Legal, healthcare trends impact Arizonans

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This year a significant of legal/healthcare/insurance trends are emerging that will impact many Arizonans. Attorney Heather Macre from Fennemore, joined Arizona Horizon to discuss these trends.

Telehealth is thriving, but privacy violation enforcement actions are likely to resume as the COVID-19 emergency wanes. Cross-state Telehealth may not be permitted as freely. At the same time, the DEA is taking steps to help Telehealth providers prescribe drugs, including scheduled narcotics, more freely.

“Healthcare costs generally are rising, just like everything else, they are responding to inflation,” said Macre. Healthcare costs are going back to their pre-pandemic levels, higher than what it is currently.

Macre tells us what mental health will rise in importance as an overall component of healthcare and we are likely to see broader health insurance coverage and a move towards mental health parity.

Regarding insurance and mental health, Macre said mental health is starting to transfer over to insurance coverage.

“We have some federal laws now that are looking to ensure that. We have some acts that are dealing with parity for mental health payments and also substance use disorder payments,” said Macre. “The Federal Government has set aside $125 million in an enforcement fund that can be used to make sure that these claims are being paid on par with physical health claims.”

We are also likely to see additional transparency reforms along the lines of the federal ban on surprise medical billing, and increased review of prescription data collection reporting.

“We are also seeing an increased government view of transparency, particularly in the pharmacy and prescription areas,” said Macre. “Hopefully we can counter some of these rising costs with some controls on pharmacy benefits and prescription drug pricing.”

The Affordable Care Act will be implementing changes to the special enrollment period (“SEP”) that may impact many marketplace plans. Starting in 2023, HealthCare.gov will only require pre-enrollment verification for SEPs due to loss of other prior coverage. For other qualifying events (marriage, divorce, permanent move, etc.) people will be able to self-attest their eligibility and proceed to enroll in coverage during their SEP.

Heather Macre, Attonrey, Fennmore

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