Bipartisan leaders of the Senate Finance Committee are working on legislation targeting pharmacy benefit managers (PBMs), the intermediaries in the prescription drug supply chain who negotiate discounts with drug companies on behalf of insurance plans. Finance Committee Chairman Ron Wyden (D-Ore.) and his GOP counterpart Sen. Mike Crapo (R-Idaho) last Thursday released an outline of the issues they aim to tackle as they craft a bill this summer. The senators indicated they are concerned about the lack of transparency in the supply chain, business practices by large, concentrated PBM firms that drive up out-of-pocket costs for seniors, and “misaligned incentives” that make higher drug list prices translate into higher compensation for intermediaries. The committee held a hearing on PBMs and the prescription drug supply chain on March 30, 2023.
Pennsylvania Governor Creates New Commonwealth Office of Digital Experience
Gov. Josh Shapiro signed an Executive Order announcing his customer service transformation strategy and establishing the Commonwealth Office of Digital Experience (CODE PA) to improve online services for Pennsylvanians and streamline the way they interact with the Commonwealth online. As part of this announcement, Gov. Shapiro named Bryanna Pardoe to the role of Executive Director of CODE PA. CODE PA will work to provide digital services that are responsive, user-friendly and accessible to every Pennsylvanian, including building a cross-agency product that allows residents to apply for related benefits that currently live separately with the Department of Human Services (DHS), the Department of Health (DOH) and the Pennsylvania Department of Education (PDE) and make them available through one platform. Click here to learn more.
The Pennsylvania Health Secretary Was Named Pediatrician of the Year
The Shapiro Administration announced Acting Secretary of Health Dr. Debra Bogen is being honored as 2023 Pediatrician of the Year by the Pennsylvania Chapter of the American Academy of Pediatrics (PA AAP). The chapter gives this award annually to recognize a pediatric fellow who exemplifies the ideals of the profession and advocates for children’s health and increased access to health services. Before joining the Commonwealth, Dr. Bogen was the Director of the Allegheny County Health Department where she was a key partner with Community Health Centers in Pittsburgh. Prior to that appointment, she was a member of the Pittsburgh region medical and research community for more than two decades. She held a primary academic appointment as Professor of Pediatrics at the University of Pittsburgh and secondary appointments in psychiatry and clinical and translational science. Dr. Bogen also served as the Vice Chair of Education for the Department of Pediatrics at UPMC Children’s Hospital of Pittsburgh. She was one of the founders of the Mid-Atlantic Mothers’ Milk Bank and served as the organization’s Volunteer Medical Director until assuming her role at the state. Read more.
Read the Report Here: Rethinking How CMS Approaches Health Equity for American Indians and Alaska Natives
A Summary of three events in 2022 between the National Indian Health Board, the Centers for Medicare & Medicaid Services (CMS), and CMS Tribal Technical Advisory Group to discuss health equity.
CMS Announces Health Insurance Marketplace Policies for 2024
This week, the Centers for Medicare & Medicaid Services (CMS) issued the final Notice of Benefit and Payment Parameters for 2024, which specifies requirements for issuers, agents, brokers, and Assisters, to offer qualified health plans (QHPs) through the Federal Marketplace, Healthcare.gov. The final rule includes policies pertaining to plan options, health equity, risk adjustment, and consumer experience. It also expands the network adequacy requirements by adding Mental Health Facilities and Substance Use Disorder Treatment Centers as new categories of Essential Community Providers (ECPs) and rural emergency hospitals as a new provider type in the Other ECP Category. The number of QHPs offered in rural areas has been growing but still lags urban areas.
Read The Kaiser Family Foundation (KFF) Research on HealthCare.gov Marketplace Plan Selections by Rural Status
The policy research organization, Kaiser Family Foundation (KFF), uses FORHP’s definition of rural to count the number of consumers who selected or were automatically re-enrolled into a health insurance plan found through the federal Marketplace as of the end of the open enrollment period.
NASHP Proposes State Strategies for Rural Behavioral Health
This brief from the National Academy for State Health Policy (NASHP) considers strategies drawn from states that participated in NASHP’s Policy Academy on Rural Mental Health Crisis Services.
Read About States’ Best Practices for Rural Economies and Health Care
Commentary from the National Governors Association Center for Best Practices summarizes themes and key takeaways from two virtual roundtables focused on equitable economic development and equitable healthcare for rural communities.
Read the Guide to Capital Resources for Rural Communities Here!
The National Organization of State Offices of Rural Health will continue to update this list of community development resources from national, federal, regional, and philanthropic organizations.
New Report on Use of Electronic Health Information Exchange Has Been Released
The Government Accountability Office (GAO) interviewed federal and state officials and reviewed survey data from providers to learn how the use of electronic health information exchange changed since the enactment of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009. GAO found that the use of electronic exchange among hospitals and physicians increased in recent years but use among small and rural hospitals was lower than that of other hospitals. This finding may be because small and rural providers are less likely to have the financial and technical resources to participate in electronic exchange—such as adequate IT staff and sufficient access to broadband internet.