Regulatory Activity in Two States Restricts How Plans Structure Specialty Drug Coverage

Two state insurance regulators, Florida and Montana, have taken recent regulatory action to address concerns raised by advocacy groups about the way specialty drugs are covered in pharmacy benefit plans offered in their states. Sally McCarty provides details of those actions and related updates on the oversight of discriminatory benefit designs. Continue reading

New Issue Brief Examines Specialty Drugs in Tiered Pharmacy Benefit Structures

Health plans have been increasingly using tiered pharmacy benefit designs. These new designs raise challenges for consumers and the state insurance regulators responsible for reviewing and approving plans for sale. CHIR faculty members Sally McCarty and David Cusano explore these issues in a new brief for the Robert Wood Johnson Foundation’s State Health Reform Assistance Network. Continue reading

Back in the Day – Lessons from Pre-reform Days: Death to the Death Spirals

While we’re struggling with Affordable Care Act (ACA) issues, there’s value in taking the time to look back and appreciate the impact of the ACA and other healthcare reforms implemented over the past few decades. To that end, CHIR faculty member and former Indiana Insurance Commissioner Sally McCarty is posting a series called “Back in the Day – Lessons from Pre-reform Days.” This installment looks at policies in a “death spiral.” Continue reading

Sebelius Will Be a Tough Act to Follow

Secretary Sebelius will soon be stepping down as head of the U.S. Department of Health and Human Services. She led the agency through an extraordinary time of health system transformation. One person who knew she would be up to the job – and who knows she’s a tough act to follow – is her former insurance commissioner colleague, Sally McCarty. In this post, Sally looks back at her two decades of working with Sebelius and celebrates the tenure of a remarkable Secretary. Continue reading

More New Resources Available to State Regulators

A set of new tools for state insurance regulators, as well as updated versions of some older resources, have recently been posted on the Robert Wood Johnson State Health Reform Assistance Network (State Network) web site. CHIR faculty Sally McCarty, David Cusano, and Max Farris, who serve as technical assistance professionals (TAPS) in the State Network Program, developed the new resources. Sally McCarty describes them here and provides information about an upcoming Webinar to introduce them and demonstrate their use. Continue reading