Health Care Legislative Update - March 26, 2024
This update covers key bills and concepts related to health care legislation, including the creation of Prescription Drug Affordability Board, updates to Cost Growth Benchmark Oversight, and expansion of reporting requirements for covered entities. The update also addresses hospital financial stability and outlines reporting obligations in detail.
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Presentation Transcript
Health Care Cabinet Legislative (Brief) Update March 26, 2024
Governor Bills (1 of 2) HB 5054 AN ACT ADDRESSING HEALTH CARE AFFORDABILITY. (Nothing came out of INS) 1 Creates a Prescription Drug Affordability Board (PDAB) 2 Defines FDA Breakthrough Drug and Orphan Drug 3 Outlines the PDAB powers 4 Establishes Cost Growth Benchmark Oversight Commission 5 Adds Performance Improvement Plan (PIP) to the CGB includes timelines and process. Allows OHS civil penalty as last resort. 6 Allows OHS to conduct Cost Market Impact Review (CMIR) for entities exceeding the CGB 7 Provides subpoena power to compel those who don t attend CGB hearing and can go to the Superior Court 8 Allows OHS to establish P&P while regulations are developed 9 Establishes affordability rate review process for OHS in consort with CID OHS conducts compliance review of insurance prior to rate review which OHS will send to CID. CID may consider in their rate review process.
Governor Bills (2 of 2) SB 9 AN ACT PROMOTING HOSPITAL FINANCIAL STABILITY. (JFS out of PH) 1-2 DPH expansion of civil penalty authority and ED diversion 3 Updates CON definitions of person and TOO to include public company and controlling interest 4 Removes CON for CT Scan; Adds TOO language 10% transfer of assets and 20% dividends, up to 12/31/25 keeps track of TOO for large group practice or health care facility via automatic issue of CON except for hospitals. Trying to assess how many TOO are out there. 5 Updates our CON criterion and allows P&P while regulations are developed. 6 Adds additional financial reporting requirements for hospitals 3
OHS Bills (1 of 2) 340B SB 241 (JFS out of PH) Outlines list of things that a covered entity would report to OHS including: A)aggregated acquisition cost for Rx; B) aggregated payment amount received for drugs and dispensed to patients; C) aggregated payment made to pharmacies under contract to dispense drugs; D) number of claims for Rx described in (B). Information must be reported by payer type (commercial, Medicaid, Medicare). Hospitals must also report at the National Drug Code level for the 50 most frequently dispensed drugs by the facility under the 340B program. Must include Rx dispensed by outpatient facilities that are identified as child facilities, based on their inclusion in the hospitals Medicare cost report. OHS shall produce and report on their website a report summarizing the info received from the covered entities required to file. APCD SB 242 (JFS out of PH) 1 removes language suggesting that hospitals need to receive APCD data prior to submitting their community benefits report data to OHS. 2 expands data collection by OHS to include non-claims data. 3. Outlines process and timeline for non-claims data reporting requirements.
OHS Bill Concepts (2 of 2) CON updates (HB 5316) (JF out of PH) 1. Definition of Large Group Practice 2. Definition of Group Practice 3. Increase reporting of group practices 4. Modify review of transfer of ownership of any large practice to any person . Require CON for proton radiotherapy machine. 5. Requires large group practices to report transfer of ownership and delays implementation of removing exemptions from CON requirements for such transfers of ownership until December 31, 2025. 6. Eliminate presumption in favor of CON application for transfer of ownership for large group practices. 7. Conforming amendment to align with removal of subdivision (b) in subsection 19a-639. 5
