affairs. The authors studied this relationship among continuously enrolled Medicaid beneficiaries from 2015-2017, with Medicaid expansion occurring in July 2016. Distance traveled decreased across eight different types of services, ranging from −3.46 miles for general practices to −0.70 miles for specialty care. Black enrollees living in nonmetropolitan areas experienced the greatest decline in travel distance, with more than nine fewer miles traveled for primary care services. The authors argue that Medicaid expansion can be a tool to address racial and geographic disparities in healthcare access.

In 2022, two significant new healthcare laws will be taking effect in Maryland, reports the Associated Press. Firstly, Maryland Senate Bill 923 allows low-income individuals who are pregnant to receive healthcare under Medicaid for up to a year after giving birth, a substantial increase from the current coverage limit of 60 days. In addition, the Maryland Medical Debt Protection Act requires hospitals to relax debt collection practices for patients with lower incomes and may no longer charge interest or additional fees on an incurred debt. Hospitals likewise can’t sue patients over unpaid bills until at least 180 days after the initial charge.

The federal government approved Arkansas’ Medicaid expansion waiver, but will only allow premiums to continue into 2022, reports the Arkansas Times. Arkansas’ new waiver does not include work requirements, which have been blocked by a federal judge, but does impose premium requirements for enrollees above 100 percent of the federal poverty level. The Obama administration originally approved the premium requirements and work requirements were approved under the Trump Administration. The Biden administration approved Arkansas’ Medicaid waiver program to begin in 2022—which purchases private insurance coverage for beneficiaries on the Marketplace—but added an addendum requiring premiums to phase out in 2022. The waiver did not request work requirements after the Biden administration revoked them in 2021.

Legislation capping the cost of insulin in Rhode Island will go into effect on Jan. 1, 2022, reports the Providence Journal. The law prohibits insurers from charging more than a $40 co-pay for a 30-day supply of insulin and prohibits applying a deductible to insulin drugs.

Oregon is preparing to offer free coverage to residents, regardless of immigration status, beginning in 2022, according to the Lund Report. The legislation, “Cover All People,” passed during the 2021 Regular Session and will go into effect in July 2022, providing an avenue for low-income undocumented immigrants to gain access to health insurance coverage. With only $100 million initially allocated, the program will be open to people regardless of immigration status who are between 19 and 25 years old and 55 and older, and will cover primary and preventive care, dental care and behavioral health services. Oregon joins six other states who have extended coverage to undocumented immigrant adults.