PRICE AND QUALITY TRANSPARENCY
Spotlight on State: South Dakota
Amy Y. Gu, Managing Editor March 25, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See South Dakota page. South Dakota has been active in regulating prescription drug pricing and transparency. The state enacted a law to prohibit pharmacy benefit managers from prohibiting or penalizing a pharmacist for providing cost-sharing information on the amount a covered individual may pay for a particular prescription drug. The legislature also passed legislation …
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Spotlight on State: Washington
Amy Y. Gu, Managing Editor March 10, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Washington page. Washington is a leader in state initiatives for healthcare price and competition and enacted several market reform initiatives in recent sessions. In 2019, it became the first state to enact legislation to implement a public option health insurance plan to bring its residents a step closer to universal health care. Washington …
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Spotlight on State: Georgia
Alex Montague, Health Policy Researcher March 8, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Georgia page. Georgia has made significant strides in legislative efforts to promote healthcare price transparency in recent sessions. The state enacted legislation in 2020 that lays the groundwork for an all-payer claims database (APCD). The law establishes an APCD advisory committee, funding for the APCD, design criteria, operation, and noncompliance penalties. The legislature …
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The Source Roundup: March 2021 Edition
Alex Montague, Health Policy Researcher March 1, 2021
Happy March! This month’s roundup focuses on health policy pieces and reports that examine 1) the future of value-based care, 2) the efficacy of various policy options to address healthcare prices, including increasing price transparency and market competition, 3) comparisons of brand-name drug prices, and 4) the impact of the Affordable Care Act on uninsured young adults. Valued-Based Reform In a white paper published this past month, The Future of Value-Based Payment: A Road Map to 2030, researchers from the Leonard Davis Institute of Health Economics at the University …
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Spotlight on State: South Carolina
Amy Y. Gu, Managing Editor February 12, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See South Carolina page. While South Carolina law does not mandate an all-payer claims database (APCD), the Division of Medicaid Policy Research at the University of South Carolina Institute for Families in Society maintains a private database of voluntary claims submissions. The South Carolina Department of Health and Human Services (SCDHHS), which operates the …
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Spotlight on State: Maine
Amy Y. Gu, Managing Editor February 4, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See Maine page. Maine is a state that actively promotes healthcare price transparency. The Maine Health Data Organization (MHDO), an independent executive agency that the legislature established in 1996, operates the state’s all-payer claims database (APCD). The MHDO has collected health insurance claims information since 2003 and currently shares claims from commercial insurance carriers, …
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The Source Roundup: February 2021 Edition
Alex Montague, Health Policy Researcher February 1, 2021
With the inauguration of a new administration in the White House, discussions ramped up on the future of health care and new legislative and regulatory possibilities. This month’s Roundup begins with three articles that look at ways to strengthen the Affordable Care Act (ACA) as well as the potential for more significant health reform through the implementation of a public option. On the price transparency front, we cover a report that looks at the effect of New Jersey’s final-offer arbitration system for resolving surprise billing disputes and the new price …
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Spotlight on State: California
Amy Y. Gu, Managing Editor January 29, 2021
This is part of a series of summaries that highlight notable legislation and initiatives in health policy and reform of all 50 states. Check back on The Source as we roll out additional states each week. See California page. The state of California is a national leader in healthcare price and competition initiatives and continues to make strides in healthcare system reform. In price transparency, California’s repeated efforts to establish an all-payer claims database came to fruition with the passage of AB 1810 in 2018, after a long road of legislative efforts …
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[Issue Brief] State Surprise Billing Protections: Are States Making the Grade for Patients?
Ada Shao, Student Fellow January 15, 2021
The ongoing COVID-19 pandemic has exacerbated the issue of health care affordability in the United States. According to a Pew Research Center study, since the pandemic began, 25% of adults have had trouble paying bills, with 11% having particular difficulty in affording medical care. Lower income Americans face an even more dire situation, with 46% having had trouble paying bills and 19% unable to afford medical care. Already stretched thin by the pandemic, the last thing Americans across the country need is to open their mailboxes to find an unexpected …
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Litigation and Enforcement Highlights – January 2021
Amy Y. Gu, Managing Editor January 14, 2021
We kick off the new year with a handful of new developments in healthcare litigation and enforcement that transpired at the end of 2020. In price transparency, a pair of legal challenges intended to block transparency efforts in drug pricing and hospital pricing, respectively, were denied by the circuit courts. On the antitrust front, the Federal Trade Commission saw both victory and defeat in its challenges of proposed mergers that would lessen competition in the healthcare markets. Judges Refuses to Block California’s Drug Pricing Transparency Law SB 17 On …
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