Health Policy Rollup: State Action We’re Watching in April 2025

Here are the bills we’re watching this month.

Arkansas: PBM Reform

The Arkansas House of Representatives voted 89 to 4 to adopt HB 1150 which specifically prohibits a pharmacy benefits manager from having a direct or indirect interest in, or otherwise holding, a permit authorized in the state for the retail sale of drugs or medicines. The measure is in the Senate for consideration.

Indiana: Medicaid Reform

The General Assembly is close to enrolling SB 2, with the House having sent an amended version back to the Senate to approve. The bill would provide for Medicaid reform, including work requirements for the Medicaid expansion population, enhanced oversight on improper Medicaid payments, limits on how the state may consider and process eligibility determinations, and other key provisions. 

Maryland: PDAB Upper Payment Limits

The General Assembly enrolled legislation (HB 424/SB 357) to authorize the state’s Prescription Drug Affordability Board’s (PDAB) to set upper payment limits (UPLs) for purchases and payor reimbursements of prescription drug products that have led or will lead to an affordability challenge. The PDAB currently only has UPL authority for government entities and Medicaid. In addition, the legislation would modify membership for the Prescription Drug Affordability Stakeholder Council, alter requirements for UPLs, and add reporting requirements for the PDAB.

Mississippi: Certificate of Need Reform

The Legislature enrolled HB 569 and sent it to the Governor’s desk, which would provide for a nuanced approach to certificate of need (CON) reform. The bill increases the threshold from when you would need to adhere to a CON process for purchasing medical equipment and for building a new clinical or non-clinical building. The bill will also require the Department of Health to conduct a study on CON laws specific to certain specialty providers. The Governor has until April 24 to sign the bill. 

Oregon: Hospital Facility Fees

The Senate Committee on Health Care voted to approve SB 539, which would limit hospitals in charging facility fees in facilities that aren’t on a hospital campus or at a facility without an emergency department. The bill also establishes reporting requirements for hospitals relative to charged or billed facility fees. The bill is likely to be considered by the full Senate in the near future. 

West Virginia: Medicaid Eligibility

Despite quick introduction and discharge to the House floor, it is unlikely that HB 3518 will now be considered by the House of Delegates. The bill would have required the state to withdraw Medicaid eligibility for the expansion population if the federal medical assistance percentage (FMAP) were to ever drop below 90 percent. House leadership opted to pull the bill after they received confirmation from the state’s Congressional delegation that reducing the FMAP for the expansion population was not currently being considered for the expected federal cuts to the Medicaid program.