Pennsylvania’s state-based health insurance marketplace has added a new qualifying event that will allow low-income households to enroll in health insurance plans at any time, according to the . Rather than being restricted to regular open enrollment period in the Fall-Winter, residents with a household income at or below 150% of the federal poverty level will automatically get a qualifying event to start coverage or change their current plan. This is intended to make it easier for low-income residents to stay and get covered.
Nevada will join the Northwest Prescription Drug Consortium for prescription drug purchasing, according to the Las Vegas Review-Journal. Once the state joins, all state residents can get a free discount program card and can use whichever pharmacy benefit provides the best price, regardless of their existing coverage or insurance status. The consortium, called ArrayRx Solutions, is coordinated by Oregon and Washington, and enables participating states to combine their drug purchasing power to lower costs and negotiate and establish discounts for consumers.
Lifespan and Care New England Health System scrapped merger plans amid federal and state opposition, according to Modern Healthcare. Lifespan and Care New England decided not to appeal after the Federal Trade Commission and Rhode Island Attorney General sued to block the deal last week, claiming it would increase prices, reduce quality and stifle wages. The healthcare systems are the two largest providers in Rhode Island and together they would have controlled most of the general inpatient care, outpatient surgery and inpatient behavioral healthcare in the state.
Michigan's governor signed a series of pharmacy benefit management (PBM) reforms into law, according to Fierce Healthcare. The legislation prohibits PBMs from preventing pharmacists from telling consumers it's less expensive to purchase drugs out-of-pocket, and will require PBMs to file transparency reports telling consumers about the backend costs and profits of their medications, among other provisions.
None of the 12 hospitals analyzed in New York City and Long Island were in full compliance with federal price transparency regulations, reports the Gothamist. A recent report from Patient Right Advocate reveals that just 14 percent of the 1,000 hospitals surveyed across the U.S. were in full compliance with the regulations. While many New York City hospitals complied with certain aspects of the new federal rule mandating hospital price transparency, many have left out certain key information. Some hospitals, like Mount Sinai, left out its discounted cash prices, but included a complete list of rates it had negotiated with health plans, while others missed the mark by a lot more. Numerous hospitals in New York City have not posted the rates that they charge insurers, while some included negotiated rates for just some insurers, but left others out.
The New Mexico legislature will hold a hearing on uninsured patients' hospital charges following the passage of HM 36, according to NM Together for Healthcare. The legislation also asks the Human Services Department to report to the legislature on how hospitals are using public funds designated for the care of low-income, uninsured patients.
The state will merge the Affordable Care Act insurance markets for individuals and small groups to create more stable pricing for health coverage, reports the Portland Press Herald. State officials say that Maine will be first in the nation to combine the two markets into a subsidized reinsurance program, with the goal of promoting more stability in the market. The merger will go into effect in 2023.
Just four out of 21 randomly sampled hospitals complied with hospital price transparency requirements in 2021, reports the Center Square. This revelation comes from a report by Patient Rights Advocate, which randomly sampled 1,000 hospitals across the U.S. As of January 2021, hospitals are required to fully disclose online prices for services, unveiling negotiated rates between hospitals and insurers. A Wall Street Journal report showed that hundreds of hospitals, including Winston-Salem's Novant Health, were using embedded codes to block access to their pricing lists. The North Carolina Attorney General also released a report in January 2022 that reviewed 147 hospitals in the state, and found that 16 were not compliant with the requirement to provide a machine-readable list of services and prices, one was not compliant with the requirement to provide a consumer-friendly shoppable list and eight were not compliant with either requirement.
A network of community health centers in upstate New York has started using a mobile medical unit to help remote patients access care, reports HealthLeaders Media. The Hudson Headwaters Health Network rolled out its first primary care van shortly before winter in 2021, with scheduled stops in three small communities, and has since added a fourth stop. The mobile unit addresses a growing problem in rural areas, where healthcare providers are scarce and health insurance rates are low. The network worked with each community to find a good location for the van, to allow visibility and easy access for patients, as well as Wi-Fi access. During the pandemic, the van has become an important resource, allowing access to testing and some vaccinations.
Idaho’s governor signed a teacher health insurance bill into law, aiming to extend better health insurance benefits to teachers across the state, reports Idaho Press. The law creates a fund for school districts that choose to join the state’s health plan and sets a path for the state to increase its contribution for teacher health insurance premiums by approximately $4,000 per teacher, such that school districts can expand family coverage and lower out-of-pocket costs for teachers.