THE VALUED VOICE

Thursday, February 24, 2022

   

Assembly Health Committee Holds Hearing on Bills Addressing Problematic Health Insurer Practices

On Feb. 16, the Assembly Committee on Health held a public hearing on proposed bills that would separately impact the ability of patients to use certain prescription drug discounts to meet cost-sharing requirements; prohibit step-therapy requirements for certain patients with breast cancer; create limits around the ability for insurance companies to deny physical therapy coverage; and require insurers to reimburse for clinician-administered drugs when a contract exists for this service.
 
The last of these bills, Assembly Bill 718, would also prohibit unilateral insurer-mandated white bagging, brown bagging and mandatory home infusion requirements for patients in need of clinician-administered drugs. Instead, the legislation would require that the insurer base decisions on the treating provider’s determination of when medications needed to be clinician-administered and would prohibit an insurance company from steering patients away from options that are available in their network.

WHA Senior Vice President Public Policy Joanne Alig and Prairie Ridge Health President and CEO John Russell, WHA’s board chair, testified in support of Assembly Bill 718, along with a host of other hospital and health system leaders and providers who provided first-hand witness to the problems these insurer policies cause for patients.
 
Due to the coming close of the legislative session, all bills heard in the Assembly Health Committee are likely to carry over into the legislative session that begins in January 2023.
 

This story originally appeared in the February 24, 2022 edition of WHA Newsletter

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Thursday, February 24, 2022

Assembly Health Committee Holds Hearing on Bills Addressing Problematic Health Insurer Practices

On Feb. 16, the Assembly Committee on Health held a public hearing on proposed bills that would separately impact the ability of patients to use certain prescription drug discounts to meet cost-sharing requirements; prohibit step-therapy requirements for certain patients with breast cancer; create limits around the ability for insurance companies to deny physical therapy coverage; and require insurers to reimburse for clinician-administered drugs when a contract exists for this service.
 
The last of these bills, Assembly Bill 718, would also prohibit unilateral insurer-mandated white bagging, brown bagging and mandatory home infusion requirements for patients in need of clinician-administered drugs. Instead, the legislation would require that the insurer base decisions on the treating provider’s determination of when medications needed to be clinician-administered and would prohibit an insurance company from steering patients away from options that are available in their network.

WHA Senior Vice President Public Policy Joanne Alig and Prairie Ridge Health President and CEO John Russell, WHA’s board chair, testified in support of Assembly Bill 718, along with a host of other hospital and health system leaders and providers who provided first-hand witness to the problems these insurer policies cause for patients.
 
Due to the coming close of the legislative session, all bills heard in the Assembly Health Committee are likely to carry over into the legislative session that begins in January 2023.
 

This story originally appeared in the February 24, 2022 edition of WHA Newsletter