Surprise Bills

Key Patient Rights Legislation Up Next Week

  Yesterday, the Assembly Health Committee passed one consumer protection measure, SB 923 (Hernandez) on a vote of 17-0, to prevent mid-year increases in co-payments and other cost-sharing by a health plan. Other key legislation also authored by Senate Health Committee Chair Dr. Ed Hernandez and sponsored by Health Access California to protect patients from unfair health care costs, including unjustified premium increases (SB908) and prescription drug price hikes (SB1010), was rescheduled from this week to next Tuesday in Assembly Health Committee. Letters of support are due today. These bills are part of a package of patients rights bills–including some of the most lobbied legislation this session–to help prevent unfair and unreasonable bills, premiums, and cost-sharing, inform consumers of their rights and options, […] Read More

Labor and Consumer Groups Join Forces to Stop Surprise Medical Bills

This week, consumer and patient advocates re-launched their effort to prevent Californians from facing surprise out-of-network medical bills. Due to the failure of the legislature to act last year, California consumers continue to receive surprise medical bills from out-of-network providers after using in-network medical facilities. These bills could come from an out-of-network anesthesiologist, pathologist, radiologist or another health professional that the patient may have never met and did not choose, costing them hundreds or thousands of dollars. Typically, consumers are unaware if they encountered an out-of-network provider until they receive the surprise bill, which can be hundreds or thousands of dollars and cause financial hardship for consumers. Further, these bills do not count toward the annual in-network cost-sharing cap of […] Read More

Prescription Costs Transparency Bill Fails in Assembly Health Committee, But Fight Continues

Earlier today the California Assembly Health Committee failed to pass AB 463 (Chiu), a bill introduced last session that would have required greater transparency around the pricing of high-cost medications. Bill author David Chiu pulled the bill because he did not have enough votes, like last year, to get it through committee.  But, as he stated, this issue is not going away and additional efforts are expected this year. Specifically, AB 463 would have required each manufacturer of a prescription drug costing more than 10,000 per year or per course of treatment to file a report each year with OSHPD (Office of Statewide Health Planning and Development) on the factors underlying the final price of the given drug, including: production […] Read More

Key Patient Protections Pass Legislature, Now On Governor’s Desk

With the California Legislature adjourning after midnight last Saturday, most of the action on priority bills for health consumers moves to the Governor’s desk. Most of the Heath Access-sponsored bills protecting consumers from unfair out-of-pocket costs are now one Governor’s signature away from enactment. There were disappointments in the final days of this year’s legislative activity, including the lack of action on a range of revenue and tobacco control measures in the special session. Health Access’ consumer protection proposal AB 533 (Bonta), to halt surprise bills, failed on a vote of 38-10—just 3 votes short of passage. Overall, though, many important patient protections passed in a productive session advancing health reform. Even if a bill makes it to the Governor’s desk and even […] Read More

End of Session Recap: Legislation to Stop Surprise Medical Bills Stalls in California Assembly; Other Key Patient Protection Measures Advance to Governor’s Desk

The California Assembly adjourned Saturday morning without passing legislation to prevent patients from facing surprise out-of-network bills after they get care in in-networks hospitals or other facilities. AB533 (Bonta), sponsored by Health Access California, would have held consumers harmless for surprise bills reflecting out-of-network charges that were outside of their control (See separate AB533 fact sheet). A broad coalition of consumer groups, insurers, the California Labor Federation and the California Chamber of Commerce) actively supported the measure, but the California Medical Association and related physician groups pulled out all the stops in a vigorous day of lobbying. The bill was “on call” throughout the day, with the vote total building each time the vote was called, but never making to the 41 votes needed […] Read More

Most Patient Protection Bills Clear Final Hurdle, En Route to Governor’s Desk; Tobacco Measures Still Pending

Earlier today the California Senate voted 25-10, on a bipartisan basis, to pass legislation to prevent patients from facing surprise out-of-network medical bills after they receive care in in-network hospitals or other facilities. Sponsored by Health Access California, AB533 (Bonta) would protect patients from “surprise” bills from out-of-network doctors when they did the right thing by going to an in-network hospital or imaging center or other facility. Under AB 533, patients would only have to pay in-network cost sharing. This bill joins two other patient protection bills, passed earlier in the day, designed to prevent unfair out-of-pocket costs: SB 137 (Hernandez) an AB 339 (Gordon). AB 533 On Surprise Bills A recent survey by Consumers Union found 1 in 4 Californians received a […] Read More

Final Week of Legislative Session: Where We Stand on Key Bills Protecting Consumers

Key patient protection bills hang in the balance this week, as Friday is the deadline for bills to pass from final floor votes in the California legislature to the Governor’s desk. In this last week of California’s legislative session, amendments have been taken on the key bills impacting health care consumers, but the substance of Health Access’ sponsored bills remains intact: to protect consumers from unfair out-of-pocket costs. SB 4 #Health4All has been scaled back to include mostly technical enrollment policy and process fixes related to covering all kids in Medi-Cal. Unfortunately, feedback from the Governor’s office has prompted bill author Senator Ricardo Lara to take out a key provision instructing the state to seek a section 1332 waiver to allow undocumented […] Read More

Key Health Care Consumer Protections to Prevent Unfair Out-of-Pocket Costs Advance to Final Floor Votes

SB137 (Ed Hernandez), to require updated, standardized & accurate health plan provider network directories, passed out of Assembly Appropriations Committee. AB533 (Bonta), to stop “surprise” billing from out-of-network doctors; AB339 (Gordon) to prevent unfair cost-sharing for specialty drugs, and AB1305 (Bonta) to limit out-of-pocket costs for individuals in family plans, passed out of Senate Appropriations Committee. SB248 (Roger Hernández), a bill to prevent large employers from offering “junk insurance,” fixing an ACA loophole,  passed the full Assembly and is now heading to the Governor’s desk. #Health4All Update: SB4 (Lara), to allow undocumented California to shop for health coverage in Covered California, seeking a Section 1332 federal waiver to remedy their exclusion in the ACA, also passed out of Assembly Appropriations. Yesterday, the Appropriations Committees of the California Senate and Assembly met […] Read More

Senate Appropriations Committee Hears Key Health Access Bill and Special Session Tobacco Control Legislation

Yesterday, the Senate Appropriations Committee heard Health Access sponsored bill, AB 533 (Bonta) on “surprise billing” and select special session tobacco control bills. AB 533 (Bonta), which would protect consumers from surprise bills from out-of-network doctors when a consumer does the right thing by going to an in-network hospital, lab or imaging center was not voted on in committee, however, Health Access, the American Cancer Society and AARP testified in support of the bill before the bill was referred to the Senate Appropriations Suspense. The following special session tobacco control bills were also heard: • SB X2 8 (Lieu) – would require all schools to be tobacco free. • SB X2 7 (Hernandez) – would increase the age of sale for […] Read More

Close-up on AB 533 (Bonta): Protecting Consumers from Surprise Medical Bills

Consumers know they can save money and limit their out-of-pocket costs by going to an in-network provider.  Too often, however, consumers who do the right thing by going to an in-network hospital or facility end up getting a surprise bill by a doctor who turns out not to be in-network. According to a recent survey by Consumers Union, nearly one in four Californians have received a surprise medical bill after a hospital visit or surgery with the price they are asked to pay an out‐of‐network rate when they thought the provider was in‐network. These surprise or “gotcha” bills can add up to hundreds, even thousands of dollars, driving some patients into medical debt. The consumer is stuck paying the bill […] Read More