IHA Daily Briefing: Nov. 25

Monday, November 25, 2019
IHA Programs on Recreational Cannabis Dec. 5
Chicago Launches “Cannabis Facts” Campaign
HFS Notices Sept. through Mid-Nov.
Systematic Coverage Disparities for Behavioral Health
Congressional Task Force Formed on EtO

IHA Programs on Recreational Cannabis Dec. 5
IHA is holding two educational programs on recreational cannabis—which will become legal on Jan. 1—to help hospitals and health systems update their policies. Both programs will be on Thursday, Dec. 5.

“Cannabis Employment Policies” is an in-person round table discussion hosted and moderated by IHA’s Legal Department from 1:30-3:30 p.m. The program was developed in response to policy questions from members and their interest in hearing what other hospitals are planning.   

The program, designed primarily for in-house counsel and human resources managers, will be video conferenced between IHA’s Naperville and Springfield offices.

The discussion will focus on how hospitals are approaching updates to their employment policies. The intent is to have a robust dialogue and share ideas to strengthen hospital policies statewide.

There is no fee to participate. Register today.

“The Clinical and Legal Issues Related to Treatment of Patients Using Cannabis” is a webinar hosted by IHA’s Illinois Risk Management Services (IRMS) from noon to 1:15 p.m. The webinar will address the various types and uses of cannabis, challenges related to patient treatment, and the development of appropriate policies and procedures surrounding cannabis.

Two expert presenters will lead the webinar:

  • Luba Andrus, RPh, MJ, a registered pharmacist with over 30 years of executive, operational and retail leadership experience in the pharmaceutical and cannabis industries; and
  • Carrie Armour, JD, an attorney and advocacy consultant with over 15 years of experience representing physicians and patients on issues including medical cannabis and pain management.

The webinar is complimentary for IRMS clients and members of IHA’s Illinois Provider Trust (IPT). The fee for IHA members who are not part of IRMS or IPT is $60 per line. Continuing education credits are available for nurses. Register today.

Those who wish to attend both the webinar and the round table discussion can view the webinar in IHA’s Naperville or Springfield offices and attend the round table discussion immediately afterward.

Meeting space and parking space for the round table discussion is limited at each location. We encourage you to register early and consider carpooling if you have multiple attendees from your facility.

Chicago Launches “Cannabis Facts” Campaign
With the legalization of recreational cannabis taking effect Jan. 1, Chicago Mayor Lori Lightfoot and the Chicago Dept. of Public Health (CDPH) have launched the “Cannabis Facts Chicago” public awareness campaign to provide health and safety tips designed to ensure safe and responsible consumption and information on the potential health impacts for youth.

“As we work to equitably stand up the recreational cannabis industry and right the wrongs of the War on Drugs, our first priority will always be the safety of our communities and residents,” said Mayor Lightfoot. “That's why the City of Chicago's departments and sister agencies are partnering with local medical providers to create a new campaign to provide our residents and communities with clear guidance around cannabis use, particularly how to protect our youth from products that could be harmful to their growth and development.”

While those over 21 years of age will be able to purchase cannabis products at licensed dispensaries, the City of Chicago is urging responsible consumption, warning that products can be much more potent than in the past and overuse can have serious health consequences, especially for youth and young adults. States and municipalities that have legalized cannabis have seen an increase in emergency room visits and hospitalizations with people experiencing such symptoms as hallucinations, paranoia, confusion, panic attacks, nausea and vomiting, especially after consuming edibles.

“We've learned from other states and cities where cannabis has been legalized, and one important lesson is around responsible consumption - take it slow and know what you're consuming,” said CDPH Acting Commissioner Allison Arwady, MD, MPH. “Overuse of cannabis, both short- and long-term, can have negative health consequences. And young people should not be using it at all.”

The City is encouraging residents considering consuming cannabis to review these health and safety tips:

  • Protect your brain
  • Know your dose
  • Avoid frequent use
  • Pregnant and breastfeeding women should abstain
  • Don't drive while high
  • Keep it safe

“The developing teenage brain is more at risk for the negative effects of cannabis use, and that's where my biggest concern is,” said Maria Rahmandar, MD, medical director of the Substance Use and Prevention Program at Ann & Robert H. Lurie Children's Hospital of Chicago. “Luckily most teens are making the healthy decision not to use cannabis, but those teens who are using it should know that they are at risk for developing mood disorders and even addiction, and parents should know that, too.”

