State News

Proposed legislation in Pennsylvania would allow the state to set payment rates for high-cost prescription drugs equivalent to prices in Canada, where prescription drugs can cost as much as 80 percent less than in the U.S., reports NASHP. This model would reduce prices for 250 high-cost drugs identified by the state, hold drug manufacturers more accountable and result in significant savings for both patients and states. If a drug manufacturer refuses to comply or withdraws their drugs from the market, they will have to pay significant penalties to the state.

The Medical Society of New Jersey has launched a new insurance denial registry for physicians’ offices to help track denials of healthcare services to New Jersey consumers, reports New Jersey 101.5. Until now, there hasn’t been a systematic way of tracing which companies, which procedures and what types of drugs are routinely denied. Understanding the reasons for insurance denials will help physicians get patients the care they need. A spokesperson for the Medical Society of New Jersey explained that such denials disrupt patient care and office workflow, and they expect many physicians' offices to contribute data.

A legislative effort to curtail surprise medical billing in Michigan has gained attention from national healthcare organizations shifting their focus to states amid stalled federal efforts, according to MiBiz. The legislation would require care providers to inform patients in advance of a scheduled procedure that their health insurer may not cover all of their medical services and that they can request care from an in-network provider. In emergency situations, the out-of-network provider would have to accept payment that’s the median amount within the region that a health insurer pays an in-network provider or accept 150 percent of what Medicare pays for a medical service, whichever is greater. If enacted, the legislation would require the Michigan Department of Finance and Insurance Services to conduct an annual survey on surprise billing that includes the number of out-of-network billing complaints and the adequacy of insurers’ care networks in Michigan.

Black patients in Pennsylvania are more than twice as likely to die prematurely of treatable health conditions compared to white patients, reports the Philadelphia Inquirer. Black patients had a mortality of 162.1 deaths per 100,000 people due to treatable health conditions, compared to 74.2 deaths per 100,000 people among white patients and 70.8 deaths per 100,000 among Hispanic patients. 

Black Ohioans make up about 13 percent of the state’s population but accounted for larger percentages of COVID-19 cases (22.8%), hospitalizations (30.6%) and deaths (18.7%), while white Ohioans make up about 82 percent of the state’s population, but accounted for smaller percentages of COVID-19 cases (53.1%), hospitalizations (56.9%) and deaths (77.5%), according to a new report from Health Policy Institute of Ohio. 

A $1.2 million grant from the U.S. Health Resources and Services Administration was awarded to fund a pilot program allowing paramedics to perform emergency care functions in order to improve healthcare access for rural citizens, reports Mainebiz. The grant will fund training for paramedics to perform urgent care skills under the direction of an emergency department via telemedicine, respond to acute 911 calls with local volunteer ambulance staff and pilot an emergency department physician consult program. The program works with community health centers in rural parts of the state to facilitate greater access to emergency services for Mainers who do not live near hospitals with emergency care services

California is poised to become the first state to develop its own line of generic drugs after the legislature overwhelmingly approved a measure directing the state’s top health agency to partner with drug companies to make or distribute a broad range of generic or biosimilar drugs that are cheaper than brand-name equivalents, reports Kaiser Health News. Though it could take years to successfully bring new generic products to the market, the move would put the state in direct competition with major generic and brand-name drug manufacturers that dominate the market, and potentially allow California to use its massive purchasing power to drive down drug prices.

Alaska ranked 32nd of 50 states and the District of Columbia on the Commonwealth Fund’s 2020 Scorecard on State Health System Performance, reports State of Reform. The state showed significant variation in its individual category measurements, ranking as high as 8th for avoidable hospital use and cost and almost last (48th) for prevention and treatment. Unmet mental health needs for adults and alcohol-related deaths have worsened in recent years, while breast cancer deaths and children who did not receive needed mental healthcare were the most improved indicators.

Hawaii’s healthcare system ranked the highest of all 50 states and the District of Columbia on the Commonwealth Fund’s 2020 Scorecard on State Health System Performance, according to State of Reform. The state was in the top 10 for all categories and placed first for avoidable hospital use and costs and healthy lives. Hawaii also performed well on prevention and treatment (#2) and access and affordability (#3). The lowest ranking was for measurements of disparity (#10) where the state has performed significantly poorer in recent years.