5 Issues Virginia: Questions and Solutions with Karen Kimsey, Drug Value Accounting, “Power COVID” – Reform State

DJ Wilson | February 18, 2021

We are working on our 2021 health policy conference in Virginia, due on April 29th. We’re posting our current agenda in two weeks so you can see what we’ve put together for you after the session is over and put to bed.

Early bird registration ends in two days for the event. So, if you know you would like to be with approximately 300 of your closest friends in the Virginia Healthcare Industry, it would be a great honor for you to join us on April 29th!

With the help of Emily Boerger

1. Questions and Answers: Karen Kimsey, DMAS Director

Karen Kimsey, director of the Virginia Medical Assistance Division, recently interviewed me about the lessons learned during the COVID-19 pandemic, next steps to improve the safety net, and DMAS’s plans to vaccinate beneficiaries . She also described a current health problem that put her in direct contact with the challenges of a health system that helps her maintain and regulate.

Kimsey says her health experience made her even more passionate about making sure people had access to coverage. But she says, “Not only is it possible to get access to health insurance, it’s also an opportunity to use health insurance, know what to do, and stand up for yourself.”

2. Committee hears bill on drug pricing

The Senate Health and Health Subcommittee elected HB 2007 from the committee on Tuesday. This bill instructs the DOH to enter into a contract with a nonprofit organization to collect and share prescription drug pricing information from each carrier, pharmacy service manager, and drug manufacturer. The bill was a topic of conversation at a recent virtual lunch in Virginia BIO where Scott Johnson of Hancock Daniel and FirstChoice Consulting discussed the potential impact of the bill.

The bill passed without changes, despite several people asking the committee to include changes that would speed up the bill’s timetable. Jill Hanken of the Virginia Poverty Law Center said the bill was an important first step in tackling drug prices, but suggested asking participants to report three years of data instead of just one. The next stage in the law is approval by the entire Senate.

3. House & Senate pass competing budget plans

The House and Senate passed competing budgets on Friday. The House version includes General Fund Requests (GF) of $ 3.4 million for home care paid sick leave, $ 37 million for the home carer reimbursement rate increase, and $ 41.6 million for the care home continuation Payments per day and start a value-based shopping program.

The Senate version is proposing to use $ 108 million in newly available federal funding for the COVID-19 response. It directs general funding towards other priorities including personal care rates, reducing the waiting list for developmental disability waiver, investing in local health districts, and providing additional support to Medicaid providers. On Monday, Governor Northam announced better-than-expected revenue of $ 730.2 million compared to the December 2020 forecast, leaving lawmakers some leeway to find a compromise.

4. TCI highlights the priorities of health equity

Ashley C. Kenneth is Senior Vice President, Policy and Legislation at the Commonwealth Institute for Fiscal Analysis (TCI). In a Q&A with reporter Shawna De La Rosa, Kenneth talks about health equality during the COVID-19 pandemic, the importance of health insurance, and the bills TCI is watching this year.

Kenneth says she is keeping an eye on some laws that will have significant ramifications for health justice, including HB 2124, which would allow undocumented individuals to receive tests, treatments, and the COVID-19 vaccine. TCI also supports budget changes 312 # 1h and 313 # 16h to expand the antenatal / FAMIS MOMS program, as well as proposed change 313 # 28h, which changes the age at which immigrant children are eligible for Medicaid from 19 to 21 would increase.

5. Implications of “chronic COVID”

I recently had the opportunity to meet with Dr. Chris Murray, Executive Director of the Institute for Health Metrics and Assessments (IHME), speaking where I learned something I didn’t know. Based on data from the Novavax COVID vaccine study, a previous illness with COVID-19 does not appear to protect against infection with the new South African strain of the virus.

According to Murray, these data suggest that without cross-variant immunity, we are entering a “world of chronic COVID” where we treat COVID like the flu every winter. In this column, I outline three immediate things that can change for us. Perhaps most importantly, hospitals and their current FFS funding models are in trouble. The video of my full interview with Murray can be found here.

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