The city of Chicago is providing information and resources about this issue on its website.

HFS Notices Sept. through Mid-Nov.
Over the past several months, the Dept. of Healthcare and Family Services has issued several notices that may impact hospitals. See IHA’s summary memo on the notices as well as informational memos that IHA has sent to members concerning some of the notices.

Systematic Coverage Disparities for Behavioral Health
Last week, independent actuarial and research firm Milliman, Inc. published Addiction and Mental Health vs. Physical Health: Widening disparities in network use and provider reimbursement (press release), a study reviewing health plans of 37 million employees and their family members over five years that confirms the growing gap in disparities for employees and their families seeking mental health and addiction treatment versus treatment for physical health conditions in 2016 and 2017.

Based on healthcare claims data from all 50 states and hundreds of health insurance plans, patients are more likely to use out-of-network care options for any kind of mental health service: inpatient, outpatient, and office visits. The report was commissioned following a similar 2017 study by Milliman that also showed statistically significant disparities for in-network behavioral healthcare use and provider reimbursement rates.

Based on Illinois-specific data, inpatient care for behavioral health was 4.25 times more likely to occur out-of-network than inpatient medical/surgical care in 2017, a 46% increase from 2013 (when the disparity was 2.91 times). Outpatient facility care for behavioral health was 4.69 times more likely to occur out-of-network than medical/surgical outpatient facility care, a 149% increase from 2013 (when the disparity was 1.88 times). Notably, behavioral health providers received 8.7% less than primary care providers and 8.0% less than medical/surgical specialists for reimbursement under similar billing codes in 2017.

The Mental Health Parity and Addiction Equity Act of 2008 requires behavioral healthcare benefits that are covered by most health insurance plans to be treated at parity with medical/surgical benefits, with subsequent implementation rules defining tests for assessing compliance and further defining benefit disparities like those found in the new Milliman report. Illinois currently has the strongest state parity law in the country that became effective Jan. 1, 2019 (Public Act 100-1024), but the law has not yet been implemented to ensure oversight and enforcement.

Earlier this year, the Illinois Attorney General’s office issued a public request to learn more about insurance companies denying, limiting or delaying substance abuse or mental health treatment to clients. The office is asking healthcare organizations concerned about a potential parity violation to encourage patients to email HealthCare@atg.state.il.us. In addition, an Illinois-specific patient toolkit is available to better understand patient insurance rights for mental health and substance use disorders.

Congressional Task Force Formed on EtO
U.S. Reps. Brad Schneider (D-IL-10) and Jody Hice (R-GA-10) have announced the formation of a bipartisan congressional task force on ethylene oxide (EtO) emissions, urging the U.S. Environmental Protection Agency (EPA) to act.

“My constituents are rightly concerned about emissions of ethylene oxide, and that is why we need the U.S. EPA to release science-based rules and educate the public on the threat of EtO so that local families can have confidence in the air they breathe,” said Congressman Schneider. “With my colleagues in the Illinois congressional delegation, I have urged the U.S. EPA to do its job, but this is a problem with scope beyond just our state. I am thrilled to form this bipartisan congressional task force with my colleague Jody Hice to coordinate the federal response of communities across the country to this threat and concentrate pressure on the U.S. EPA to act. Public health is not a partisan issue, and we will be working to expand our task force with more affected communities.”

The task force supports legislative efforts like H.R. 1152, introduced by Schneider, which would require EPA to issue new, strict EtO emissions standards for medical sterilization and chemical facilities and require the EPA to notify the public no more than 30 days after it learns that the new standards have been violated. A majority of task force members are co-sponsors of the legislation.

Members of the Ethylene Oxide Task Force represent half a dozen communities from three states affected by EtO and include: Hank Johnson (D-GA-4), Barry Loudermilk (R-GA-11), David Scott (D-GA-13), Dan Lipinski (D-IL-3), Sean Casten (D-IL-6), Bill Foster (D-IL-11), Lauren Underwood (D-IL-14) and Susan Wild (D-PA-7).