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New NASHP Model Legislation Helps States Bring Transparency to Pharmacy Benefit Managers

The National Academy for State Health Policy (NASHP) has released model legislation to help states shed light on the opaque business practices of pharmacy benefit managers (PBMs). States can use the model bill to require the licensing of PBMs, ban gag clauses that prevent pharmacists from sharing lower-price drug options with consumers, and require more […]

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  • #NASHPCONF18: State Policymakers Share Views on the Evolving Individual Insurance Markets
    State Health Policy Blog

    During NASHP’s 31st Annual State Health Policy Conference last week, experts and state officials assessed the dramatic sea changes that recent federal action has imposed on their individual health insurance markets, what they are doing to stabilize them, and what the future holds. Below, NASHP summarizes what panelists said about the current state of their […]

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  • State Lawmaker Will Guzzardi Plots His Next Move to Curb Generic Drug Price Gouging in Illinois
    State Health Policy Blog

    Earlier this year, Illinois state Rep. Will Guzzardi proposed an aggressive, anti-price-gouging bill that banned manufacturers from excessively hiking the costs of generic drugs sold to Illinois residents for his first foray into prescription cost control legislation. Guzzardi’s bill was one of a dozen anti-price gouging measures introduced in state legislature this year. The bill […]

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  • How States Address Social Determinants of Health in Their Medicaid Contracts and Contract Guidance Documents

    To encourage investments in population health, states are increasingly using levers available in their managed care and value-based contracts to address social determinants of health, such as housing and employment. With support from the Robert Wood Johnson Foundation, the National Academy for State Health Policy examined Medicaid contracts and contract guidance documents in 11 states […]

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  • Pharmacy Benefit Manager Model Legislation: Questions and Answers

    These questions and answers explain the role pharmacy benefit managers (PBM) play in the drug supply chain and highlight NASHP’s model PBM legislation that states can use to better oversee PBMs and protect consumers. What are pharmacy benefit managers? Pharmacy benefit managers (PBMs) contract with health plans to administer their pharmacy benefits. Depending what a health […]

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  • Medicaid and CHIP Levers to Promote Lead Screening and Treatment: Indiana’s Experience
    Publications

    Addressing lead hazards today generates future economic benefits and improved health outcomes for children. In partnership with the Health Resources and Services Administration, NASHP is publishing a series of case studies highlighting state initiatives to promote lead screening and treatment. This study explores Indiana’s efforts to address this issue within its Medicaid and Children’s Health […]

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  • Lower-Cost, Short-Term Insurance Plan Approved, But at What Cost to State Markets and Consumers?
    State Health Policy Blog

    Last week, the federal government released its final rule expanding the availability of short-term health insurance plans, which are usually less costly and do not have to cover pre-existing conditions or certain health care services. Increased enrollment in short-term plans is expected to upend states’ individual insurance markets unless states take steps to offset their […]

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  • State Strategies to Incorporate Oral Health into Medicaid Payment and Delivery Models for People with Chronic Medical Conditions
    Publications

    State health policymakers know oral health is an essential component of overall health and well-being, but state Medicaid programs face increasing costs and growing demands. Many of their enrollees struggle with high-cost, chronic conditions — often linked to oral health issues. To explore possible approaches to improve oral health care, NASHP interviewed key Medicaid officials […]

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  • Overcoming Payment Challenges to Realize the Promise of Telehealth
    State Health Policy Blog

    Telehealth– using telecommunications to improve patient care – has the potential to improve health care access and quality, especially in rural and medically-underserved areas. But inconsistent public and private insurance coverage and other challenges have hindered implementation of this promising health care tool. The National Academy for State Health Policy’s (NASHP) Patient-Centered Outcomes Research Workgroup […]

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    July 31, 2018 | Filed under: Front Page, State Health Policy Blog
  • Three-Part Series: Improving Care for People Living with HIV: Opportunities for State Medicaid-Ryan White HIV/AIDS Program Collaboration
    Publications

    States play critical roles in ensuring that people living with HIV (PLWH) have access to quality care through their Medicaid and Ryan White HIV/AIDS programs. PLWH can be among the most medically complex individuals covered by state health programs, and their care can cost five-times more than the average Medicaid beneficiary. Given limited resources, state […]

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