Policy Committee Meeting

Approval of previous meeting minutes

Correction:  Members Alderman and Tilstra were on the roster for Policy Subcommittee meeting minutes.  This is an error.  These members will be removed.

Action: Amy Gavigilo made a motion to approve the meeting minutes with the above changes made. Kerry Hansen seconded.  Approved 4/4.

Old Business

Legislative Debrief Session:

Director Barnes spoke about the results of the four (4) bills that RDAC was supporting this 2024 legislative session. All bills passed as a part of an omnibus package in part or in whole (summary below):

RDAC Funding (HF3841/SF3927)

PASSED

What it does: Fully funds the base operating budget.
How it helps the community: Allows the Council to address its duties described in statute.

Outcome:
A one-time appropriation for $342,000 was included for FY25.

Prior Authorization Reform (SF3532/HF3578)

PASSED

What it does: Would streamline prior authorization and require reporting related to how and when prior authorization is being used by payers
How it helps the community: Increases timely access to treatments.

Outcome:
A number of reductions of prior authorization requirements were included, including:
Treatment of a chronic condition. (effective January 1, 2026)
An authorization for treatment of a chronic health condition does not expire unless the standard of treatment for that health condition changes. A chronic health condition is a condition that is expected to last one year or more and:

1. requires ongoing medical attention to effectively manage the condition or prevent an adverse health event; or
2. limits one or more activities of daily living.

Unbundling Gene products for rare diseases from current reimbursements to hospitals (SF4058/HF3664)

PASSED

What it does: Would provide separate reimbursement for biological products provided in the inpatient hospital setting as part of cell or gene therapy to treat rare diseases.
How it helps the community: Increases access to available treatments.

Outcome:
Gene therapy products administered in an inpatient setting will be unbundled from the DRG effective July 1, 2025.

Expanded coverage of rWGS for critically ill infants with suspected rare disease (SF2445/HF3330)

PASSED

What it does: Would increase coverage for rapid whole genome sequencing for children under the age of 21.
How it helps the community: Reduces time to diagnosis.

Outcome:
Commercial payers (including managed care organizations contracted with the State) must cover rWGS for children 21 years and younger in the ICU. Reimbursement must be separate from the DRG/capitated payment. Effective January 1, 2025.

New Business - Next Steps:

State Agency Policy

RDAC has hired a Policy consultant on a limited budget to assist in the follow up of the portions of the four bills that did not pass, or language that was removed and needs to be changed to keep the bills moving. We will be partnering with other state agencies.

Community (Patient Group) Informational Meeting, end of June

A tentative date is set for 6/27/24. RDAC will provide a debrief to the PAG’s and is considering expanding the meeting to medical groups and other interested parties. One page(s) have been developed with key points. There is a medical facing one page and a patient facing one page.

Public Comment

None

Adjourn Meeting

Motion called to adjourn by Kerry Hansen and seconded by Rae Blaylark at 4:48 pm. Passed 3/3.