5 Things Virginia: Q&A w/Karen Kimsey, Drug pricing bill, “Chronic COVID”

We are building towards our 2021 Virginia State of Reform Health Policy Conference coming up on April 29th. We release our Topical Agenda in two weeks so you can see what we have teed up for you after the session is done and put to bed.

Early Bird registration ends in two days for the event. So, if you know you want to be with about 300 of your closest friends in Virginia health care, virtually of course, we’d be honored to have you sign up to be with us on April 29th!

 

 

 

 

With help from Emily Boerger

1. Q&A: Karen Kimsey, DMAS Director

Karen Kimsey, Director of the Virginia Dept. of Medical Assistance Services, recently joined me for a conversation on lessons learned during the COVID-19 pandemic, the next steps for improving the safety net, and DMAS’s plans to get beneficiaries vaccinated. She also described a recent health issue that brought her in direct contact with the challenges of a health care system she helps maintain and regulate.

Kimsey says her health experience has made her even more passionate about making sure people are able to access coverage. But she says, “It is not only being able to gain access to health coverage, but it’s also the ability to use the coverage, knowing what to do, and being able to advocate for yourself.”

 

2. Committee hears bill on drug pricing

The Senate Education and Health Subcommittee on Health voted HB 2007 out of committee on Tuesday, a bill directing the DOH to enter into a contract with a nonprofit organization to collect and share prescription drug pricing information from every carrier, pharmacy benefits manager, and drug manufacturer. The bill was a topic of conversation at a recent Virginia BIO virtual luncheon where Scott Johnson, of Hancock Daniel and FirstChoice Consulting, discussed potential implications of the bill.

The bill passed without amendments though several people urged the committee to include changes that would speed up the bill’s timeline. Jill Hanken, of the Virginia Poverty Law Center, said the bill is an important first step towards addressing drug pricing but suggested asking participants to report three years of data instead of just one. The bill’s next stop will be to the full Senate for approval.

 

3. House & Senate pass competing budget plans

The House and Senate passed competing budget plans on Friday. The House version includes $3.4 million in general fund approps (GF) to provide paid sick leave for home health-care workers, $37 million GF to boost the reimbursement rate for home health-care workers, and $41.6 million GF to continue nursing home per diem payments and begin a value-based purchasing program.

The Senate version suggests using $108 million in newly available federal funds for the COVID-19 response. It redirects general funds to other priorities including personal care rates, reducing the developmental disability waiver waiting list, investing in local health districts, and providing additional support to Medicaid providers. On Monday, Gov. Northam announced better than expected revenues, with $730.2 million over the December 2020 forecast, giving legislators a little wiggle room as the find a compromise.

 

4. TCI highlights health equity priorities

Ashley C. Kenneth is the Senior Vice President for Policy and Legislative Affairs for the Commonwealth Institute for Fiscal Analysis (TCI). In a Q&A with reporter Shawna De La Rosa, Kenneth discusses health equity during the COVID-19 pandemic, the importance of health coverage, and the bills TCI is watching this year.

Kenneth says she is keeping her eye on a few pieces of legislation which will have significant consequences for equity in health care including HB 2124, which would allow for undocumented individuals to receive testing, treatment, and the COVID-19 vaccine. TCI also supports budget amendments 312#1h and 313#16h, to expand the prenatal/FAMIS MOMS Program, as well as amendment proposal 313#28h, which would increase the age that immigrant children are eligible for Medicaid from 19 to 21.

 

5. Implications of “chronic COVID”

I recently had the opportunity to speak with Dr. Chris Murray, Executive Director of the Institute for Health Metrics and Evaluations (IHME), where I learned something I didn’t know. Based on data from the Novavax COVID vaccine trial, being previously sick with COVID-19 appears to offer no protection from being infected with the new South African strain of the virus.

Without cross-variant immunity, Murray says this data indicates we may be moving to a “world of chronic COVID” where every winter we treat COVID as we do the flu. I outline three immediate things that may change for us in this column. Perhaps the most important is this: hospitals and their current FFS financing models are in trouble. Video of my full conversation with Murray is available here.