State News

Virginia will allocate $10 million in CARES Act funding to Unite Virginia, a platform that connects residents to health and social service providers, State of Reform reports. With the goal of achieving health equity in mind, Unite Virginia will allow healthcare providers to refer patients in need to support services within and outside of the medical field. These services include housing, food programs and other social services for Virginians in need.

A previous Wisconsin Watch/WPR investigation found that hospitals statewide sued dozens of patients during the early weeks of the pandemic, despite several hospitals pledging to pause or at least slow down aggressive debt collection during the public health crisis, reports Wisconsin Watch. However, one of those hospitals, Froedtert South, filed 314 lawsuits in small claims court against debtors in 2020. The lawsuits collectively sought to recoup about $1.1 million in alleged debt, ranging from $555 to $9,970 per lawsuit – at least eight defendants in 2020 filed for bankruptcy. Other Wisconsin healthcare providers have sued over debt in recent months, court records show, although Froedtert South stands out in volume.

A North Carolina task force established to address inequalities amplified by COVID-19 in communities of color has recommended looking at pressing public health issues such as “sick buildings” that can increase COVID spread, reports Costal Review Online. The problem of “sick buildings” is caused by legacy pollutants, such as radon, asbestos, mildew, and mold, that can arise from delayed maintenance of aging buildings, according to the task force’s first biannual report. The report notes that, “Nowhere is this problem more apparent than in NC’s public schools, especially those in hyper-segregated, concentrated poverty communities,” and that this issue disproportionately impacts communities of color. The report goes on to explain that because of aging and poorly functioning HVAC systems, children in “sick” school buildings are exposed to chemical and biological contaminants that adversely affect their health. The report also notes that these “sick buildings” with poor ventilation can also exacerbate COVID-19 by increasing its spread.

Colorado’s health insurance marketplace has launched a Public Benefit Corporation (PBC), which will offer healthcare ancillary products and services across the state and aims to increase consumer health literacy, according to Connect for Health Colorado. The PBC will also administer the plans and financial assistance, which will fund the state’s reinsurance program, provide financial help to people with low incomes whose net premium would increase as the individual market price for insurance decreases and set up a fund to provide financial help to people who don’t otherwise qualify under the ACA. The financial help will be in the form of a separate state-funded subsidy, available to people beginning in 2023.

UNC Health, North Carolina’s largest academic health system, has rolled out its new cost transparency tool via an app and on their website, reports North Carolina Health News. The tool makes it possible for consumers with or without insurance to estimate how much an office visit, simple procedure or inpatient service will cost. The tool results from a new rule from the Centers for Medicare and Medicaid Services (CMS), effective Jan. 1, 2021, in which all hospitals are required to provide public lists of standard charges for healthcare services in an easily accessible, easily searchable format. Transparency initiatives such as these, however, have had mixed success in getting patients to use them. For example, in 2007 New Hampshire created a website that provided negotiated out-of-pocket costs and negotiated prices for common procedures, but a 2014 study found that only about one percent of patients actually used the service over the course of three years.

Kansas has passed a number of policies to increase telehealth utilization as a result of the COVID-19 pandemic, according to a report by the Kansas Health Institute. Researchers identified several actions that state policymakers have taken, including: requiring payment parity for telehealth services; expanding services allowed under telehealth; allowing services to be provided via telephone, in addition to live video; and expanding allowed “originating” sites to include patients’ homes in addition to nursing facilities. Additionally, the Governor enacted multiple executive orders with provisions pertaining to telehealth, including licensure. Some of these provisions were later codified, allowing out-of-state physicians to treat Kansas patients via telehealth without securing a Kansas license, provided certain requirements are met. In the months and years ahead, Kansas policymakers must decide which changes should continue and whether additional changes are needed to encourage the appropriate use of telehealth.

The Illinois Department of Healthcare and Family Services has proposed a new equity-centric plan to transform healthcare in the state, reports the Center Square. The plan recognizes social and structural determinants of health, as well as medical ones, and proposes ways to address them. The new plan, if implemented, will fund pilot projects and planning grants to address both healthcare and social determinants of health, emphasize collaboration between community-based organizations and one unrelated healthcare provider, and ensure that health equity is both measurable and the primary focus of each project. Pilots would fall into three collaboration categories: cross-provider partnerships, safety net hospital partnerships and critical access or distressed hospital partnerships.

Between 2014 and 2019 the Minnesota Department of Revenue took $81.6 million in refunds from about 24,000 taxpayers per year to pay medical debt that some of the state’s largest nonprofit hospitals said they were owed, reports the Star Tribune, with some Minnesotans’ refunds seized more than once. Only one other state, South Carolina, takes individual tax refunds on behalf of private healthcare companies. In Minnesota, hospitals and other healthcare firms do not need a court judgement or order before retaining the state to take tax refunds on their behalf, and the Department of Revenue earns a $15 fee for every collection made through this program and does not check to ensure a health provider’s claim is valid before seizing a refund. Hospitals insist that they have begun to take on dangerous amounts of debt from uncompensated care – in 2017, Minnesota hospitals provided $691 million in uncompensated care, with 25 percent of that total considered bad-debt, according to the Minnesota Hospital Association’s 2018 Community Benefit Report.

The U.S. Supreme Court upheld Arkansas’ law regulating pharmacy benefit managers (PBMs), ruling that it is not preempted by ERISA, reports Fierce Healthcare. Arkansas’ law prohibits PBMs from reimbursing pharmacies at lower rates than the cost required to dispense prescriptions and allows pharmacies to refuse to sell a drug if the upper limit that plans will pay for it is too low. Opponents of the law argue that it increases costs for patients and could potentially result in pharmacies not carrying needed medications; proponents argue that the law protects rural and independent pharmacies from too-low reimbursement rates. The ruling paves the way for other states to pass laws regulating PBMs and explore other cost-regulating measures.