News

Health Affairs Study Shows Variance in State Laws on Nurse Staffing Minimums

• An August 2024 Health Affairs study examines state legislation regarding nurse staffing minimums as of January 2024. The study found that 23 states do not have any statutes or administrative codes for these minimums and staffing minimum requirements in the remaining states vary widely. California and Oregon have the most detailed state policies and require specific staff-to-patient ratios for different hospital units. Arizona, Massachusetts, New York, Ohio, and Oklahoma only mandate ratios for one type of hospital unit. Eleven states have implemented staffing plans and eight states mandate nurse staffing committees. Five states without any staffing minimums have introduced legislation while Idaho has statutorily prohibited any minimum staffing ratios. However, in all states that require staffing minimums funding mechanisms are not addressed. According to the authors of the study, states should detail requirements on how funding should be acquired and spent to assist hospitals in reaching compliance with minimum staffing ratios. Last year, a bill introduced in the House by Democrats in the House Energy & Commerce Committee included minimum staffing ratios by hospital unit. CMS is currently embroiled in a lawsuit in Texas brought by the nursing home industry over the agency’s newly required staffing minimums, arguing that CMS overstepped its authority (Inside Health Policy, August 8).

Arkansas Fines Four PBMs Over Reimbursement Rates

• The Arkansas Department of Insurance is seeking to fine four PBMs for ignoring a state bulletin requiring PBMs to cease pharmacy reimbursements that are below national average drug acquisition costs. Caremark, Magellan, Express Scripts, and MedImpact may be liable for $5,000 per violation, amounting to $1.47 million. The Arkansas Insurance Commissioner and Governor have scheduled disciplinary action hearings relating to the fines, but no further information has been provided (Health Payer Specialist, August 9).

New York Governor Announces Recipients of Social Care Network Program Funding

• On August 7, New York Governor Kathy Hochul announced nine organizations statewide will receive a total of $500 million over the next three years to create a new Social Care Network (SCN) program as a part of its 1115 demonstration waiver, the New York Health Equity Reform waiver, approved by CMS in January. The SCN program is one component of a $7.5 billion three-year waiver with nearly $6 billion of federal funding to address health disparities in low-income communities by providing access to nutritional meals, housing supports, transportation, and other social services (Healthcare Innovation, August 9; New York State, August 7).

Florida Expected to Release Invitation to Negotiate for Children’s Medicaid Contract

• This week, Florida is expected to publish an Invitation to Negotiate for the Medicaid contract that covers individuals age 21 years and younger with medically complex diagnoses. The program provides services to approximately 87,500 enrollees, is worth approximately $2.1 billion annually, and is currently held by Centene’s Sunshine Health Plan. The current contract was procured in 2019 and expires in January 2025. There is no information available regarding how many health plans the state will award contracts or if any additional changes will be made to the contract (Health Payer Specialist, August 12).