HHS Finalizes Rule on Discrimination in Healthcare

The Department of Health and Human Services (HHS) released a final rule on discrimination in healthcare on the basis of race, color, national origin, age, disability, sex, pregnancy, gender identity and sex stereotyping, under section 1557 of the Affordable Care Act. The final rule does not resolve whether discrimination on the basis of an individual's sexual orientation is a form of sex discrimination, instead clarifying that HHS's Office for Civil Rights will evaluate sex discrimination complaints on an individual basis to determine if they can be addressed by the provisions in this final rule. The final rule also requires healthcare entities to enhance language assistance for consumers with limited English proficiency and make information and facilities more accessible to individuals with disabilities. In addition to these procedural safeguards, the main substantive change under section 1557 is the extension of protections against sex discrimination to the healthcare setting. Existing laws already protected against discrimination based on race, age, or disability in most healthcare settings.

Supreme Court Declines to Rule on Contraceptive Mandate

The Supreme Court opted not to decide the merits in Zubik v. Burwell, in which religious organizations that were entitled to an accommodation from the Affordable Care Act's contraceptive coverage mandate argued that the accommodation itself imposed a burden on their exercise of religion. Instead, the Supreme Court vacated the lower court decisions and asked each of the appeals courts that have ruled on the issue to reconsider their decisions in light of information the plaintiffs and the government provided to the Supreme Court. In supplemental briefings submitted at the Court's request, both the government and the religious organizations said they would be satisfied with a solution that allowed the employees of religious employers to receive coverage for contraceptives without the employer needing to pay for the contraceptives and without the employer being required to notify their insurers or the government of their religious objections. Eight of the nine federal appeals courts that had previously ruled on this issue had concluded that the existing accommodation did not infringe on the plaintiffs' free exercise of religion.

Maryland: Governor Signs Expansive Contraceptive Bill Into Law

Governor Larry Hogan (R) signed into law the Contraceptive Equity Act, which eliminates co-payments and prior authorization for most contraceptive methods, including emergency contraception (the "morning-after pill") and vasectomies, for Medicaid beneficiaries and individuals enrolled in State-regulated insurance plans. The bill, which passed with bipartisan support, also requires carriers to cover a single dispensation of a six-month supply of prescription contraceptives. The bill was supported by insurers, who cited an anticipated decrease in unintended pregnancies. Maryland will become the first state to require insurers to pay for over-the-counter contraceptives when the law takes effect in 2018.

New York: Governor Creates Task Force to Combat Opiate Crisis

Governor Andrew Cuomo (D) announced a new multi-disciplinary Heroin Task Force charged with developing an action plan to combat the State's opiate addiction crisis. Lieutenant Governor Kathy Hochul (D) will lead "healthcare providers, policy advocates, educators, parents and New Yorkers in recovery" in increasing awareness of addiction, expanding statewide prevention and treatment programming, and improving recovery support services. The task force's work will build on Governor Cuomo's recent efforts to stem heroin and opioid addiction that include expanding opiate treatment services, launching a public awareness and prevention campaign, and implementing electronic prescription drug monitoring systems.

Oklahoma: Governor Authorizes State to Seek 1332 Waiver

The Governor signed SB 1386 authorizing the State to pursue a 1332 State Innovation Waiver to create "Oklahoma health insurance products" that improve healthcare quality while controlling costs. The legislation permits the State to submit multiple waivers, including an 1115 waiver to participate in a Delivery System Reform Incentive Payment Program or an uncompensated care pool. While the legislation does not dictate details of the waivers, it requires them to be consistent with the State's Health Improvement Plan, a healthcare transformation and public health improvement initiative being rolled out under a State Innovation Model grant. The legislation further authorizes the Oklahoma Insurance Department to begin conducting individual and small group plan rate reviews upon implementation of a 1332 waiver (Oklahoma is one of only five states that does not currently do rate reviews). The authorization is effective November 1, 2016; a waiver application could be submitted to the federal government early next year.