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California bill to limit health care premium subsidies passes Senate
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A California bill with union support that would restrict groups like the American Kidney Fund from helping patients on dialysis pay health care insurance premiums passed the state Senate on May 30 and is heading for a vote in the assembly later this month.
“SB 1156 protects patients by making sure that financially interested third-parties pay premiums for the full-plan year, even if the patient stops treatments that benefit the provider so that the patient does not lose health care coverage mid-year,” bill sponsor Sen. Connie M. Leyva, said in a prepared statement. “This measure simply requires that provider-funded organizations follow disclosure requirements and certify that consumers do not have better available options open to them. These providers have a right to make a profit, but not when those financial interests can hurt patients or even keep them from receiving the care they need.”
Under SB 1156, third-party payers of insurance premiums would have to:
certify that patients are not eligible for Medicare, Medi-Cal or covered California subsidies and would have to disclose to regulators of their intention to pay a patient’s premiums in advance;
ensure continuity of care for consumers by requiring third-party payers to pay premiums for the full-plan year, even if the patient stops treatments that benefit the provider; and
prove they meet these requirements. “Failure by the third-party payer to meet these requirements means the financially interested provider is only entitled to a predetermined payment rate for any services provided to that patient,” Leyva said in a previous press release. That rate would be the same as Medicare rates.
The bill also impacts health care providers who operate addiction centers.
SB 1156 is supported by America’s Health Insurance Plans, Association of California Life and Health Insurance Companies, Blue Shield of California, California Association of Health Plans, California Association of Health Underwriters, California Labor Federation, California Rural Legal Assistance Foundation, Health Net, Kaiser Permanente, Latino Coalition for a Healthy California and Service Employees International Union California.
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