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WA Enacts Law Keeping Medical Debt Off Credit Reports Washington Gov. Bob Ferguson (D) signed a bill ( SB 5480 ) prohibiting collection agencies from reporting unpaid medical debt to credit agencies. The measure, which takes effect on July 27, is similar...

State Lawmakers Target PSAOs After targeting pharmacy benefit managers for years for contributing to the high cost of prescription drugs, state lawmakers have begun setting their sights on pharmacy services administrative organizations, or PSAOs, which...

AR Lawmakers Pass Bill Banning PBMs from Running Pharmacies The Arkansas legislature passed a bill ( HB 1150 ) that would make the state the first in the nation to prohibit pharmacy benefit managers from operating retail pharmacies. A spokesman for...

MT Targets Insurers’ Use of AI Montana’s House Committee on Business and Labor held a public hearing last week on a bill ( HB 556 ) that would regulate the use of artificial intelligence in healthcare utilization review and management. Among...

CA Bill Focuses on Mental Health of Wildfire Victims A bill ( AB 1032 ) introduced in the California Assembly would require healthcare service plans and insurers to reimburse enrollees or insureds who live in a county where a state or local emergency...

AR Lawmakers Considering Aggressive PBM Regulation A bill ( HB 1150 ) under consideration in the Arkansas House may be the most aggressive effort to regulate pharmacy benefit mangers yet. The measure would bar PBMs from owning pharmacies, potentially...

More PBM Regulation Under Consideration in IA After passing pharmacy benefit manager regulations last year, Iowa lawmakers are considering a pair of bills ( HSB 99 and SSB 1074 ) that would require all prescription drug contracts to use a pass-through...

Lawsuit Accuses GoodRX, PBMs of Price-Fixing A proposed class action lawsuit filed in federal court in California alleges online prescription drug price comparison platform GoodRx and several pharmacy benefit managers, including CVS Caremark and Express...

AR Looks to Bar PBMs from Owning Pharmacies Arkansas Rep. Jeremiah Moore (R) has introduced a bill ( HB 1150 ) that would prohibit pharmacy benefit managers from owning pharmacies. Moore said the noncompetitive practice raises drug prices. ( ARKANSAS...

New MA Law Increases Oversight of Private Equity Investment in Healthcare Massachusetts Gov. Maura Healey (D) signed a bill ( HB 5159 ) expanding oversight of private equity investment in the healthcare sector. The law is the first in the nation to...

Telemedicine Still ‘Critical Focus’ for State Lawmakers: This year states passed at least 176 bills that adjust existing laws to accommodate the higher demand for telehealth services since the Covid-19 pandemic. That total roughly equals the...

Nursing Home Industry Pushing for Repeal of Nurse Staffing Mandate With President-elect Donald Trump returning to the White House next year, the nursing home industry has been ramping up its efforts to kill the Biden administration’s new nurse...

Federal Regulators Move to Block UnitedHealth Acquisition of Amedisys The U.S. Department of Justice and Democratic attorneys general of Illinois, Maryland, New Jersey and New York filed an antitrust lawsuit aimed at blocking UnitedHealth Group from...

Big Changes Ahead for Obamacare? During his campaign President-elect Donald J. Trump said he had the “concepts of a plan” to replace the Affordable Care Act, which he attempted to kill in his first term. But with Republicans likely to control...

Insurance Coverage for Speech Therapy Developing Legislative Trend? Pennsylvania became the second state to enact legislation ( HB 2268 ) requiring health insurers to cover speech therapy for children who stutter. The bill’s sponsor, Rep. Brandon...

MI Addresses Multiple Healthcare Issues Gov. Gretchen Whitmer (D) signed over half a dozen bills dealing with healthcare and family support. The measures include SB 790 and SB 791 , allowing home help caregivers to unionize, and SB 929 , increasing...

CA Enacts Guardrails for Use of AI in Healthcare California Gov. Gavin Newsom (D) signed a pair of bills making the state one of the first to establish guardrails for the use of artificial intelligence in healthcare. One of the measures ( SB 1120 )...

AI in Healthcare Bills Awaiting Gov’s Action in CA California could soon establish new guardrails for the use of artificial intelligence in healthcare with a pair of bills awaiting action by Gov. Gavin Newsom (D). One of the measures ( SB 1120...

CA Nears Restricting Private-Equity Healthcare Acquisitions The California Legislature passed a bill ( AB 3129 ) that, if signed by Gov. Gavin Newsom (D), would require the state attorney general’s approval before a private equity group or hedge...

CA Lawmakers Pass PBM Legislation California joined a nationwide movement to tighten restrictions on pharmacy benefit managers with the approval of SB 966 days before adjourning its legislative session on Aug. 31. If signed by Gov. Gavin Newsom (D)...

MA Expands Access to Maternal Health Care Massachusetts Gov. Maura Healy (D) signed legislation ( HB 4999 ) expanding access to maternal health services in the state. Among other things, the measure provides for the licensing of midwives—reducing...

Provide your health system clients with a form policy and procedure document addressing both formal and informal government requests (e.g., from law enforcement). Ensure your clients and their workforce members comply with requests from government entities...

Bill Regulating PBMs Nearing Passage in CA California lawmakers are on track to pass a bill ( SB 966 ) in the coming weeks regulating pharmacy benefit managers. The measure would prohibit PBM practices as steering patients to PBM-affiliated pharmacies...

Provide guidance on the process for handling complaints and grievances filed by individuals who are covered under commercial health insurance policies. Better understand your client's obligations in the context of complaints and grievances, the structure...

Provide this HIPAA Special Enrollment Rights Notice to your employees who have become eligible to participate in your group health plans subject to the Employee Retirement Income Security Act (ERISA). Comply with ERISA by notifying your employees of their...