From California's ban on all abortion fees from payers to a national cap on insulin, here are five recently passed bills that affect insurers:
Michigan reforms prior authorization: The Michigan Legislature passed a bill March 24 that requires payers to publish prior authorization requirements on their website, including aggregated information about prior authorization approval and denials. Individuals with a financial stake in the outcome of prior authorization decisions are banned from the decision-making process. Urgent and nonurgent prior authorization requests must be acted upon in a timely manner. Clinicians and patients must be properly notified of new or amended prior authorization requirements. Payers must base their prior authorization requirements on clinical, evidence-based criteria established with input from practicing physicians.
California bans payer abortion fees: Gov. Gavin Newsom signed legislation March 22 that bans payers from charging any out-of-pocket costs for abortion services, including copays, deductibles or other cost-sharing requirements. The also prohibits payers from imposing utilization management practices on covered abortion and abortion-related services.
U.S. House passes insulin cap: A bill capping the consumer cost of insulin at $35 per month passed the House of Representatives March 31. Senate Majority Leader Chuck Schumer is proposing a compromise bill that would roll back insulin costs to 2006 levels and ban rebate payments for insulin to pharmacy benefit managers.
Congress extends telehealth flexibilities: A March 10 omnibus spending bill allows employers to continue offering telehealth coverage to employees with health savings accounts before they meet an annual deductible. The bill also allows Medicare-enrolled providers to bill for telehealth services and cover telehealth visit costs for adults 65 and older and those that occur within a patient's home and in healthcare facilities.
Georgia enforces mental health parity: Gov. Brian Kemp signed a bill April 4 that increases enforcement of mental healthcare parity from payers and requires parity reports to the state.