Below is a round-up of payer-centric news for the week of Jan. 22, 2024
L.A. Care Health Plan offer PPE supplies to 10 California counties
A coalition of organizations are working together to address a shortage of personal protective equipment in the state that has existed since the start of the COVID-19 pandemic.
The group, which includes L.A. Care Health Plan, Inland Empire Health Plan and the Hospital Association, is called the Southern California PPE Consortium. Ultimately, the consortium hopes it will be able to create a local stockpile, once the "ordering volume reaches a sustainable level," according to a press release.
LA. Care Health Plan CEO John Baackes, one of the leaders spearheading this coalition, hopes raw PPE materials will be manufactured locally.
Ten Southern California counties will participate including Los Angeles, Ventura, San Bernardino, Orange, Riverside, San Diego, Kern, San Luis Obispo, Santa Barbara and Imperial.
Participating providers will sign a three-year letter of agreement.
New Jersey mandates infertility services coverage for LGBT+ community
A new bill requiring private health insurers to cover infertility services such as in vitro fertilization, intrauterine insemination, genetic testing and embryo transfers was recently signed into law by Governor Phil Murphy (D-NJ).
Perhaps most notably, the law does not allow coverage to be denied based on sexual orientation.
"There are many different paths toward starting a family, each defined by their own unique challenges and joys,” said Gov. Murphy in a statement. “For those who struggle with infertility and for same-sex couples, the possibility of starting a family is deeply impacted by the availability and accessibility of infertility care and other medical services that, without coverage, can be extremely costly."
The law received praise from groups such as the Planned Parenthood Action Fund of New Jersey, Garden State Equality Action Fund, the American Society of Reproductive Medicine and the NJ State Bar Association.
New Mark Cuban Cost Plus Drug Company partnership
Another company has been added to pharmacy benefit manager Liviniti's network, and this time it is Mark Cuban Cost Plus Drug Company.
"We are excited to join forces with a like-minded company such as Liviniti,” said Alex Oshmyansky, CEO of Cost Plus Drugs. “We are committed to revolutionizing the pharmaceutical landscape through transparent drug pricing and working with Liviniti aligns seamlessly with our mission. Together, we are ensuring affordability, accessibility, and clarity in medication costs, empowering individuals to make informed choices about their health and well-being."
Earlier this month, Liviniti and Noom partnered together. Liviniti utilizes a pass-through pricing approach rather than spread pricing or rebates, according to a press release.
Record number enrolled in Colorado Option plans
More than 80,000 people are now enrolled in Colorado Option, Colorado's public option insurance plans.
The figure marks a 188% increase from the 2023 open enrollment period. Public option enrollments now equal more than one-third of all enrollments during the open period.
“The reality is Coloradans chose the Colorado Option in record numbers for 2024, even while special interests continue to try to mislead Coloradans about the Colorado Option,” said Colorado Insurance Commissioner Michael Conway. “That means that once again, Coloradans are choosing the Colorado Option to save money and get a better health plan."
He said that in all 64 counties in the state, Colorado Option plans had the lowest or second-lowest costs.
In June 2021, the Colorado Option was enacted into law statewide.
Pilot project for prior auth. process launches
Velatura Public Benefit Corporation, an interoperability provider, and Spesana, Inc., a company seeking to improve patient care with a precision medicine platform, recently announced a new pilot project that attempts to revamp the prior authorization process for oncologists and specialty providers.
The two companies are seeking to reduce the time a patient has to wait for a prior authorization decision. Oncologists will use Spesana's platform to speed up the request and approval process, according to a press release. While the project is initially for oncologists, it could eventually be expanded for all prior authorization requests.
The new project will be deployed to 10 participants in Michigan and Missouri later this year.