5 Things in Virginia: Public Comments on Reinsurance Waiver, Paid Family and Medical Leave Bill, Profitability – State of Reform

With the Thanksgiving vacation next week, I wanted to take a moment to thank you on behalf of the entire State of Reform team for your continued support. Whether it’s attending our conferences, reading our coverage of health care and health policy in Virginia, or sponsoring our events, we appreciate you!

Thanks again and happy Thanksgiving!

Emilie Boerger
State of reform

1. End of the reinsurance public comment period

The public comment period for Virginia’s proposed Section 1332 waiver request, which would establish a state-based reinsurance program, ended on November 1. Several organizations, including Kaiser Permanente and CareFirst Blue Cross Blue Shield, submitted statements supporting the goals of the reinsurance program, but highlighted potential areas for improvement, particularly related to the uncertain impact of federal programs.

Kaiser was particularly concerned on the uncertain ‘future of the federal premium subsidy landscape’ and how this might impact the request for exemption. They also suggested that the Bureau of Insurance perform actuarial analyzes to assess potential overlap costs for “high risk” members of the state reinsurance program and the state reinsurance program. federal risk adjustment program. The BOI has until January 1 to implement the final changes before submitting the project to CMS.

2. Boysko files an invoice for family and medical leave

The first pre-deposited invoice for Virginia’s 2022 legislative session would guarantee up to 12 weeks of paid family and medical leave for caregivers across the Commonwealth. Senate Bill 1, which Senator Jennifer B. Boysko introduced on Monday, would allow caregivers on leave to receive up to 80% of their average weekly salary, starting two weeks after filing a claim.

The bill would apply to caregivers of new children and family caregivers who treat critically ill people, among others. The invoice summary Says: “Funding for the program is provided through assessed bonuses to employers and employees starting in 2024.” A recent survey found that 73% of Virginians support paid family leave for caregivers, and 82% support the granting of a tax credit to eligible caregivers to offset expenses.

3. Video: Curve the Rx Cost Curve

Improving the accessibility and affordability of biosimilars was a key topic of conversation during our recent “5 Slides: Bending the Rx Cost Curve” virtual conversation. Sarah Ikenberry of the FDA says biosimilars are underused due to a lack of education and awareness from suppliers. A national survey in March 2021 found that about half of providers had no experience prescribing these types of drugs.

Panelists also discussed affordability challenges, including limited transparency and the impact of PBM discounts. “We are dehumanizing treatment by involving too many intermediaries, imposing additional costs on the less privileged,” said Dr Kashyap Patel of the Community Oncology Alliance. The video of their full conversation is available here.

4. Five Top 50 Most Profitable Virginia Hospitals

Five Virginia hospitals are among the 50 most profitable hospitals in the country, according to a recent analysis of the Low Institute. The analysis assessed health outcomes against Medicare costs for more than 3,000 hospitals nationwide.

Inova Alexandria Hospital ranked first in the Commonwealth and 15th overall for cost effectiveness, although it ranked near the bottom of the state (67th out of 76 hospitals) on pay equity measures . Four other Virginia facilities are in the top 50: Inova Loudoun Hospital (29), Sentara Princess Anne Hospital (31), Southside Community Hospital (36), and Inova Mount Vernon Hospital (38).

5. Health provisions in the revised BBB plan

With the release of President Biden’s cut “Rebuild betterState of Reform columnist Jim Capretta broke down some of the health policy elements that have made their way into the President’s updated National Program. The revised BBB plan includes Medicare coverage for hearing services and a permanent increase 6 percentage points of the federal match rate for states offering HCBS services that meet new national standards.

Capretta’s latest column also delves into the details of the home version plan and its provisions that attempt to close the coverage gap. He writes: “People who are now not eligible for both Medicaid and ACA grants would be enrolled in private plans offered on the scholarships, with the federal government paying the full cost of their premiums and most of their cost sharing.” also. “