Pharmacy Benefit Manager Fees Regulated

Posted on by klb520

On December 14, 2021, the Centers for Medicare and Medicaid Services (CMS) unexpectedly issued a letter to U.S. Senator Ron Widen (D-OR) indicating that CMS plans to use its “administrative authority to issue proposed rulemaking” addressing price concessions and direct and indirect remuneration (DIR) fees that pharmacy benefit managers (PBMs) have increasingly charged to specialty and retail pharmacy providers in Medicare and other pharmacy benefit programs in recent years. The proposed regulation was issued on January 12.

Water Assistance Program Applications Available

Posted on by klb520

The Low-Income Household Water Assistance Program (LIHWAP) is a temporary emergency program to help low-income families pay overdue water bills. LIHWAP is a grant. Recipients do not have to repay it. LIHWAP crisis grants may be available if an individual and/or household has an emergency and are in jeopardy of losing their water service. Eligible recipients can receive one crisis grant for their drinking water service and one crisis grant for their wastewater service, up to $2,500 each. Click here for more information about the program or how to apply.

Preventive Care Guidelines Mean Improved Coverage

Posted on by klb520

The U.S. Department of Human Services, through the Health Resources and Services Administration (HRSA), has updated comprehensive preventive care and screening guidelines for women and for infants, children and adolescents. Under the Affordable Care Act, certain group health plans and insurance issuers must provide coverage with no out-of-pocket cost for preventive health services within these HRSA-supported comprehensive guidelines. Among a number of updates, for the first time the guidelines will require such group health plans and insurance plans to provide coverage without a co-pay or deductible for double electric breast pumps. Read more.

Health Center Volunteer Health Professional Program

Posted on by klb520

The Senate HELP Committee released a discussion draft of the Prepare for and Respond to Existing Viruses, Emerging New Threats, and Pandemics Act (PREVENT Pandemics Act). This legislation focuses on strengthening the nation’s public health and medical preparedness and response systems in the wake of the COVID-19 pandemic. In particular, the bill includes language that removes the current statutory expiration date for the Health Center Volunteer Health Professionals Program. Currently, more than 100 health centers utilize more than 500 volunteer providers through the program. NACHC has pushed for an extension given the ongoing workforce shortages that many health centers are facing. A section-by-section summary and full text are available. The Senate HELP Committee is accepting comments on the draft through February 4, 2022, and could move to mark up the legislation after reviewing stakeholder feedback.

Build Back Better Act and Appropriations Continue

Posted on by klb520

President Biden expressed support last week for breaking up the Build Back Better Act into smaller pieces of legislation. However, this strategy is problematic since the bill was designed to be passed using reconciliation, which can only be used a limited number of times per year and avoids a filibuster in the Senate by requiring only 51 votes. Republicans have resisted negotiating an omnibus FY22 with the BBB Act unresolved, and House and Senate appropriators have struggled to overcome issues in determining top-level funding numbers and including policy riders, like the Hyde Amendment. Another continuing resolution (CR) after the current one ends on February 18, 2022, is possible as House and Senate appropriators work to strike a deal. Congress is also considering including additional supplemental COVID-19 relief funding as well as telehealth flexibility extensions in an omnibus appropriations bill.

Waivers Extended

Posted on by klb520

The state Senate passed SB 1019 this week by a 49-0 vote. Introduced by Senator Michelle Brooks, the legislation would further provide for COVID-19 regulatory flexibility authority, essentially extending some of the waivers and require the Departments to submit reports to the legislature by May 31, 2022, of any waived rules or regulations that should be made permanent.

Rural-Urban Differences in Adverse and Positive Childhood Experiences: Results from the National Survey of Children’s Health

Posted on by lad3

Adverse childhood experiences (ACEs) are events of abuse, neglect, and household dysfunction occurring between birth and 17 years of age. Studies have found a direct correlation between ACEs and risky behaviors, poor physical health, and poor mental health outcomes in childhood. Positive childhood experiences (PCEs) include a nurturing, safe, and supportive environment allowing for health development and overall wellness. In prior research, rural-urban differences in PCEs have not been examined using all 50 states. This brief examines the types and counts of ACEs and PCEs for rural and urban children. The study also reports on the differences between rural and urban ACEs and PCEs across all 50 states and the District of Columbia.

Contact Information:

Elizabeth Crouch, PhD
Rural and Minority Health Research Center
Phone: 803.576.6055
crouchel@mailbox.sc.edu

Additional Resources of Interest:

What is the State of LGBTQ Health? Take the Survey!

Posted on by lad3

What is the state of LGBTQ health?

The National Coalition for LGBTQ Health’s Inaugural State of LGBTQ Health National Survey™ assesses the healthcare landscape for LGBTQ patient populations. This survey covers intersectional topics in LGBTQ health including clinical/behavioral health, stigma, social justice, housing/homelessness, health disparities among communities of color, and COVID-19.

The insights you provide by completing this brief yet comprehensive survey will help inform ongoing advocacy, education, research, and training activities that support LGBTQ health care. Your input also will help determine the theme for the Coalition’s 20th Annual National LGBTQ Health Awareness Week to be held March 21-25, 2022.

Don’t miss this important opportunity to provide input on the state of the LGBTQ healthcare landscape. The deadline for participation is Friday, February 18, 2022.

The survey should take no more than 15 minutes to complete. All individual responses are kept confidential and data will only be reported in aggregate.

Thank you in advance for your participation as we all work together to advance LGBTQ health care!

Click here to take the survey.

Access to Mental Health Services in Rural Pennsylvania Research Findings Released

Posted on by lad3

Kutztown University of Pennsylvania researchers Dr. Juliana Svistova, Dr. Ahyoung Lee, Dr. Christopher Harris, Dr. Juyoung Song, Jillian Horton, Barbe Fogarty, Julia Hansen, and Carlie Mills conducted the research, which assessed the demand for mental health services in rural Pennsylvania, with a focus on youth and the elderly.

The research also identified challenges rural populations face in accessing mental health care and identified options for improving and expanding mental health care services for underserved rural Pennsylvanians.

Read the executive summary here.

The full report can be accessed here: Access to Mental Health Services in Rural Pennsylvania

Pennsylvania Law Requiring Insurers to Cover Breast MRIs, Ultrasounds Now in Full Effect

Posted on by lad3

PA Breast Cancer Coalition’s Act 52 of 2020 / Senate Bill 595

Beginning January 1, 2022, all insurers are required to cover breast MRIs and ultrasounds for women insured under Pennsylvania law with high-risk conditions. The requirements are a result of the PA Breast Cancer Coalition’s Act 52 of 2020 (Senate Bill 595), sponsored by PA Sen. Bob Mensch. As your existing insurance policy expires, under law the new version will be required to cover breast MRIs and ultrasounds for women with:

  • A personal history of breast cancer
  • A family history of breast cancer
  • A genetic predisposition to breast cancer
  • Extremely dense breast tissue
  • Heterogeneously dense breast tissue with 1 additional high-risk factor

Co-pays, deductibles and co-insurance may still apply.