Latest California Healthline Stories
Big Week Ahead — and the Budget Looms
You’re going to see a lot of bills passed this week, at least through the committee phase of legislation. This is the final week, ending July 2, for laws to be approved out of committee, so legislators are likely looking at long, agenda-packed hearings.
For instance, the Senate Committee for Appropriations meets today (Monday), with a grand total of 96 items on its agenda. Good luck with that.
Also, July 1 is the beginning of the fiscal year, and that leads into the next deadline: passing a state budget.
Out-of-State Physician Reviews Questioned
It’s relatively common practice for utilization reviews — that is, a request for medical services reviewed to comply with treatment guidelines — to be conducted by out-of-state physicians.
A new law, SB 933 by Senate member Paul Fong (D-Cupertino), would end that practice.
On Wednesday, the Senate Labor and Industrial Relations Committee approved Fong’s bill. It is headed to the Senate floor for a vote … maybe. A policy review is under way to determine whether the bill should first go through the Appropriations Committee.
Despite Best Intentions, New Ratios Creating Problems
Requiring insurers to spend a certain amount on patient care was a widely acclaimed element of the health care overhaul. However, early efforts to set standards for medical-loss ratios are delayed, and resistance is growing. While some say industrywide MLR standards remain achievable, others are warning that it’s a “fool’s errand.”
Tweaking Laws for In-Home Supportive Services
Last year around this time, the state legislature adopted a budget trailer bill called ABX4 19 by Assembly member Noreen Evans (D-Santa Rosa), which required background checks for In-Home Supportive Services providers.
But there were some unintended consequences of that well-intentioned law, according to Assembly member Ted Lieu (D-Torrance). Lieu hopes to fix a few details with his own bill, AB 1763, which is before the Senate Human Services Committee this week.
“Providers sometimes move from one county to another, or they have clients in multiple counties,” Lieu said. “The way the law’s written now, you may have to go through and pay for the same background check multiple times.”
High-Risk Success Riding on Twin Bills
Last week the Assembly passed AB 1887 by Mike Villines (R-Clovis) and the Senate passed SB 227 by Elaine Alquist (D-Santa Clara). The two-bill package would establish a temporary high-risk insurance pool to meet federal guidelines for national health care reform.
The legislation is now being considered in the appropriations committees in each house. The bills are procedurally joined, which means one can’t become law without the other. At stake is $761 million in federal funding, which is one reason the proposed laws have urgency status.
But urgency status has one big drawback — that means both bills need a two-thirds vote to become law.
Enrollment Work Group Gets Down to Business
Last week, the Health IT Policy Committee’s recently created Enrollment Work Group held its inaugural meeting. Meeting participants seemed excited and eager to get down to business, but they were realistic about the challenges that lie ahead, especially with such tight deadlines.
Insurance Czar May Gain New Clout in California
With the state’s pending implementation of national health care reform, the role of state insurance commissioner is in position to assume new political power in California.
Bill Aims to Limit Rate Hikes to One a Year
Beth Capell could barely contain her disbelief at the idea — that health plans and insurers suddenly might offer to lower their rates. And that they’d do that twice in one year.
“Not once in a blue moon,” she said.
Capell, policy advocate for Health Access California, was speaking at Wednesday’s Senate Health Committee hearing, presenting her side of what seemed like a relatively straightforward bill. AB 2042 (Mike Feuer, D-Los Angeles) seeks to prevent health plans and insurers from raising rates more than once a year.
Proposal Gives Stronger Status to Mental Health Claims
The Assembly Health Committee on Tuesday passed SB 1169 (Alan Lowenthal, D-Long Beach), which aims to raise the status of mental health claims.
“There are two problems in how mental health conditions are handled,” bill author Lowenthal said. “Plans and insurers require daily prior authorizations, but they don’t do that with physical conditions. And the second thing is that they often delay payments and authorization.”
Lowenthal said he hopes to even the mental health playing field, by requiring a tracking number to be assigned to every mental health claim, and by pushing health insurers to give mental health treatment the same urgency shown to physical treatment authorizations.
Assembly OKs High Risk-Pool to Protect ‘Uninsurable’
The state Assembly passed AB 1887 (Mike Villines, R-Clovis) that establishes a temporary high-risk health insurance pool program in California.
It’s designed to cover patients with a pre-existing condition who have been rejected for coverage by a private health plan. It would insure high-risk patients here for the next four years, until the federal government sets up a permanent health care exchange in 2014.
The legislation complies with new federal health care reform law, and allows the state to tap into $761 million a year in federal funds. High-risk coverage is expected to reach about 30,000 people in California.