News

• As part of its approach to whole-person care, HHS expressed support for music and music therapy services and CMS clarified that these services can be covered by Medicare and Medicaid. As part of these efforts to expand whole-person care and access to music therapy services, SAMHSA announced its Art of Recovery Campaign that starts in 2024. Music therapy services are proven to help with pain management and stress reduction, and researchers are currently examining whether sound vibrations absorbed through the body can help alleviate the symptoms of Parkinson’s disease, fibromyalgia, and depression (Inside Health Policy, December 29).

Federal Studies and Report

• On December 28, CMS released the updated enrollment numbers for Medicare, Medicaid, and CHIP. As of September 2023, CMS data revealed the following:
  • 66,472,325 individuals are enrolled in Medicare, this is an increase of 134,147 since the previous reporting period.
    • 33,990,369 are enrolled in original Medicare.
    • 32,481,956 are enrolled in Medicare Advantage or other health plans and includes enrollment with and without prescription drug coverage.
    • 52,204,330 are enrolled in Medicare Part D and includes enrollment in stand-alone prescription drug plans as well as Medicare Advantage plans that offer prescription drug coverage.
    • More than 12 million individuals are dually eligible for Medicare and Medicaid and are counted in the enrollment figures for both programs.
  • 88,414,773 individuals are enrolled in Medicaid and CHIP, a decrease of 1,593,385 since the previous reporting period.
    • 81,408,432 are enrolled in Medicaid.
    • 7,006,341 are enrolled in CHIP.

CMS also included its quarterly MAGI report and unwinding data information in the bulletin (Medicaid.gov, December 28).

17 States Update Healthcare Laws for 2024

• Seventeen states have healthcare laws that are taking effect in 2024. These laws cover key issues like reproductive care, patient documentation, wages, and reimbursement. Below are some of the laws taking effect:

California

• • Some laws have been updated and some new laws include the following:
    • Borderline personality disorder has been added to the list of mental illnesses that make an individual eligible for pretrial diversion (avoidance of jail time if charged with a non-violent offense). Previously, the list was limited to bipolar disorder, schizophrenia and post-traumatic stress disorder.
    • Providers who distribute mail-ordered abortion pills or perform gender-affirming treatment are provided new protections.
    • Physician assistants are allowed to provide surgical abortions without direct physician supervision.
    • The minimum wage for healthcare workers, including nursing assistants, medical technicians and janitorial staff, will be raised to $23 per hour June 1 and  will reach $25 per hour by 2026.

Minnesota

• • Healthcare facilities that earn average annual revenue between $10 million and $80 million must notify the state health department of upcoming mergers or acquisitions. The state plans to use the information to track the number of transactions in the state and how they might affect access, cost and quality of care services. However, the health department and attorney general are not permitted to stop a merger or acquisition.

The state also updated laws concerning contraceptive care and doula-related services:

• • • Hospitals and primary care providers must provide MinnesotaCare enrollees with comprehensive and scientifically accurate contraception options.
    • Health plans are required to cover contraceptive care with no cost-sharing or referral requirements.
    • The state’s Medicaid and MinnesotaCare programs must reimburse hospitals separately for long-acting, reversible contraceptives, such as an IUD, given immediately after birth in an inpatient hospital setting.
    • Medical assistance and health plans are required to provide a year’s supply of any prescribed contraceptive.
    • Doula services reimbursement increased to $100 per prenatal or postpartum visit and to $1,400 for services provided at birth.

Nebraska

• • Medicaid postpartum coverage has been extended to 12 months, from 60 days.

Pennsylvania

• • Insurers are required to have a communications network for prior authorization requests to be submitted and returned electronically.

Rhode Island

• • Properly trained pharmacists can prescribe and dispense hormonal contraceptives.

Texas

• • Health insurers must create and maintain websites where providers can verify if patients are covered by the issuer and see a patient’s potential deductible, copayment or coinsurance.

Utah

• • Healthcare employees are eligible to receive mental health treatment coverage from an out-of-network mental health provider on a one-time basis as part of their health benefit plan. (Modern Healthcare January 2).

News

• Hospital merger and acquisition (M&A) activities are expected to grow in 2024 due to financial pressures, the combining of competitors, and growth of insurers. It is not estimated that these M&A activities will reach pre-pandemic levels, but cross-market health system combinations are becoming more common and are expected to continue. Key factors influencing these activities include labor costs, growth of primary care companies, and increasing training opportunities at community hospitals that are available to medical students (Modern Healthcare, December 26).

• With nearly 20 years of experience in strategic policy development, Managing Director of Sellers Dorsey, Jennifer Duffy, brings a wealth of knowledge to the Firm’s state-based New Jersey practice. We recently sat down with Jennifer to ask about her experience and the work she does each day to enhance healthcare quality, equity, and access for underserved populations. Click here to read our Q&A with Jennifer.
• Thanks to our readers’ constructive feedback, we’re thrilled to introduce our newly designed Sellers Dorsey Digest coming next week. Bringing you the latest news in Medicaid and healthcare all in one place, the Digest has a new look with the same timely insights to keep you informed. Thank you for your continued readership and we hope you enjoy our new design!