March 12, 2018
The Honorable Dr. Ed Hernandez
Chair, Senate Health Committee
State Capitol, Room 2191
Sacramento, CA 95814
Re: SB 1278 (Bradford) Oppose Unless Amended
Dear Senator Hernandez:
It is with great regret the Addiction Treatment Advocacy Coalition cannot support SB 1278 Patient Brokering/Kickback bill in its current form. As you know, the Addiction Treatment Advocacy Coalition supported SB 636 because it originally contained text that also gave substance use providers the ability to manage their businesses based upon information provided by health plans. With similar language stripped from the new version of the bill, ATAC, and many of its members, no longer support the bill in its current form.
The insurance lobby opposes any concession to their practices that hurt out-of-network treatment providers, which was illustrated by their opposition to elements of SB 636. Please see the attached copy of their letter opposing the elimination of direct payment to patients that costs California taxpayers hundred of millions of dollars annually.
As you know the following language from the original bill SB 636 has been stripped from the new SB 1278:
- It is the intent of the Legislature that nonmedical, subacute treatment programs that provide alcohol addiction or narcotic addiction treatment receive information from health insurance providers regarding coverage of treatment services for patients, clients, or customers, including all of the following:
(1) That verification that services are covered, orally or in writing, or both, constitutes an intent to cover the costs of those services, subject to the limitations expressed in the enrollee’s or subscriber’s policy.
(2) That an authorization of services constitutes an affirmative representation that the services are covered and treatment providers are entitled to rely on that authorization.
(3) That after the service has been initiated, any verification, orally or in writing, or both, that the cost of extending the duration of the services will be covered, constitutes an intent to cover the cost of those services, subject to the limitations expressed in the enrollee’s or subscriber’s policy.
(4) That the health insurance provider will rely on the definition of medical necessity as defined in the American Society of Addiction Medicine or the most current Diagnostic and Statistical Manual of Mental Disorders.
(b) This section does not expand or alter the benefits available to the enrollee or subscriber under a plan.
If the language above is added to SB 1268, ATAC and its members would enthusiastically support SB 1268.
ATAC Board of Directors
The following presidents, CEOs and owners representing of /for these profit treatment facilities in California: