Leyva Bill Protecting Consumers Suffering From Kidney Disease and Addiction Advances to Assembly

SB 1156 Creates Patient Safeguards, Puts End to Predatory Business Practices

Wednesday, May 30, 2018

SACRAMENTO – In order to improve consumer protections and rein in predatory behavior that is driving up health care costs for Californians, the California State Senate today approved legislation with bipartisan support seeking to put an end to insurance schemes carried out by profit driven businesses primarily targeted at individuals undergoing treatment for kidney disease and addiction.

Since the passage of the Affordable Care Act (ACA), patients cannot be denied health coverage based on a pre-existing condition. This profound advancement for consumers has also provided an opportunity for dishonest providers to take advantage of sick people by enrolling them in commercial coverage to maximize high reimbursement rates for services. This coverage is not always in the best interest of the patient, can result in higher out-of-pocket costs or disruption in care, and is being imposed upon consumers even though these patients are eligible for public coverage like Medicare or Medi-Cal.

“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,” Senator Leyva noted. “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. I appreciate my Senate colleagues supporting this common sense measure that creates safeguards for patients so that they are not caught up in schemes where they may lose their health insurance and which can ultimately raise premiums for other Californians.”

Now proceeding to the California State Assembly for consideration, 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 SEIU California.