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California Gov. Arnold Schwarzenegger (R) and Democratic legislators are nearing agreements on several pieces of statute law that would limit insurers' profits on individual health plans, want plans to provide a minimum countersink of benefits and confine insurers' ability to rescind coverage, the Los Angeles Times reports. According to the Times, "The newfangled focus reflects how far Schwarzenegger remains from his original health care finish: to orchestrate medical insurance for the five one thousand thousand Californians wHO lack it." State lawmakers rejected Schwarzenegger's proposal in January, simply many of the measures now beingness considered were included in the governor's plan.
For example, department of State Sen. Sheila Kuehl (D) says she is "very near" an agreement with the regulator on legislation that would require insurers to spend at least 85% of premium income on medical care. Aides to the governor have requested that the flier (SB 1440) be amended to free new types of health insurance insurance coverage from the 85% doorstep for the first deuce years that they ar available.
In addition, Schwarzenegger is in talks with Sen. Darrel Steinberg (D-Sacramento) over changes to a bill (SB 1522) that would require individual health insurance policies to handle physician services, preventive care and hospital services. It also would cap members' annual out-of-pocket costs and require country regulators to classify health plans into five categories, with the aim of making it easier for consumers to compare health insurance options. Gov. Schwarzenegger has asked Steinberg to drop the coverage mandates from the bill and keep it focused on categorizing health plans.
Three bills dealing with health insurance policy rescissions also ar making their way through the state Legislature. Democrats want to require health insurers to seek state regulators' approval before rescinding policies and permitting rescissions only in the low gear 18 months that a member has a health insurance policy. Schwarzenegger supports allowing insurers to continue the ability to repeal policies, merely he wants to make a work that would have independent arbitrators see whether insurers could delete coverage. He also supports creating new rules intended to boost insurers' review of applicants' medical histories (Rau, Los Angeles Times, 8/4).
Other Bills
Summaries of news about early recent action on health insurance regulation in California appear on a lower floor.
"Balance Billing": The California Department of Managed Health Care on Friday announced that it has completed new regulations aimed at limiting the practice of "balance charge" in emergency care situations. Balance billing occurs when health care providers government note patients directly for aesculapian charges that health plans do non cover. The new rules permit DMHC to learn action against providers wHO use balance billing (Glover, Sacramento Bee, 8/2).
DMHC authority: Also on Friday, the governor vetoed a bill (AB 1155) that would have widened DMHC's authority to fine health insurers that did non pay medical bills. Schwarzenegger said the bill was aimed at sidestepping DMHC's independent contravention resolution process (Los Angeles Times, 8/2).
Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for e-mail delivery at http://www.kaisernetwork.
