In this month’s edition, you’ll find information and insight about upcoming Medicaid redeterminations, coverage of various healthcare-related legislation being considered in Denver, and an update on the work of the Prescription Drug Affordability Board. Thanks for reading! Eli Kirshbaum  State of Reform   1. Health leaders continue preparation for Medicaid redeterminations The federal Public Health … Read more

This edition includes coverage of a bill to prohibit Medicaid coverage of step therapy, a report showing the significant contribution Florida hospitals make to the state’s economy, and information about upcoming Medicaid redeterminations. Thanks for reading! Eli Kirshbaum State of Reform   1. Legislature looks to eliminate step therapy in Medicaid We’re monitoring the progress … Read more

On Feb. 20th, Florida’s Senate Committee on Health Policy unanimously passed Senate Bill 112, which seeks to remove step therapy protocols for Medicaid recipients for the treatment of serious mental illness (SMI).  Step therapy is a common insurance practice that establishes which prescription drugs and medical treatments are covered by insurance companies and programs like … Read more

A bill to ensure that a patient or physician’s appeal of a step therapy or prior authorization denial is reviewed by a specified clinical peer was enrolled and sent to Gov. Gavin Newsom’s desk on Aug. 31st.      Assembly Bill 1880, sponsored by Asm. Joaquin Arambula (D – Fresno), requires a health plan’s utilization … Read more