Next week is the final push for legislators to get their bills through policy committees before the legislative summer recess. This year, recess begins upon adjournment of session on July 3, and they will resume on Monday, August 5. Below is a snapshot of where some of CSAP’s priority bills currently are in the legislative process.

SB 1184 (Eggman) Mental health: involuntary treatment: antipsychotic medication – Sponsor
This is CSAP’s bill regarding gaps between Riese hearings. It passed the Assembly Judiciary Committee this week with Dr. Erick Cheung returning to Sacramento for lead testimony. The bill passed with committee amendments and next goes to the Assembly Appropriations Committee after recess.

AB 3260 (Pellerin) Health care coverage: reviews and grievances – Co-Sponsor
This bill will prohibit health plans and disability insurers from overriding urgency determinations made by healthcare providers and delaying their responses to consumers’ urgent claims and grievances as a result.

There have been two sets of amendments since this bill was heard in the Assembly Appropriations Committee. The first is the author’s set of amendments, developed with technical assistance from the California Department of Insurance (CDI). They can be summarized as follows:

Places language about internal grievances in a new section of the insurance code.
Adds a new section on claims so that the insurance code and health and safety code have substantially similar provisions, which will help create a more uniform experience for consumers, and means that the improvements the bill makes will apply to plans/insurers regulated by either department.
Adds a new section that provides CDI with the authority to act as a finder of fact and to issue binding orders to health insurers to comply with the Insurance Code. This is comparable to DMHC’s authority under the Health & Safety Code, and was necessary to effectuate the bill’s intended improvements.
The latest committee (Senate Health) pushed back hard on certain elements of the bill, most notably the language that would have made a provider’s designation of urgency binding on health plans/insurers. The chair indicated that he could not support the bill without restrictions on this language, so it came out. A fight for another day.

On the positive side, the bill still has provisions that call for the automatic resolution of grievances in consumers’ favor when plans/insurers fail to comply with the timelines for resolving grievances. This is a big win, because this language faced considerable opposition. FYI, each quarter, roughly ten thousand grievances are not resolved within the required 30-day timeline. There will be two exceptions to this: 1) when plans don’t have the clinical information necessary to resolve a grievance, and 2) when the grievance concerns experimental treatment.