National – WTW and Riskonnect announced a partnership to pilot a new Risk Diagnostic Tool. Risk Diagnostic Tool will connect claims and exposure data.
Workers’ Compensation Research Institute (WCRI) released an updated version of its 16th Edition Free Medical Price Index for Workers’ Compensation. This study aims to provide comparisons from 2008 – 2023 of prices paid for medical professional services across 36 states.
Connecticut – Late last week, Governor Ned Lamont signed HB 5279. As a reminder, HB 5279 would expand workers’ compensation to include deaths or disabilities resulting from a cerebrovascular incident or pulmonary embolism for firefighters or police officers and would expand the time when an officer or firefighter is considered in the line of duty to start 24 hours after attending training or engaging in duties.
Massachusetts – H945 has been gaining attraction in the House. The bill is bipartisan and currently has 28 cosponsors. If passed, the bill aims to implement prescription drug cost transparency and affordability. Specifically, the bill would require Pharmacy Benefit Managers (PBMs) to disclose their financial agreements and pricing practices.
H934 is currently in the House. H934 aims to provide compensation reform for Pharmacy Benefit Managers (PBMs). If passed, the bill would require PBMs to disclose their compensation structure and aims to enhance affordability by preventing unfair pricing practices from PBMs.
Louisiana – SB 444 was discussed in a hearing in the House Committee on Insurance this week. As a reminder, if passed SB 44 would not allow Pharmacy Benefit Managers (PBMs) to reimburse a pharmacy or pharmacists in Louisiana an amount less than the acquisition cost for the covered drug.
Massachusetts – Two Massachusetts bills of note are currently in the House:
Minnesota – Five Democratic State Representatives (Steve Elkins, Robert Bierman, Andy Smith, Kristin Bahner, Peter Fischer) introduced recently introduced two bills regarding Pharmacy Benefit Managers (PBMs).
- HF5469 would require both PBMs and health carriers to include lower-cost drugs within their formularies, formulary structure, and formulary tiering.
- HF 5470 would establish PBMs’ general reimbursement practices, update the maximum allowable cost pricing requirements, and modify the PBMs business practices.
Missouri – State Rep. Deb Lavender is hoping to address public concerns related to PBMs cost, transparency, and access to prescription medications by introducing the following to the bill late last week:
- HB 2424 would prohibit public funding of PBMs.
- HB 2425 would create provisions related to PBMs. Specifically, the bill states that PBMs cannot reduce any reimbursement payment to a pharmacist or pharmacy for a prescription drug’s ingredient cost or dispensing fee if the pharmacist or pharmacy submits a reimbursement claim at least 60 days after the fulfillment.
New Jersey –
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- A1899 would expand pharmacy technicians’ authority. If passed, the bill would allow pharmacy technicians to administer drugs and vaccines (specifically COVID-19 vaccine).
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- S1192 would require prescription drug coverage for serious mental illness without prior utilization or authorization management. According to the bill text, serious mental illness would include: bipolar disorders (including hypomanic, manic, depressive, and mixed), depression, major depressive disorders, obsessive-compulsive disorders, paranoid and other psychological disorders, schizo-affective disorders, as well as schizophrenia and PTSD.
Tennessee – Tennessee Bureau of Workers’ Compensation announced its 2024 Annual Report. The report covers the impact of reforms from the 2013 Workers' Compensation Reform Act.
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