ADEA State Update

Insurance Update - May 2018

(State Policy, Insurance, Medicare and Medicaid, ACA) Permanent link   All Posts

May2018InsuranceLouisiana’s HB 780 would create an independent review process for dental service claims made through Medicaid-managed care in the state. A dental claims review panel would be created in the Louisiana Department of Health comprising one representative from each dental coordinated care network; a number of dentist representatives equal to the number of representatives from dental coordinated care networks, nominated by the Louisiana Dental Association; and the dean of the Louisiana State University School of Dentistry or his designee. As of May 3, 2018, HB 780 was reported favorably by the Senate Committee on Health and Welfare and referred to the Legislative Bureau for review before returning to the Louisiana House of Representatives for final passage.

In California, AB 2517 sets a path for universal health coverage in the state. The bill would establish an Advisory Panel on Health Care Delivery Systems and Universal Coverage in the California Health and Human Services Agency and would require the advisory panel to develop a plan to achieve universal coverage and a unified publicly financed health care system. The bill would require the Secretary of California Health and Human Services to appoint members to the advisory panel, as provided, and would require the advisory panel to convene public meetings at least quarterly, beginning on or before March 1, 2019. As of May 1, 2018, the bill has been passed by the Committee on Health and referred to the Committee on Appropriations.

Colorado has a proposed amendment to Regulation 4-2-53 that would require health plans that offer embedded dental coverage to report network adequacy, meaning that a general dentist or other dental provider is accessible within a specific distance of travel from enrollees. A hearing was held on May 1, 2018, regarding this proposed rule change.

In California, SB 1008 would modify reporting requirements for health care service plans that include dental services, outlining deductibles, benefit limits, coverage, reimbursement levels, estimated annual out-of-pocket expenses, limitations, exceptions and waiting periods for the policy. As of May 1, 2018, SB 1008 was passed by the Committee on Health and referred to the Committee on Appropriations.

In South Carolina, H 5226 would require coverage of certain dental services for nursing home residents under the state’s Medicaid program. The bill text outlines the procedures that would be covered. On April 10, 2018, H 5226 was referred to the Committee on Ways and Means.

In New Jersey, a two-package bill seeks to institute a state individual mandate for insurance in response to the federal Affordable Care Act’s (ACA) individual mandate being essentially nullified. A 3380 would reestablish a “shared responsibility tax,” which would require state residents to obtain health insurance coverage or pay a fee—a requirement that essentially reflects the rules of the ACA as originally intended. Another bill, A 3379 would create a state reinsurance program, the Health Insurance Premium Security Plan, to bring stability to the state health insurance marketplace. On April 12, the substitute bill for A 3380, S 1877, passed both chambers.

In Minnesota, HF 4451 would establish a buy-in option for MinnesotaCare, the state’s Medicaid program. The state commissioner of human services would be instructed to pursue a federal waiver to allow state residents to use advance premium tax credits and cost-sharing reductions and purchase MinnesotaCare coverage through the MNsure insurance marketplace website, alongside commercial health plans. The buy-in option would be funded through surplus funds in the Minnesota premium security plan and/or the premium subsidy program. As of April 23, this bill has been referred to the House Committee on Health and Human Services Reform.

Duggan Dental