The state’s power crisis will not be the only cause of sparks this year in Sacramento, as doctors, hospitals and HMOs go toe-to-toe over health care-related legislation.
While all sides are still slogging through more than 100 health care-related bills introduced by the Feb. 23 deadline, the major players in the debate have staked out key positions on a variety of sponsored bills.
Among the top priorities for the California Medical Association, which represents 34,000 doctors, is a bill that would allow doctors and other medical care providers to collectively arbitrate payment and other disputes against insurers.
Introduced by Assemblyman Fred Keeley, D-Santa Cruz, AB 1600 is already being branded by HMOs as an illegal move to extract higher payments from insurers.
“They are using the rubric of arbitration, but it’s what we call collusion,” said Bill Wehrle, chief lobbyist for the California Association of Health Plans, an insurer trade group. “It’s the ability to drag in outside parties to coerce a payment that the market won’t support.”
The CMA counters that it needs the legislation because just seven plans control 80 percent of the managed care market in the state, giving those plans unfair power over medical care providers.
Also high on the CMA agenda is AB 32, which would extend health coverage to the uninsured through several mechanisms, including allowing employers to enter into purchasing pools. It is sponsored by Assemblyman Keith Richman, R-Granada Hills.
The CMA also wants to funnel more money into the state’s emergency rooms through an additional $300 million in state funding to hospitals and doctors. The bill, SB 254, is being carried by Sen. Joe Dunn, D-Garden Grove, and is being co-sponsored by the California Healthcare Association, the hospital trade group.
The CMA and CHA are also co-sponsoring SB 117, a bill intended to ensure payments for emergency services by mandating that health plans pay providers directly rather than delegating the responsibility.
The health plans, meanwhile, are seeking legislation to protect patients when HMOs and medical providers are unable to come to terms on new contracts. A prolonged dispute between Sutter Health and Blue Cross earlier this year disrupted care for more than 100,000 patients in Northern California for months.
The insurers have asked Assemblywoman Helen Thomson, D-Vacaville, who intervened in the dispute, to include language in bill AB 1522 that would require doctors and hospitals to continue to provide care in such situations.
“You would allow patients to see their physicians until their next open enrollment period. What we have suggested in that period is a slight (rate) increase the standard rate, plus inflation,” said Bobby Pena, the CAHP’s spokesman.
The health plans are also supporting another bill by Thomson, AB 39, that would provide tax credits to small businesses to encourage them to buy health coverage for their employees.
CHA, the hospital trade group, has called its top priority reversing the nursing shortage in the state. To that end, it is sponsoring two nursing education bills, including SB 317 by Sen. Deborah Ortiz, D-Sacramento, which would provide funding for specialty nursing education programs.
