Brown Signs Raft of New Health Laws
Source: SF Gate
California consumers will have the strongest protections in the nation against getting blindsided by unexpected out-of-network medical bills as part of legislation signed into law by Gov. Jerry Brown.
AB72 was one of 10 consumer-protection measures — eight related to health care — signed Friday by the governor. They include a law that will require health insurers to notify their policyholders when regulators think their price hikes are too high, and one that will allow people to be informed of their rights to timely access to health care and to an interpreter.
The surprise medical bill legislation is designed to prevent patients, many of whom checked in advance to make sure their doctor and hospital were in their insurer’s list of contracted providers, from getting hit with out-of-network charges after undergoing a procedure or agreeing to services.
“No patient should pay for a surprise bill or be forced into bankruptcy because of a complicated and unfair billing system,” Assemblyman Rob Bonta, D-Alameda, the bill’s author, said in a statement released just after the bill was signed.
The law, which goes into effect in July, would keep patients out of what is essentially an issue between the insurer and the health providers.
While insurers generally contract with providers for rates, some doctors, particularly hospital specialists such as anesthesiologists, radiologists and pathologists, don’t have contracts because they don’t think they will be adequately reimbursed. So a patient who goes to an in-network hospital for surgery can get hit with an unexpected anesthesiologist’s bill.
The law will require insurers to reimburse these out-of-network providers at 125 percent of the rate Medicare pays, or at the insurer’s average contracted rate, whichever is greater.
The physician groups that represent California pathologists, radiologists and anesthesiologists opposed the bill, but consumer advocates were elated.
“It will take the sting out of surprise medical bills,” said Betsy Imholz, director of special projects for Consumers Union, the policy arm of the publication Consumer Reports.
Last year, the Consumer Reports’ National Research Center conducted a survey that found that nearly 1 in 4 privately insured Californians received a surprise medical bill in which their health plan paid less than expected in the past two years. Among those respondents, again nearly 1 in 4 were charged at an out-of-network rate when they thought a provider was in their network.
The new law is stronger than similar out-of-network protections in New York and Florida, Imholz said. She said she hopes California’s law will serve as a model for other states.
Consumers Union supported two other bills that were signed into law Friday, including SB908 by Sen. Ed Hernandez, D-Azusa, which will require insurers to inform policyholders in writing when regulators found a price hike “unreasonable” or “not justified.” The group also supported SB1135, by Sen. Bill Monning, D-Carmel, which would require health plans and insurers to let consumers know about their rights to timely access and an interpreter.
The law that will alert people to high price hikes for coverage will go into effect Jan. 1.
Other legislation signed by governor
Gov. Jerry Brown also signed these health care bills:
AB796 Extends indefinitely existing law that requires the state’s Department of Developmental Services to contract with regional centers to provide services for people with developmental disabilities, including autism
AB1954 Prevents patients from needing a referral to see a reproductive health care provider
AB2024 Eases hiring restrictions for critical-care and rural hospitals to expand access
SB908 Requires insurers to notify patients of premium rate changes deemed unreasonable by state regulators
SB999 Requires public and private health plans to cover and dispense hormonal birth control for up to 12 months, eliminating the need for women to get refills every 30 or 90 days
SB 1135 Provides for notice of timely access to care
SB 1365 Requires hospitals to notify patients scheduled in hospital-based outpatient clinics when services are available in a non-hospital location to reduce the potential of steering patients to a certain facility in which the hospital has a financial interest.