Publications
State Policy Check-up
January
8, 2007
Arizona
The Department of Health Services will hold a January 30 hearing to consider
revisions to and simplification of the State's Healthcare Group Program, which
offers small group coverage to residents with a history of medical problems.
John Spain at
jps@stateside.com
Arkansas
The Arkansas Department of Human Services Drug
Review Committee will meet January 11 to receive public comments regarding short-
and long-acting Beta Agonists.
Robert Axelrod at ar@stateside.com
The Arkansas Department of Human Services Drug
Utilization Review Board will hold a hearing January 17 to discuss proposed
clinical criteria and edits for Protopic and Elidel, to update the Arkansas
Medicaid Evidence-based Prescription Drug Program regarding the December review
for second generation antidepressants, and to re-review quantity limit edits
and dose-optimization for C-II stimulants.
Robert Axelrod at ar@stateside.com
California
The California Department of Health Services (CDHS)
will hold a hearing January 15 to discuss the State's recommendations for the
use of Preventive Health and Health Services Block Grant funds for 2007. The
Federal Centers for Disease Control and Prevention have made the block grant
available to the CDHS for the development and implementation of programs to
decrease the mortality rates of preventable diseases and injuries.
Eathen Gums IV at eg@stateside.com
Connecticut
The Connecticut Department of Consumer Protection
has amended regulations governing the administration of influenza vaccine by
pharmacists. The amendments revise pharmacist qualifying training requirements,
systems for control, and reporting requirements. The amendments were adopted
by the Secretary of the State November 30, 2006.
Eathen Gums IV
at eg@stateside.com
Governor M. Jodi Rell (R) unveiled a proposal December 27 to provide affordable,
comprehensive health insurance to uninsured adults in Connecticut. The initiative,
called the Charter Oak Health Plan, will be open to adults of all income levels
and will cost each participant about $250 a month in premiums. The Charter Oak
Health Plan will offer a full prescription drug package with co-pays ranging
from $10 to $15. Enrollees with pre-existing medical conditions would not be
restricted from coverage.
Josh Fisher at
jkf@stateside.com
Florida
The Consumer Health Information and Policy Physicians
Data Technical Workgroup of the Agency for Healthcare Administration will meet
January 11 to discuss implementation of Florida statutes that mandate transparency
in health care through public reporting of health care data.
John Spain at
jps@stateside.com
The Agency for Healthcare Administration will meet
January 26 to discuss technical aspects of the Enhanced Benefits Program, under
which Florida Medicaid Reform Health Plan members can receive pharmacy credits
by taking part in activities that improve health.
John Spain at
jps@stateside.com
The Office of Insurance Regulation will hold a
hearing January 31 to set standards of review for charges over $30 within its
Discount Medical Plan program.
John Spain at
jps@stateside.com
Idaho
On January 9, interim committee reports will be
given to the state legislature by several committees, including the Mental Health
and Health Care committees.
Emily Wolkoff at egw@stateside.com
Iowa
The Iowa Human Services Department has proposed increases to maximum income
for individuals and households seeking Medicaid supplementary assistance. The
revisions increase the maximum family life home payment and maximum residential
care per-diem of individuals eligible for Medicaid supplementary assistance.
Written comments regarding the amendments are due on or before January 24. The
Department will hold a hearing January 24.
Eathen Gums IV at eg@stateside.com
Kansas
The Kansas Health Policy Authority is accepting comments until January 13 regarding
provider participation, scope of services and reimbursements for the Medicaid
Program. A hearing to address the submitted comments will be held on January
16.
Robert Axelrod at ra@stateside.com
Kentucky
The Kentucky Cabinet for Health Services Pharmacy and Therapeutics Advisory
Committee will meet January 18 to discuss its plans for implementing measures
to control the cost of prescription drugs in the Medicaid program. The Committee
was established in 2002 to review and develop a preferred drug list.
Eathen Gums IV at eg@stateside.com
Louisiana
The House Committee on Insurance is scheduled to meet January 9 and 10 to discuss
possible health insurance reform legislation.
Daniel Clark at dwc@stateside.com
Maryland
The Health Care Commission is scheduled to meet January 18. The Commission's
responsibilities include developing a comprehensive standard health benefit
plan, establishing the HMO Quality and Performance Evaluation System and adopting
a state health plan related to Certificate of Need decisions.
Josh Fisher at jkf@stateside.com
Missouri
The Missouri Drug Utilization Review Board will meet January 17 to discuss prior
authorization and other pharmacy cost control issues.
Eathen Gums IV at eg@stateside.com
South Carolina
Governor Mark Sanford (R) released his executive budget January 3. The budget
recommends a $60 million increase in Medicaid funding, as well as $4 million
for prevention partnership grants and $2 million for chronic disease prevention
to the Department of Health and Environmental Control (DHEC).
Josh Fisher at jkf@stateside.com
The South Carolina Department of Health & Human Services Pharmacy &
Therapeutics Committee is scheduled to meet on February 1. The agenda is not
available at present.
Josh Fisher at jkf@stateside.com
Tennessee
The Tennessee Department of Finance and Administration's Bureau of TennCare
will hold a hearing January 17 to consider amendments to regulations governing
cost-effective alternative services and claims for services denied which exceed
benefit limits. The amendments allow provision of cost-effective alternative
services when they are either alternative to covered Medicaid services that
are cost-effective, or preventative in nature and offered to avoid the necessity
of more costly treatment in the future.
