A JOINT RESOLUTION directing the Department for Medicaid Services to request guidance from the Centers for Medicare and Medicaid Services for Medicaid coverage on prescription digital therapeutics in the Commonwealth of Kentucky.
Impact
If approved, this resolution could significantly alter Medicaid’s approach in covering digital health tools, thereby paving the way for broader access to innovative treatments. By possibly integrating PDTs into Kentucky's Medicaid offerings, it aims to enhance the treatment landscape for individuals struggling with addictions, especially in light of increased challenges due to the COVID-19 pandemic. This could also set a precedent for other states looking to similarly enhance their Medicaid programs with digital health innovations.
Summary
HJR28 is a Joint Resolution from the Commonwealth of Kentucky that directs the Department for Medicaid Services to seek guidance from the Centers for Medicare and Medicaid Services regarding Medicaid coverage for prescription digital therapeutics (PDTs). The initiative is prompted by alarming statistics from the Kentucky Office of Drug Control Policy, which reported nearly 2,000 overdose deaths in 2020. PDTs represent a new frontier in healthcare, offering software-based treatments that provide clinicians and patients with remote, evidence-based modalities to address not only substance use disorders but also mental health conditions.
Sentiment
The general sentiment toward HJR28 appears supportive, particularly given the urgent need for effective interventions in the opioid crisis. Health advocates and providers are likely to see value in expanding Medicaid coverage to include new modalities of treatment that can support patients anytime, thus addressing barriers to traditional in-person care. However, there may also be cautious optimism, as stakeholders await the specific guidance from federal agencies on the feasibility of reimbursement and coverage structures.
Contention
A notable point of contention may arise from discussions surrounding the adoption of new technologies within the Medicaid framework, particularly relating to the costs and logistics of integrating PDTs. Concerns could be raised about the efficiency and effectiveness of delivering these digital therapeutics, alongside the ongoing assessment of outcomes in the context of addiction treatment. Additionally, as digital therapeutics evolve, policymakers must ensure that regulations keep pace to safeguard patient outcomes and address potential disparities in access.
Urging the Department of Human Services of the Commonwealth to submit a state plan amendment to the Centers for Medicare and Medicaid Services to provide reimbursement for emergency medical services for the nontransport of Medicaid patients, and urging the Centers for Medicare and Medicaid Services to expeditiously review and approve the state plan amendment submitted by the Department of Human Services.
A JOINT RESOLUTION directing the Department for Medicaid Services to provide the Legislative Research Commission with a report regarding pharmacist payment parity.
To Amend The Medicaid Fraud Act And The Medicaid Fraud False Claims Act; And To Update Language And Definitions To Reflect Changes Within The Healthcare System;.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Requires Medicaid reimbursement for covered behavioral health services provided by local education agency to student who is eligible Medicaid beneficiary.
Provides for presumptive eligibility for home and community-based services and services provided through program of all-inclusive care for the elderly under Medicaid.