5 things Maryland: Q&A w / Dr. Margaret Moon, Spending Affordability Briefing, HCBS Rate Increases – State of Reform

With the Thanksgiving holiday this week, I would like to take a moment to say 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 Maryland or sponsoring our events, we appreciate you!

Thanks again and Merry Thanksgiving!

Emily Boerger
Managing editor
State of reform

Questions and Answers: Dr. Margaret Moon discusses vaccine distribution to children

Dr. Margaret Moon is the director of the Department of Pediatrics at Johns Hopkins University School of Medicine. In this Q&A, Moon discusses COVID-19 vaccine distribution plans for children, which include distribution to primary pediatricians’ offices, mobile clinics and pharmacies.

She also addresses parents’ vaccine problems. When thinking about rare side effects like myocarditis among children who received the vaccine, Moon says it is important for parents to look at the big picture. “[Myocarditis] was still very rare … But because people still care about vaccines, I think people focus on the risk of the vaccine and forget the risk of the disease itself. “

2. Healthcare Highlights in Affordable Orientation

Medicaid reimbursement rates, behavioral health, COVID aids and more are toughened up in Maryland’s budget plan for fiscal year 2023. The Department of Legislative Services’ Office of Policy Analysis released its Spending Affordability Briefing this month, outlining how the state could acquire funds ahead of the forthcoming legislative session.

The Office estimates that enrollment in Medicaid may decrease after the federal public health emergency ends, resulting in a decrease in the provider’s reimbursement rate. Potential funding allocations include $ 68.6 million to local health departments and an increase of $ 57.5 million to the Developmental Disabilities Administration.

Video: Bending the Rx cost curve

Improving the availability and affordability of biosimilars was a central topic of conversation on our latest virtual conversation “5 Slides: Bending the Rx cost curve”. Sarah Ikenberry at the FDA says biosimilars are underutilized due to lack of education and awareness from providers. A national survey from March 2021 showed that about half of the providers had no experience prescribing these types of medications.

Panelists also discussed challenges in terms of affordability, including limited transparency and the impact of PBM rebates. “We dehumanize treatment by bringing in too many middlemen, by putting extra costs on the people who are least privileged,” said Dr. Kashyap Patel at the Community Oncology Alliance. Video of their full conversation is available here.

4. MDH announces HCBS rate hikes

Earlier this month, the Department of Health announced Medicaid rate increases for Maryland’s home and community-based services (HCBS). The increases were the result of the state’s FY2022 budget law, which requires Medicaid to spend at least 75% of ARPA reinvestment dollars on one-time provider rate increases.

The rate increases include an increase of 5.5% for most providers of HCBS developmental disabilities, an increase of 5.4% for most providers of HCBS behavioral health and applied behavior analysis and an increase of 5.2% for long-term community service providers and support . The increased tariffs are aimed at services and providers eligible for the 10% improved federal match established through ARPA.

5. Gov. Hogan calls for rejection of BBB plan

The U.S. House passed President Bidens Build Back Better Act on Friday, sending it about $ 2 trillion in spending proposals to the Senate. A fact sheet from the White House says that through the law, 34,000 uninsured Marylanders would obtain health coverage and 53,300 would save hundreds of dollars a year on premiums. The plan also invests in affordable childcare, universal pre-K and workforce development.

Following its adoption, Governor Hogan described the bill as “nothing more than a ruthless bag of massive tax increases, Democratic Party wish list items and distributions to special interests,” and called on the U.S. Senate to reject the bill. For more details on the health-related provisions in the plan, be sure to check out State of Reform Columnist Jim Capretta’s latest piece.