State News

Illinois | Aug 11, 2023 | News Story | Consolidation

Illinois Enacts Hospital Antitrust Legislation

Illinois has passed hospital antitrust legislation monitoring mergers and acquisitions, according
to Becker's ASC Review. Health care providers will now be required to notify the state attorney
general of proposed mergers acquisitions or contracting affiliations. Notification of such
transactions is one tool states can use to monitor and highlight mergers and acquisitions that
may result in increased prices for patients. Failing to provide proper notice will result in a penalty
of up to $500 per day.

Illinois | Aug 7, 2023 | Report | Drug Costs

Illinois Caps Prices for Insulin and EpiPens

Illinois will offer a discount program that will allow diabetics to buy insulin for $35 per month at a
post-rebate price, according to WAND. House Bills 2189 is intended to build on previous
legislation that capped insulin prices for only about 15 percent of the population through
insurance for state employees. Starting in 2025, program participants will be able to get official
cards from the state with information about how to request reimbursement from their health
insurance and how pharmacies will honor the discount. The state also passed House Bill 3639
which caps EpiPens at $60 per two-pack, however this is not a discount program and the cap
may only apply to state-regulated plans.

Missouri | Aug 4, 2023 | Report | Population Health

Missouri Releases Maternal Mortality Report; Finds Maternal Mortality Has Increased

The 2020 Maternal Mortality in Missouri report revealed an increase in maternal mortality rates,
with 32 people dying per 100,000 live births, up from about 25 per 100,000 from 2017 to 2019,
according to St. Louis Public Radio. The leading causes of death in Missouri’s pregnant and
postpartum women were overdoses, suicides, and other mental health problems. Most new
mothers died between 43 days and one year after they gave birth, with the highest rate of
mortality was among women who had a Medicaid-covered pregnancy. The report examined
deaths between 2018 and 2020, prior to the state expanding postpartum Medicaid coverage – in
2023, the state legislature voted to extend Medicaid coverage for new mothers up to twelve
months following birth, a move providers hope will result in fewer postpartum deaths.

Illinois | Jul 28, 2023 | News Story | Drug Costs

Illinois Prohibits Price Gouging of Generic Medications

Illinois has passed a law prohibiting price gouging of certain prescription medications, reported by the Office of Senator Koehler. Effective January, 2024, House Bill 3957 prohibits manufacturers and distributors from engaging in price gouging of essential off-patent and generic medication, making Illinois the first state in the country to do so.

New York | Jul 20, 2023 | News StoryNew York and Connecticut | Jul 20, 2023 | News Story | Health Costs

New York and Connecticut Increase Regulation Over Hospital and Health System Fees

New York and Connecticut have recently enacted and expanded laws regulating facility fee
billing, reports Mintz. The regulations in New York, effective June 21, adopted patient notice
requirements and made New York the first state to place an outright ban on facility fees related
to preventative care. The Connecticut legislation, which goes into effect July 1, 2024, will
expand existing oversight of facility fee billing by prohibiting hospitals and health systems from
collecting facility fees for outpatient health care services provided on a hospital campus.

New Jersey | Jul 10, 2023 | News Story | Drug Costs

New Jersey Governor Signs Bills Dedicated to Lowering the Cost of Prescription Drugs

New Jersey Governor Phil Murphy signed three bills into law designed to lower prescription drug
costs in the state, reports New Jersey Business Magazine. The legislation includes establishes
a Drug Affordability Council to create prescription drug affordability policy reforms and requires
drug manufacturers to report pricing data to the state. Another bill, S3240, caps out-of-pocket
costs for insulin at $50 per month and requires insurers to cover certain diabetes medications. A
third bill, S3241, increases oversight of pharmacy benefit managers and requires them to
disclose certain pricing information.

Wyoming | Jul 7, 2023 | Report | Health Costs

High Costs, Limited Access Still Plague Wyoming Health Care

Wyoming ranks 49 out of 51 states (including the District of Columbia) in terms of health system
performance, reports the Casper Star Tribune. The report cited defines performance based on
the rate of premature death, metrics related to reproductive and women’s health, and health
care access and affordability. The question of what kind of health care Wyomingites want
remains unanswered, and affordable health insurance is only part of the solution. Factors like
economic, social, cultural, and geographic barriers to health care must also be considered, as
well as new strategies to increase the efficiency of health care delivery.

Oregon | Jul 7, 2023 | Report | Health Costs

Oregon Expands Free Health Insurance for Low-Income Oregonians Regardless of Immigration Status

Oregon has expanded its Medicaid look-alike program, Healthier Oregon, to all residents who
qualify, regardless of their immigration status, reports The Lund Report. The program began in
2021, originally covering those 19-24 and 55 years and older. State officials estimate 55,000
people will be covered through the program.

Maryland | Jul 5, 2023 | News Story | Health Costs

Maryland Expands Medicaid Benefits to Include Pregnancy Care for Non-Citizens

Maryland will now offer coverage for pregnant and postpartum people, regardless of citizenship
status, according to the Baltimore Sun. This is part of the Healthy Babies Initiative, which aims
to reduce the number of maternal deaths in the state. Starting July 1, 2023, pregnant, income-
eligible residents will be able to receive the same benefits available to other pregnant individuals
with Medicaid coverage, including physical and behavioral health care, dental care, prescription
drug coverage without copays, through the CHIP “unborn child” option, plus an additional four
months of postpartum coverage using Health Service Initiative authority.

Rhode Island | Jun 29, 2023 | Report | Drug Costs

Rhode Island Passed Legislation Eliminating Out-of-Pocket Costs for HIV-Prevention and Post Exposure Medication

Rhode Island has passed legislation that allows insured individuals to access HIV-prevention
and post-exposure medications without any out-of-pocket costs, reports the Rhode Island
. The CDC estimates that only about one-quarter of individuals at risk of HIV
transmission are using PReP due to high costs, which can be up to $2,000 per month without
insurance. In addition to requiring all health insurance carriers in the state to cover pre-exposure
prophylaxis (PrEP) and post-exposure prophylaxis (PEP), the legislation also authorizes
pharmacists to prescribe the drug to eligible patients, potentially decreasing wait times for
patients prescribed PEP, which is most effective if taken within seventy-two hours of potential
exposure. Rhode Island joins a growing list of states that have passed similar legislation,
including Maine, Nevada, and Virginia.