Tuesday, June 24, 2014

AB 2400 (Ridley-Thomas) deserves support plus an amendment

AB 2400 (Ridley-Thomas), sponsored by the California Medical Association, deserves support. As matters stand now, certain Goliath-like health plans force physicians to accept  contract terms that are harmful to patients, for instance, contractual terms that are adverse to patients with chronic diseases who are more expensive to maintain than healthy 30 year olds. The idea is to force physicians to drop their sickest chronic patients to reduce corporate expenses and increase executive compensation. This bill would put a stop to the perfidious corporate healthcare practice of dropping doctors who insist upon trying to negotiate contract terms or who refuse to accept unilateral material changes in existing contracts. This corporate practice is known as "take-it-or-leave-it."

This bill would allow changes in health plans only if the provider has negotiated or agreed with the provision and if the provision is in accordance with state or federal laws and regulations. Otherwise, the provider will be enabled to opt out of the contract even though it was previously agreed upon. This bill is aimed at the unfair and heavy-handed practices imposed upon patients and their physicians by group health plans and PPOs. It is expected to spill over into Workers Comp, e.g., Coventry (Aetna), Anthem/Blue Cross, etc.

Meanwhile, here's the latest heavy-handed move to inconvenience injured workers and their treating physicians: Travelers Indemnity Company and Constitution State Services, quoting CLC 4600.2, have informed their providers that starting June 20th "all prescriptions for workers compensation related medications and medical supplies must be filled by a network pharmacy ... no payments will be made  for prescriptions or medical supplies provided by a non-network pharmacy, clinic, or medical  office after July 31, 2014."

A provision to take down this latest dictate should be amended into AB 2400 by the authors.

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