The recent OC task force on dealing with the abuses on the Socal Drug Rehab facilities is only one of many developments aimed at culling this issue, with California looking at a new legislation proposed aimed at dealing with the same issue, and even tacking in the supposedly outsized profits of the dialysis industry.
The legislation, Senate Bill 1156, is already scheduled an April key Senate hearing, with its message saying that some anti-addiction providers, middlemen and charities are setting up patients for fraudulent insurance claims, wherein the premiums are paid simply for the kickback. The result of these fraudulent claims are an increased costs in insurance not only in Socal Drug Rehab facilities, but across the whole industry in America.
State Senator Connie Leyva (D-Chino), is the bill’s chief sponsor, and said that providers do have the right to make profit, unless said profit compromises the well-being of patients and drives up health insurance, not only for other Californians, but people across the country.
Premium assistance programs, where providers provide premiums for the patients unable to afford them, have already taken heat from health insurers, with the programs coming in as a result of the Affordable Care Act of 2014. Said law made for easier patient enrollment to lengthy or costly treatment programs because the law prevents insurers from denying application from patients with preexistent conditions. A lot of insurer says that it also allowed for more fraudulent or unjustified billings. Most of the fraudulent and questionable billings have been noted to come from individual policies bought via the state insurance marketplaces established as part of the terms of the ACA.
Additionally, critics say that subpar care may be provided to victims of the scam, which not only compromises their well-being but also costs more for the insurer.
The bill’s opposition, however, says that its supporters are exaggerating the issue, and that this bill might reduce the ability of customers to receive healthcare from legitimate groups when so many Americans struggle to pay their medical bills.
The representatives of the anti-addiction industry admit that there have been such fraudulent and abusive cases, but that this new legislation would not be as effective as simply strengthening the enforcement of anti-kickback laws, which are already present in current legislation, that are aimed at patient-steering and conflicting interest.
The Senate Health committee is due to discuss the bill at a hearing, scheduled at the 18th of April.