California bill lowers reimbursement for certain dialysis, substance abuse patients

A law signed by Gov. Gavin Newsom will lower payment to certain healthcare providers, including dialysis clinics and substance use disorder treatment centers, for services provided to patients who receive premium assistance.

Premium assistance tax credits help subsidize insurance costs for eligible lower-income individuals and families who sign up for health plans through California's ACA marketplace.

Under the California law, dialysis clinics, substance use disorder treatment centers and other certain healthcare providers will be paid at Medicare rates for services provided to patients who receive premium assistance, Mr. Newsom wrote in a letter to the California State Assembly. He said the law also mandates that health plans accept premium payments from charities and other insurers on patients' behalf.

The law overall aims to prevent dialysis clinics, substance use disorder treatment centers and other certain healthcare providers from submitting inflated claims for reimbursement under third-party arrangements, according to a news release from the California Association of Health Plans, which supports the law.

Dialysis is Life Support, a coalition of physicians, nurses, hospitals, dialysis caregivers, veterans, community and business groups and more than 4,000 dialysis patients, is opposed to the law and said it "will upend the lives of thousands of low-income, vulnerable dialysis patients by eliminating the charitable premium assistance provided by nonprofit organizations like the American Kidney Fund."

Read more about the law here.

 

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