Patient Rights and Access to Care: Assembly Health Committee Advances 7 Bills

February 2, 2010

The Assembly Committee on Health favorably reported seven bills today. For more information on a particular bill, please contact the sponsor listed after the description.

Help for low-income Medicare Part D Enrollees – Low-income people on Medicaid do not have to pay co-payments that would block them from getting their medicine. But if they are also on Medicare (“dual eligibles”), Part D requires them to pay co-payments. This bill would have Medicaid pay Part D co-payments for dual eligibles if they are more than $200 a year. (A.884, Gottfried)

Disclosure of Medical Error – Requires a health care practitioner to tell patients about mistakes that cause, or are likely to cause, harm to the patient. (A.1673, Gottfried)

Early Intervention Funding – Health insurers commonly avoid paying for Early Intervention services provided to children they cover, requiring state and local governments to pay. This bill would assess health insurers $100 million to help fund Early Intervention services for children under 3 with disabilities. Health insurers would no longer have to cover those services. (A.4058-A, Paulin)

Fair Prescribing Guidelines – Prohibits health plans from giving financial incentives to health care providers for switching from one prescription drug to another. (A.5448, Perry)

Medicaid Provider Audit Protection – Some Medicaid health care providers are being targeted by the Office of the Medicaid Inspector General because of clerical mistakes, errors, or misinterpretations that do not constitute fraud and abuse. This bill limits the withholding of provider payments based on the preliminary findings of a pending audit unless a written report establishes probable cause of criminal conduct. (A.7448-A, Schimminger)

Adult Home Resident Rights – Gives adult home residents the right to designate resident and legal representatives, choose their own health care providers, and to be fully informed about, and refuse, treatment. (A.9551, Gottfried)

School-Based Health Center Access – Eliminates barriers to kids using their school’s School-Based Health Center when they are covered by Child Health Plus managed care plans. The plan would be required to pay for the service, without a referral from the child’s primary care practitioner. The center would be required to discuss any service or treatment with the primary care practitioner. (A.9717, Gottfried)