Contact: Alison MacLeod (916)225-6317
AB 2157 Passed Unanimously by California Senate
CSA Sponsored Legislation Heads to the Governor for Signature
(Sacramento, CA) The California Society of Anesthesiologists (CSA) is pleased to announce that AB 2157 (Wood) was passed unanimously by the California Senate on August 24th, and now heads to Governor Gavin Newsom for his consideration. The Governor has until the end of September to sign or veto the bills passed by the state Legislature at the end of this 2019/2020 legislative session.
AB 2157, sponsored by CSA and authored by the Assembly Health Committee Chair Jim Wood, D.D.S. (D-Santa Rosa), passed out of both the Assembly and Senate with bipartisan and unanimous support. The legislation codifies recent sub-regulatory guidance issued by the California Department of Managed Health Care (DMHC) and provides better balance between physicians and health plans and/or insurers over billing and payment disputes for out-of-network health care services provided in an in-network facility.
“Unfortunately, we have seen a growing number of cases where AB 72 was used to make unreasonable demands on anesthesiology groups and even threaten cancelled contracts,” said Antonio Hernandez Conte, MD, Chair of Legislative and Practice Affairs for CSA. “That was unsustainable, and would effectively diminish patient access to anesthesiology services. We are pleased that AB 2157 will create a more level playing field so the IDRP can work as intended – keeping patients out of the middle of these contract disputes while at the same time supporting a process that ensures fair negotiations and protects patient access to care.”
Specifically, AB 2157 provides the following requirements for the Independent Dispute Resolution Process that can be triggered by AB 72 (Bonta) from 2016:
- Ensures that information submitted through the IDRP must be kept confidential from either disputing party.
- That the independent arbiter conducts a “de novo” review of the claim dispute based solely on the information and documents timely submitted into evidence by the parties.
- That the independent arbiter assigns reviewers to each case based on their relevant education, background, and medical claims payment and clinical experience.
“AB 2157 is a smart and tailored approach to ensuring physicians are not artificially disadvantaged when going through the adjudication process. We are glad the Legislature understood the importance of this legislation and made it a priority in the midst of so many other legislative challenges for the state” added Dr. Hernandez Conte.
As author of the bill and Chair of the Assembly Health Committee, Assemblymember Wood provided critical stewardship of AB 2157 as it moved through the legislative process. His first-hand experience as a health care practitioner provided understanding on how the interactions between providers and insurance companies directly impact patient access and quality of care.
“We appreciated the opportunity to work with Assemblymember Wood and find a way to address this important issue – the contract negotiations between health plans and providers are complicated but have real world implications for our patients and the efficacy of our healthcare systems,” said Jeff Poage, MD, President of CSA.
CSA district directors and members throughout the state engaged in effective grassroots outreach and advocacy calls with key members of the Legislature to educate them about the importance of AB 2157. In particular, CSA District Directors Lawrence Ong, MD, Jeffrey Rusheen, MD, Robin Seaberg, MD, Sydney Thomson, MD, Christian Borhringer, MBBS, and Henry Gonzalez, MD were instrumental in leading virtual meetings and phone calls with key legislators – educating them about the importance of the bill and why it matters to their district and to the future of healthcare in California. Additionally, CSA greatly appreciates the involvement of so many more members who wrote letters or who joined legislative outreach phone calls as local constituents to provide additional grassroots support – including Folu Ani, MD, Robert Wong, MD, Puja Trivedi, MD, Jim Hlavacek, MD, Ellen Wang, MD, Larry Sullivan, MD, Michael Champeau, MD, Chien Chow, MD, as well as Ron Pearl, MD, President-Elect for CSA, Sunny Jha, MD, Director of the CSA Early Career Practice Forum and Felipe Perez, MD, Vice Chair for the CSA Legislative Affairs Committee.
“It was great to see CSA’s grassroots advocacy program in action and working effectively,” said Sydney Thomson, MD, Director for CSA District 3. “We were able to share our own experiences and inform policymakers how the legislation impacts our specialty, our practices and patient access to care. Building these channels for communication is so important not just for this piece of legislation, but for the overall CSA mission to positively impact public policy - promoting patient safety, preserving physician-led anesthesia care, and increasing access to quality care in California.”
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