From expansions of Medicaid to include noncitizens to a requirement to cover fertility care, these are seven recently passed state laws that affect payers.
Gov. Doug Ducey signed legislation May 5 requiring payers to cover biomarker testing for cancer patients when there is a clinical need. The coverage requirement begins in 2023 and only applies if the biomarker is recommended by the FDA, CMS or nationally recognized clinical practice guidelines. Arizona joins just a handful of other states that require insurance plans to cover biomarker testing.
Gov. Janet Mills signed legislation May 2 that requires insurance companies to cover fertility care starting in 2024. The new law will also prohibit payers from implementing waiting periods before members can seek fertility care.
Lawmakers in California, Illinois and Connecticut have recently acted to expand Medicaid coverage to noncitizens. California opened its Medicaid program eligibility to noncitizens over 50 starting May 1. The Illinois General Assembly sent Gov. J.B. Pritzker a bill April 20 that will expand Medicaid coverage to noncitizen residents 42 and older. On May 3, Connecticut lawmakers sent a state budget proposal to Gov. Ned Lamont that would expand Medicaid eligibility to children 12 and under whose parents meet the income criteria, regardless of immigration status.
Gov. Ron DeSantis signed legislation April 8 that bans payers from altering health coverage policies of organ donors. Under the new law, payers cannot raise members' premiums, deny or limit coverage, or cancel the policy or parts of the policy based on the fact that a Florida resident has donated an organ. The legislation also applies to life insurance, disability insurance and long-term care insurance plans and takes effect July 1.
Payers in Colorado are being required to collect demographic data voluntarily given by network providers, including data on race, ethnicity, disability status, sexual orientation and gender identity. Under a state rule that took effect March 2, payers are required to collect "demographic data voluntarily submitted by network providers and their front office staff for the carriers' Colorado Option standardized plans." A state law passed last year requires payers to offer the "Colorado Option" plan on the ACA marketplace. Though the law is in effect, Colorado Option plans won't become available until Jan. 1, 2023.