Our legislative rep Dave Renner, CAE, shares the latest health-care-related updates from the Minnesota Legislature, including:
- support for primary care payment reform and improving how health care payment information is collected in Minnesota;
- movement on legislation banning conversion therapy;
- the introduction of legislation to lower the age pharmacists can administer vaccinations;
- movement on a bill prohibiting race or ethnicity from being used as factors for organ transplant decisions; and more.
Support for Better Data on Health Care Payments
The Minnesota Academy of Family Physician’s (MAFP) top legislative priority in 2022—to improve the data collected on how health care is paid—was heard by the House State Government Finance and Policy Committee on Friday, March 11, 2022. MAFP President Deb Dittberner, MD, MBA, testified in strong support of the bill (HF 3696).
Minnesota’s All-Payer Claims Database collects payment information from insurance claims from all payers for research to better understand how health care is paid. However, it is missing a large portion of payments, as reimbursements for non-claims-based/value-based payments are not included in insurance claims.
In her testimony, Dittberner stressed the importance of value-based payments to support primary care services. “There are several non-claims-based payments that affect the way that I, as a physician, and others in my practice provide care for patients. Value-based payments support physicians in taking on patients with increased complexity, such as multiple chronic diseases, which take more time and effort outside of routine office visits to effectively manage their diseases, ” said Dittberner.
Learn more about HF 3696 and how it will help provide a more complete picture of health care spending in our state and help inform any next steps on health care payment reform.
Because the committee did not receive the correct version of the bill, they did not take action. The next step for the bill is the House Judiciary Finance and Civil Law Committee to deal with data privacy provisions.
The MAFP remains optimistic that the bill will move forward and pass this session.
Bill to Ban Conversation Therapy Passes House Committee
The Preventative Health Policy Division of the House Health Finance and Policy Committee met on March 2, 2022, to hear HF 2156 (author: Representative Athena Hollins, DFL—St. Paul), a bill banning conversion therapy in Minnesota.
Specifically, the legislation prohibits “conversion therapy” for children and vulnerable adults, defined as a practice “that seeks to change an individual’s sexual orientation or gender identity, including efforts to change behaviors or gender expressions or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same gender.” It also prohibits medical assistance coverage and misrepresentation of conversion therapy services or products.
Many state and national medical organizations have stated that there is no medical basis for conversion therapy and it can be harmful to those who experience it.
The bill was passed by the division and referred to the House Health Finance and Policy Committee. The bill has not received a committee hearing in the Senate.
Proposal to Lower the Age of Vaccinations Administered by Pharmacists
Legislation to lower the age that pharmacists are allowed to administer vaccinations was introduced last week.
HF 4009 (Representative Kristin Bahner, DFL—Maple Grove) would change current law—that allows pharmacists to administer influenza and COVID-19 vaccinations to children over the age of 6 and all other vaccinations to individuals over the age of 13—to allow pharmacists to administer all vaccinations to anyone over the age of 3.
Lowering the age could reduce annual well-child visits for children over the age of three by removing a reason to see a physician for vaccines. These well-child visits are critical to the health and well-being of Minnesota’s children. Any decrease in well visits may lead to less child health screenings in areas such as growth, development, hearing, vision, blood pressure, vaccination history and more.
The bill also raises patient safety concerns about whether pharmacists are trained to address the potential adverse outcomes that may occur with some childhood vaccines.
HF 4009 has not yet been given a hearing in committee. There is no Senate companion bill.
Bill Prohibiting Race/Ethnicity as Factors in Organ Transplant Decisions Passes House Committee
HF 3972 (author: Representative Ruth Richardson, DFL—Mendota Heights) passed the House Judiciary Finance and Civil Law Committee unanimously on March 10, 2022, and was referred to the House floor. The legislation would prohibit race or ethnicity from being used as factors for organ transplant decisions.
“The organ donation system has been failing patients of color through every phase of the process,” noted Richardson during the committee hearing, “From getting on the wait list, to finding a match, to getting a donor, patients of color in need of transplants experience different treatment in a system rooted in inequity.”
Prohibiting discriminatory practices regarding access to organ transplants is an important step in addressing health disparities in Minnesota, which has some of the greatest racial health disparities in the country.
House and Senate Committees Pass Separate Reinsurance Bills
A bill to continue the state’s reinsurance program for individual insurance products through the 2023 benefit year passed both Senate and House committees last week.
In the Senate, SF 3472 (author: Senator Gary Dahms, R—Redwood Falls) passed the Senate Health and Human Services Finance and Policy Committee; and, in the House, HF 3717 (author: Representative Zach Stephenson, DFL—Coon Rapids) passed the House Health Finance and Policy Committee.
The reinsurance program is designed to reduce the cost of premiums for those purchasing coverage in the individual market. It is funded with both federal and state money and has subsidized insurers by paying a portion of medical bills over a certain threshold. Minnesota’s reinsurance program is scheduled to end when we reach the end of a five-year waiver we received from the Centers for Medicare and Medicaid Services (CMS). The waiver can be renewed through action by the Legislature.
The Minnesota Council of Health Plans, Minnesota Chamber of Commerce and Minnesota Business Partnership strongly support the continuation of the program. Several organizations representing serious, acute and chronic health condition groups also testified in favor, citing reduction of health care premiums and the increased number of individuals obtaining health insurance through the individual market.
Opposition to the bill has come from SEIU Healthcare Minnesota, Minnesota Nurses Association, TakeAction Minnesota and The Land Stewardship Project, who argued that reinsurance is an insufficient tool to control health insurance premiums and it provides large subsidies to insurers without requiring appropriate coverage.
The bills have significant differences, with the House including new coverage requirements for the individual and small-group markets. It also includes an amendment to study payment reform, including a public option.
The legislation will likely go to a conference committee for negotiations after each chamber finishes committee hearings and holding initial floor votes.
Bill to Limit Provider Termination Passes House Committee
The House Commerce Committee heard HF 1936 (author: Representative Carlie Kotyza-Witthuhn, DFL—Eden Prairie) that would prohibit health plans from terminating a provider from their network unless there was cause and require health plan companies to establish an appeal process for a provider whose contract is terminated.
Several groups testified in support of the bill, including the Minnesota Chiropractic Association, Minnesota Optometric Association and Minnesota Medical Group Managers. The Minnesota Council of Health Plans testified in opposition, noting that providers are not required to follow the same standard if they interfere with a patient’s contract. This bill would not apply to self-insured ERISA plans or Medicare.