Support for the model legislation is not universal. The California Health Benefits Review Program (CHBRP) presented an opposition to the model language, along with a veto letter from California Gov. Gavin Newsom. Both detail the potential increased costs of the proposal and estimate that the legislation could require coverage for more than 500 tests that are not currently supported by clinical guidelines. Gov. Newsom’s letter asserted that tests supported by clinical evidence are already covered by California health plans.
The consideration of biomarker testing model legislation is especially timely. A number of states are considering legislation this session. NCOIL is scheduled to vote on the model language at its summer meeting in July. As states continue to take up this issue, NCOIL’s model will have a great deal of influence moving into the next legislative year if it is ultimately approved.
Hospital Price Transparency
The pricing transparency movement is beginning to move beyond just PBMs. In Florida, Gov. Ron Desantis’ proposed drug pricing legislation is taking aim at manufacturer pricing transparency. In another expansion of price transparency, the Health Insurance and Long-term Care Issues Committee discussed draft language of NCOIL’s proposed hospital price transparency model.
The model bill would require hospitals to maintain a price list for standard fees, such as supplies, procedures, room and board and facility fees. The idea behind this model bill is to promote competition among facilities to lower costs and fees. Although the model language limits these reporting requirements to hospitals, we will closely monitor state legislation to see if there are efforts for those requirements to expand beyond hospitals. Although there will likely be very little impact on rheumatology from this model bill, it is important to be aware of these efforts because they may eventually creep over to impact other clinics and facilities.
This model legislation will also be eligible for approval at NCOIL’s summer meeting. The ACR will continue to watch this and other transparency issues moving forward to ensure they do not negatively impact our members.
Wrapping Up
The issues considered at the spring meeting underscore the importance of the ACR’s partnership with NCOIL. NCOIL is a unique and bipartisan organization that gives the ACR the opportunity to discuss health policy solutions in the early stages of development. Having the provider voice represented at this forum is invaluable, and the ACR appreciates the opportunity to work with and support the work of NCOIL. To learn more, you can access most of the meeting presentations online.