Eathen Gums IV at eg@stateside.com
Texas
The Texas State Board of Pharmacy has proposed amendments to provisions regarding
pharmacy records. The amendments would allow pharmacies to document information
regarding the dispensing of a prescription either as a printed hard-copy or
electronically in the pharmacy's data processing system. Comments on the proposed
amendments are due by January 26. The earliest possible date of adoption is
January 14.
Eathen Gums IV at eg@stateside.com
The Texas State Board of Pharmacy has proposed amendments to provisions concerning
pharmacy operational standards. The revisions would allow institutional pharmacies
to distribute prepackaged drugs for other institutional pharmacies under common
ownership in compliance with Senate Bill 492 passed by the 79th Texas Legislature,
Regular Session. Comments must be received by January 26. The earliest possible
date of adoption is January 14.
Eathen Gums IV at eg@stateside.com
Wyoming
The Wyoming Joint Labor, Health, and Social Services Committee will meet January
8 with the State Healthcare Commission to discuss policy recommendations for
the upcoming session.
Maggie Young at my@stateside.com
Spotlight on...
Electronic
Health Technology
The adoption of electronic health
record technology is widely regarded as critical to enhancing the performance
and quality of the nation's health care system. Policymakers view these technology
initiatives as a real opportunity to advance health care quality by improving
compliance with recommended care for patients with acute and chronic conditions,
reducing disparities in treatment and medical errors, and lowering overall health
care costs for both private and public payers. While the benefits of electronic
health records are clear, there are privacy and security considerations that
need to be addressed before widespread implementation.
A recent study released by the Markle
Foundation indicates that Americans overwhelmingly want to have electronic copies
of their medical records and believe that having greater access to their information
will reduce medical mistakes and costly repeat procedures. Despite the overwhelming
interest in being a more active participant in their own health care, and having
their medical information available online to themselves and their physicians,
those polled also have very serious concerns about the privacy and security
of their medical information. The same study found that eight in 10 Americans
are very concerned about identity theft or fraud and the possibility of their
data being used by marketers without their permission, with three-quarters of
those surveyed saying the government has a role in establishing privacy and
confidentiality protections for electronic health information.
Recently, five of the largest employers
in the U.S. joined forces to provide a secure, confidential repository for their
employee's medical records. Wal-Mart Stores, Intel, BP America, Pitney Bowes
and Applied Materials are launching an initiative under which they will invest
at least $5 million to provide electronic portable personal health records to
employees through a web-based framework. Other employers and states are being
invited to pay a fee to join the coalition, which is expected to launch its
service in mid-2007. A key element of the health record initiative is that individuals
control the information in their own health records. The records are expected
to be held by an independent, not-for-profit organization.
Electronic health records have also
garnered a great deal of attention within the states. In 2006, there was a significant
increase in legislative measures addressing health information technology. While
only fifteen states introduced electronic health care measures in 2005, state
legislatures introduced over 100 bills during the 2006 legislative session.
To date, a total of 14 states have enacted legislation addressing health information
technology issues. The majority of the measures enacted in 2006 created offices
or study committees to develop and implement a strategy for the adoption and
use of electronic health records. Other bills, such as those introduced in Louisiana,
New York, and Michigan, support the National Governors' Association (NGA) e-Health
initiatives by creating an infrastructure for an interoperable health care information
exchange infrastructure.
The NGA secured a $2 million one-year
contract from the Department of Health and Human Services to create the State
Alliance for e-Health. The initiative is a collaborative state effort to improve
the nation's health care system by identifying barriers and establishing best
practices to resolve state-level health IT problems that affect multiple states
and pose challenges for interoperable electronic health information exchange.
This is an opportunity for Governors to identify inter- and intra-state based
health information technology policies and best practices.
Not
surprisingly, privacy of health care information is a huge concern for privacy
advocates. Many are concerned with the vulnerability and sensitivity of electronic
health records, while others have expressed fears that employers would be enabled
to access and use electronic health information, which could impact employment
decisions or be sold for marketing purposes. And yet other privacy advocates
have raised concerns about the protection of information, citing the possibility
that electronic health records present yet another opportunity for identity
thieves and hackers to steal very personal information.
In the aftermath of the 2005 hurricanes,
access to electronic health records would have greatly assisted health providers
who treated displaced residents far from their Gulf Coast homes. Most individuals
can easily envision the benefits of electronic health records, especially in
emergency situations. However, the challenges regarding security and confidentiality
still need to be addressed in the eyes of critics, who worry that with the recent
initiatives proposed by major employers, misuse of information is even more
likely. As privacy advocates have argued, if patients are not confident about
confidentiality, they may withhold critical information from their physicians,
jeopardizing their care and the integrity of an electronic health records system.
As such, not only will this issue be revisited
in 2007 by most states, but the debate will likely now also be shaped by industry
initiatives to make a system of electronic health records a reality.
Phyllis Mitchell at pm2@stateside.com
Every two weeks, members of Stateside
Associates' Health Care Practice select some health care-related state events
and public policy issues to highlight in State Policy Check-up. Providing
consulting, strategic planning, lobbyist management and legislative and regulatory
monitoring services, the professionals of the Health Care Practice support both
corporate and association clients.
For more information about these or for assistance
in managing your health care issue needs, please contact Kate Viar or Phyllis
Mitchell at (703) 525-7466.
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