Our legislative rep Dave Renner, CAE, shares an update on the health and human services budget agreement and areas we’ve been tracking (telehealth, expansion of Medical Assistance postpartum, tobacco prevention and more).
The Minnesota House and Senate finally reached agreement on the health and human services budget late last week; details were released on June 24, 2021.
Telehealth
Included in the final budget agreement is language to expand coverage for telehealth services for both private and public health plans, expanding the definition of “originating site” to require insurers to cover telehealth from wherever the patient is located (including the patient’s home). Under the old law, the patient had to be at a hospital or clinic to receive telehealth services.
The agreement also requires the coverage of audio-only services offered over the telephone for the next two years. This coverage is scheduled to sunset on July 1, 2023.
The sunset was included for two reasons:
- To allow more data to be collected on how telephone-only services meet patients’ needs and whether a similar quality of care can be provided without video.
- To not have to book the costs of the expanded coverage in the out-years (by having the coverage sunset at the start of the next fiscal year).
To gather additional data, the legislature directed the commissioners of health and human services to study the impact of telehealth expansion on access to care, health outcomes, patient satisfaction and innovation in health care delivery. They will also examine whether telehealth reduces health disparities and the impact of audio-only services on equity and health outcomes. The preliminary report is due to the legislature by January 15, 2023, including recommendations whether audio-only services should continue as a telehealth option.
Maternal Health
The final budget agreement includes expanding Medical Assistance coverage for pregnant persons to 12-months postpartum. For many pregnant patients, coverage stops after 60 days under the current law. This expanded coverage is an important step to address the health disparities that exist in maternity care.
The agreement also allocates money for the Dignity in Pregnancy and Childbirth Act, which requires hospitals with obstetric care and birth centers to develop or access a continuing education curriculum for direct care employees to address anti-racism and implicit bias. The curriculum is aimed at identifying cultural barriers to inclusion, corrective measures to promote anti-racism practices and addressing health disparities in perinatal care. The act also directs the Commissioner of Health to work with Black communities, Indigenous communities and other communities of color to promote racial, ethnic and language diversity in midwifes and doulas.
Tobacco Prevention
The final bill includes $4 million each year of new money for tobacco and vaping prevention and cessation programs. This new money is especially needed with the sunset of ClearWay Minnesota at the end of the year. While the final amount is lower than what the House originally proposed, it is ongoing funding (the Senate originally proposed funding for one year only).
Also, the final bill maintains funding for the Statewide Health Improvement Program (SHIP) that funds local counties and communities for programs to address smoking and obesity. In addition, grants for local public health agencies are increased by $15 million each year.
Human Herpesvirus Cytomeglovirus
The final bill includes increased funding for educational materials about human herpesvirus cytomegalovirus (CMV) for health care practitioners and expectant parents and directs the advisory committee to review congenital CMV for inclusion on the list of tests to be performed as part of newborn screening.
Mid-Year Formulary Changes
One important provision that was NOT included in the final bill was language to limit insurers and pharmacy benefit managers (PBM) from changing drug coverage during an enrollee’s contract year. The language would have prohibited insurers from forcing a patient who was using a medication to a new drug. This language was in the House version of the bill, but not included in the final agreement.