As the largest industry in California with over $367 billion estimated to be spent in the state, healthcare is always an issue that generates dozens of bill proposals in any legislative cycle. The term that ended in 2016 was no exception. From negotiating passage of a managed care organization tax during a special legislative session on health to mandatory use of prescription drug databases, below are highlights of several (but not all) health-related laws effective in 2017.
- CURES: Authorized prescribers will be required to consult the state’s Controlled Substances Utilization Review and Evaluation System (CURES) prior to prescribing a Schedule II, III, or IV drug to a patient for the first time and at least four months thereafter if the patient continues the prescription. There is a special clause in this law delaying its effectiveness until six months after the California Department of Justice certifies that updates to the CURES database provide a reliable online resource for such use.
- Right-To-Try: California now joins a list of other states that allow terminally ill patients to use experimental drugs that do not yet have full regulatory approval. The law authorizes, but does not require, health plans to cover investigational drugs and protects physicians from disciplinary action if they recommend their use after other treatment options have been exhausted.
- Epinephrine Auto Injectors (EAIs): Businesses and public agencies in California are now defined as “authorized entities” allowed to keep epinephrine auto injectors (EAIs) on hand to help treat emergency allergic reactions. Liability and professional review protections remain in place for physicians and surgeons issuing a prescription or order for EAIs, unless their issuance of the prescription or order constitutes gross negligence or willful and malicious conduct.
- Surprise Bills: With the rise of narrow networks, patients experience what some call “surprise” medical bills for out-of-network services. Starting July 1, 2017, a new law will require healthcare service plan contracts or health insurance policies issued, amended, or renewed to provide the enrollee or insured the ability to pay the in-network cost if the provider’s network status was not previously disclosed. The law also requires that an independent dispute resolution process be in place by September 1 of this year.
- Premiums: A new law will allow consumers to learn when their health insurance premium rates have been considered “unreasonable” by state officials. Currently, this notice is posted online, but the new law will require health insurers to notify individuals and small businesses in writing at least 60 days before a rate increase so that consumers can shop around for a new policy if they choose.
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