State News

Indiana has passed multiple laws aimed at monitoring the growth of private health care prices reports Fox 59. House Act 1004 requires a third-party contractor to review the prices non-profit hospitals are charging, compared to 285 percent of the Medicare reimbursement rate. In addition, Senate Act 8 requires pharmacy benefit managers, who are responsible for negotiating drug prices with manufacturers, to pass on at least 85 percent of their cost savings from rebates and discounts on to consumers.

Colorado passed legislation eliminating the practice of “spread pricing,” that is, up-charging up prescription drugs by middlemen, on state-regulated individual and group policies and the state’s Medicaid program beginning January 2025, according to the Colorado Department of Health Care Policy and Financing. The legislation contains a provision enabling self-insured employers to opt-in to the policy. Eliminating spread pricing is estimated to save currently impacted employers an average of 10-25 percent on their prescription drug costs. The legislation also requires transparency reporting from pharmacy benefit managers and insurance carriers.

The Oregon Health Authority published the annual report on cost growth trends in the state, finding that total health care expenditures per person increased between 2018-2019 and slightly decreased between 2019-2020, reports AboutHealthTransparency.Org. Expenditures decreased the most for Medicaid between 2019-202 by 6.3 percent, and the least for the commercial market, at 1.6 percent. Retail pharmacy spending continued to increase during the pandemic, while spending in most other service categories declined during this time period.

Nevada has expanded their Medicaid services to now include annual dental coverage up to $2,500 for adults over 21 with disabilities, according to Nevada Current. With attributes such as dental clinics refusing or opting out of providing dental services, those with intellectual and developmental disabilities have higher rates of poor oral care and oral diseases. Nevada’s expansion of dental services has caused a network of trained dentists to create a safe network to provide services for disabled persons on Medicaid throughout the state.

Colorado has passed a law ensuring additional protections against medical debt for consumers, reported in Lexcology. Senate Bill 23-29 caps the interest rate on medical debt at 3 percent annually and requires debt collectors or collection agencies to provide consumers with an itemized statement of debt and allows them to dispute its validity, among other provisions related to debt collection practices. It also requires health care providers to provide an estimate of the total cost of a health care service upon request to a person who intends to self-pay for the service and sets a cap that the final cost may exceed the self-pay estimate by 15 percent.

Washington has passed a law eliminating cost-sharing for abortions for state-regulated health plans, reports The Seattle Times. However, this does not apply to private, employer-sponsored health insurance plans, on which a majority of residents rely on for coverage.

Delaware's Office of Value-Based Health Care Delivery has issued the annual progress report, available on the Insurance Commissioner of the State of Delaware’s website. The report concentrates on the implementation of value-based care in the state, which aims to shift the focus from the quantity of care to the quality of care provided, ultimately reducing costs for patients.

Colorado Governor Jared Polis signed legislation eliminating co-pays for pharmacy and other health care services for Colorado’s Medicaid program, reports State of Reform. Colorado residents with Medicaid coverage will have services such as hospital services, physician services, and prescription drugs covered without any cost-sharing, beginning in July. Additionally, the legislation will enable the state to pay providers more and access additional federal funding to make up the difference from the lost co-pay revenue.

North Dakota has passed a new law capping the cost of insulin for state employees, reports AARP. The law caps the out-of-pocket cost for a 30-day supply of insulin, as well as copayments for diabetic supplies, at $25 per month for employees covered by the state’s Public Employees Retirement System. The high cost of insulin has been a significant financial burden for many diabetes patients in the state, where the average price of insulin tripled between 2002 and 2013.