Narrow Networks Bill Passes Floor Vote

The Assembly this week approved a bill to limit narrow networks in California’s health plans.

The legislation already passed a Senate vote and is expected to get concurrence today on the Senate floor and move to the governor’s desk for final approval.

SB 964 by Sen. Ed Hernandez (D-West Covina) directs the Department of Managed Health Care to develop standardized methodologies for health insurers to file required annual reports on timeliness compliance, and requires DMHC to review and post findings on those reports. It also eliminates an exemption on Medi-Cal managed care plan audits and requires DMHC to coordinate those plans’ surveys, as well.

“I introduced the bill in response to complaints we’ve heard about inadequate networks in the Medi-Cal program, as well as at Covered California,” Hernandez said. “By increasing oversight and network adequacy enforcement, SB 964 will help consumers select the right plan for themselves and access the care they need.”

Assembly member Rob Bonta (D-Oakland) introduced the measure Tuesday on the Assembly floor, and said the bill came in response to numerous public complaints.

“Since 2012 there have been hundreds of complaints about access and inadequate networks,” Bonta said.  

Consumers have raised concerns about narrow networks in Covered California policies and provider access in Medi-Cal managed care plans, he said.

“With millions more covered by health insurance,” Bonta said, “it is incumbent on the state to ensure that people who have purchased insurance or are on Medi-Cal are actually able to use that coverage to see a qualified provider.”

The bill passed the Assembly on a 52-18 vote.

Another Hernandez bill passed the Assembly on Tuesday. SB 1004 would require the Department of Health Care Services to establish standards ensuring the delivery of palliative care services by Medi-Cal managed care plans, including hospice care.

SB 1004 unanimously passed the Assembly on a 72-0 vote. Concurrence in the Senate is expected today.

“Palliative care offers many of the same services as hospice but earlier in the disease state and it doesn’t require ‘giving up the fight’ to beat the illness,” Hernandez said. “Numerous studies have been published demonstrating evidence that palliative care leads to better outcomes, higher patient satisfaction and lower health care costs.”

Categories: Capitol Desk