Healio Special Report: Health Care and Politics
Healio Special Report: Health Care and Politics
July 10, 2019
2 min read

California dialysis profits bill advances in Senate

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The California Senate Health Committee approved a bill on July 3 that would limit how much dialysis providers could charge private health plans if patients received premium assistance from groups like the American Kidney Fund.

“As the cost of health care continues to skyrocket in California, we need to do more to keep providers from gouging consumers,” state Assembly member Jim Wood (D-Santa Rosa), the author of AB 290, said. “In too many cases, critically ill patients are seen as cash cows, not as people who desperately need life-saving treatment.”

The bill will next be considered by the Senate Appropriations Committee. It was approved by the state Assembly on May 22.

The legislation is supported by Health Access California, the California Labor Federation, SEIU California, California Association of Health Plans, and the Association of California Life and Health Insurance companies, but opposed by dialysis providers in the state.

In testimony before the Senate Health Committee, AKF president LaVarne Burton said, “I am extremely concerned that thousands of dialysis and transplant patients who depend on AKF in California are closer to losing an essential financial lifeline that gives them access to lifesaving medical care. All of our state senators have to understand the gravity of the consequences if AB 290 becomes law and AKF is forced to discontinue its charitable premium assistance program in California.”

Wood introduced the bill on January 28, less than 4 months after California Governor Edmund G. “Jerry” Brown Jr. vetoed similar legislation that would have allowed state health regulators to cap dialysis profits. California voters also turned down the proposal at the polls in November 2018.

Through its Health Insurance Premium Program, funded by dialysis providers, the American Kidney Fund will pay health plan premiums on behalf of patients who qualify for the assistance. Dialysis providers have been charged with “steering” patients to more expensive commercial plans – with premiums covered by the AKF – to charge higher prices for dialysis care. AB 290 is also directed at curbing third-party payers covering premiums for drug addiction treatment facilities.

While the American Kidney Fund can still offer premium assistance to patients if AB290 is approved, dialysis providers can charge no more than Medicare rates for dialysis treatments for patients who have their premiums covered.

“AB 290 will increase consumer protection and provide transparency to health plans about where the payments for treatment are coming from, and remove the financial incentive of third-party health care providers to bill health plans for inflated and unnecessary medical claims,” the California Association of Health Plans said in a press release. – by Mark E. Neumann

Reference: www.calhealthplans.org/news