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CA AB290
Bill
AI Summary
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Requires health care service plans and health insurers to accept premium payments from specified third parties including government programs, Indian tribes, and family members without restrictions.
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Establishes requirements for other "financially interested entities" making third-party payments, including providing full-year assistance, disclosing enrollee/insured names, not conditioning assistance on specific treatments, and offering information about all coverage options.
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Creates an independent dispute resolution process by October 1, 2021 to determine appropriate reimbursement rates for financially interested providers, with rates effective January 1, 2022 based on the higher of Medicare rates or dispute resolution determinations for contracted providers.
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Prohibits chronic dialysis clinics from steering patients toward specific coverage options and requires posting notice directing Medicare coverage questions to the Health Insurance Counseling and Advocacy Program.
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Becomes operative July 1, 2020 for entities covered by a specific HHS Office of Inspector General advisory opinion, unless those entities request an updated opinion from the federal agency regarding federal law compliance.
Legislative Description
Health care service plans and health insurance: third-party payments.
Last Action
Chaptered by Secretary of State - Chapter 862, Statutes of 2019.
10/13/2019