Surprise Bills

Key Consumer Protections Bills Move Forward

Earlier today Senate Health Committee passed several key bills benefiting health care consumers, including two sponsored by Health Access California: AB 339 (Gordon), dealing with high cost specialty medications and AB 533 (Bonta), which halts surprise bills from out-of-network providers. Both bills go beyond Affordable Care Act to provide improved patient protections—ensuring that the cost sharing protections apply to consumers living with chronic conditions (AB 339), and taking consumers out of the middle of disputes between health plans and providers about charges for out-of-network care. AB339 (Gordon) presented today by Assembly Member Rob Bonta, would require insurers to cover medically necessary prescription drugs and limit cost-sharing on specialty drugs and other needed medications. This bill passed out of Senate Health on a […] Read More

Key Consumer Protection Bills Face Crucial Vote NEXT WEEK

With next Friday’s (July 17) deadline for policy committees to meet and consider bills from the opposite house, critical patient protection bills will be debated and voted on in the Assembly Health Committee this Tuesday and in Senate Health Committee on Wednesday. Community groups have the next few days to mobilize networks to encourage committee members (Assembly Health Committee members and Senate Health Committee Members) to vote for the bills (find your legislator here). For details on each bill, and where we are in the process, see our weekly bill matrix. Also see our blog on bill hearings for the week of July 6-10.  #HEALTH4ALL NOW RUNNING ON MULTIPLE TRACKS After the recent victory in the state budget covering children in […] Read More

Legislative Recap at Halfway Point: Key Bills Pass Floor Votes

In this article… SB 4 Would Take Historic Steps to Cover Remaining Uninsured Patient Protection Bills to Limit Out-of-Pocket Costs Other bills on transparency, Medi-Cal, and more This blog entry was written by Sawait Hezchias-Seyoum, Health Care Policy Advocate, Health Access. The Senate and Assembly adjourned yesterday, one day ahead of the June 5th deadline to pass all bills out of the first legislative chamber. The good news is that most key bills of interest to health care consumers have passed out of the house of origin, while one bill, opposed by public health groups, was defeated. Bills moving forward deal with limits and protections against unfair out-of-pocket costs; efforts at improving Medi-Cal; and a significant expansion of access to coverage […] Read More

Key Health Consumer Bills Move to Floor NEXT WEEK

California Legislative Appropriations Committees just voted to pass key legislation, including SB4 #Health4All (Lara) to expand coverage regardless of immigration status and several patient protection bills limiting out-of-pocket costs. Though some bills were amended in today’s suspense hearings (details below), all will advance to floor votes next week. To advance this year, all bills must pass by the June 5th deadline. Health Access CA-Sponsored Bills on Out-of-Pocket Costs Heading to Floor Votes SB137 Accurate Provider Directories (Hernández):This bill, co-sponsored with CPEHN and Consumers Union, sets standards for health plan provider directories and creates more oversight on accuracy so people know whether their doctor is in network when they shop coverage, change coverage, or try to use their coverage. SB137 passed […] Read More

Legislative Re-Cap: After the First Deadline…

Last Friday was the deadline for all policy committees in the California legislature to hear and report on all bills with fiscal implications–and the good news is that many key bills of interest to health care consumers have passed their first critical hearing. While some bills stalled (including almost all of those Health Access opposed but also a few that advocates supported), bills moving forward include limits and protections against unfair out-of-pocket costs; efforts at greater transparency on cost and quality in our health system; and an expansion of access to coverage for all regardless of immigration status. For details on each bill, see our weekly bill matrix.  These bills still have a long path to final passage, including a June 5th […] Read More

The LA Times weighs in…

The LA Times editorial board endorsed two Health Access California-sponsored bills this weekend to prevent surprise out-of-pocket out-of-network costs. SB137(Hernandez) would require real-time accurate and standardized provider directories; AB533(Bonta) would ensure that consumers who go to an in-network hospital or facility does not get out-of-network bills from any of the doctors or other providers they may encounter. The entire editorial is worth reading, but here’s an excerpt: “…people want to know before they sign up for a narrow network plan whether they’ll be able to keep the doctors they like, or how far they’d have to travel to see someone willing to take new patients. And in too many cases, they’ve enrolled only to be turned away by doctors who […] Read More

Health Committees Vote….

This week we had key policy committee hearings, in advance of the end-of-the-month deadlines to pass bills. Yesterday, in the California Assembly Health Committee, numerous key bills advanced. Surprise Bills: Our sponsored legislation, AB533(Bonta) passed on a 17-0 vote, to prevent consumers from getting out-of-network bills when going to a in-network hospital or facility. Even when patients do the right thing and make sure to go to an in-network facility, these “surprise bills” can amount to hundreds if not thousands of dollars and put a family’s finances at risk–if not prevent lower-income patients from getting needed care. Broad support for the bill came from consumer groups like Consumers Union, labor groups, and insurers. Assemblyman Bonta recognized that all stakeholders agreed […] Read More

Balance Billing on YouTube…

Here’s a new video by the California Department of Managed Health Care explaining balance billing and your rights if you have these unfair bills. Take a look! Health Access California promotes quality, affordable health care for all Californians.

What the “balance billing” court ruling means….

As my colleague Anthony Wright said, and which has been trumpeted in front-page headlines around the state today, the ruling in the Prospect case is a big win for consumers—and it is particularly sweet since it was a unanimous and conclusive decision in a case that might well have led to murky law, as did the appellate case that it overturned. Here is what the California Supreme Court said: For HMO members, it is always clear in advance who has to provide emergency services — any emergency room doctor to whom the member goes in an emergency — and who has to pay for those services — the HMO. The conflict arises when there is no advance agreement between the […] Read More

Victory at the Supreme Court!

Big consumer victory today. The California Supreme Court ruled 7-0 to protect patients from unfair bills during disputes between insurers and providers. This unanimous ruling by California Supreme Court in Prospect Medical Group vs. Northridge Medical Center, is clear and unequivocal. The case states directly, that when there’s a billing dispute between an emergency room doctors and an HMO, “a patient who is a member of an HMO may not be injected into the dispute. Emergency room doctors may not bill the patient for the disputed amount.” After years of contentious fights through legislation and regulations, this is big news. As Health Access California has always contended, insured consumers should not have their credit and financial future ruined by unfair […] Read More