Roundup of selected state health developments, first-quarter 2024 

April 22, 2024

 

While most state legislatures stayed busy in the first quarter of 2024, comparatively few leave- and insurance-related bills became law. Instead, much of that activity took place on the regulatory front. For example, Delaware and Oregon issued extensive paid family and medical leave (PFML) regulations. Two cities (New York City and Minneapolis) and Washington state changed their paid sick and safe leave (PSSL) mandates. A judicial challenge prevailed in stopping an attempted revision to Puerto Rico’s PSSL law. Indiana, Oregon and Washington passed laws limiting prescription drug (Rx) practices of pharmacy benefit managers (PBMs). Laws in Mississippi, Washington, DC, and Wyoming curbed prior-authorization requirements. New Jersey, South Dakota and Washington expanded telehealth access. Alabama drew national attention due to a state supreme court decision on the legal status of extrauterine embryos and subsequent legislation attempting to protect in vitro fertilization (IVF). A district court put an Illinois wage and pay parity law on hold, but Washington, DC, enacted a similar law. A change to Pennsylvania’s tax code impacts the treatment of dependent care flexible spending accounts (DCFSAs), potentially requiring changes to Form W-2 for the 2023 tax year.

Download the 13-page print-friendly PDF to read details for each jurisdiction. Here are some highlights of the coverage.

Delaware amended its existing PFML regulations, while Oregon addressed inconsistencies between its unpaid family leave and PFML laws. Washington focused on healthcare provider disclosures.

Puerto Rico’s paid vacation and sick leave requirements will remain unchanged after the US Supreme Court declined to review a decision invalidating 2021 amendments to the law. Washington expanded the “family member” definition in its PSSL law. New York City amended its PSSL ordinance to allow a private right of action. Duluth repealed its PSSL ordinance in deference to Minnesota’s new law, while Minneapolis issued regulations for its PSSL ordinance. Seattle ramped up enforcement of the app-based PSSL requirement.

An Indiana law restricts the use of PBM rebates. A New Jersey law requires fully insured plans to take into account discounts from online Rx platforms. Oregon laws address clinician-administered drugs and third-party financial assistance. A Washington law imposes limits on PBMs working on behalf of fully insured plans (with a self-funded ERISA plan opt-in).

A New Jersey law expanded its fertility coverage requirement to include in vitro fertilization (IVF) and cover a broader range of participants. California expanded a coverage mandate for preexposure prophylaxis (PrEP) and postexposure prophylaxis (PEP) drugs. Mississippi, Washington, DC, and Wyoming laws focused on prior-authorization requirements, imposing turnaround timelines more condensed than the federal standard of 72 hours for urgent claims and 15 days for nonurgent claims.

New Jersey and South Dakota joined interstate compacts, expanding access to telehealth services. Interstate licensure compacts for several professions continue to garner interest at the state level. These laws generally simplify the licensing process and improve access to providers, particularly in rural and other underserved areas. Washington eased the requirements for establishing an audio-only patient-provider relationship and passed a law allowing out-of-state practitioners to provide telehealth services in the state.

Alabama created a stir with a court ruling and ensuing legislation related to the legal status of extrauterine embryos. Illinois focused on pay and benefits parity for day and temporary workers. Minnesota limited pay-history inquiries, and Washington, DC, did the same while enacting wage transparency requirements. Pennsylvania updated its tax code for DCFSAs.

• Roundup: US employer resources on states’ recent equal pay laws (April 4, 2024)
• Litigation update on selected state benefit and leave laws (March 28, 2024)
• Practice of prior authorization draws increased scrutiny (Feb. 29, 2024)
• 2024 state paid family and medical leave contributions and benefits (Jan. 31, 2024)
• Roundup: State accrued paid leave mandates (Oct. 25, 2023)
• Roundup of selected state health developments, first-quarter 2023 (May 19, 2023)

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