SACRAMENTO – First District Assemblyman Wesley Chesbro (D-North Coast) has introduced a bill, AB 2586, that would help protect and maintain access to health care by ensuring patients have full and complete information about their health care provider network.
“This bill will help the state crack down on health plans and insurers that promise consumers a fully staffed physician network, but instead give them a phantom network with insufficient providers and misleading provider directories,” Chesbro said.
“Some of these provider directories even include names of physicians who are deceased, retired or no longer practicing in the state,” he said.
The most recent and egregious example is Anthem Blue Cross’ attempt to force new and unfair contracts on Healthy Families providers in Humboldt County, according to Chesbro.
This “recontracting initiative” gave physicians no choice but to sever their relationships with Blue Cross, which left children enrolled in Healthy Families with no access to medically necessary care other than the emergency room
“AB 2586 will also require health plans and insurers to get approval from regulators before narrowing or modifying its provider network through re-contracting schemes,” he said. “And they will be required to notify affected enrollees and providers before terminating contracts and narrowing networks.”
If it becomes law, AB 2586 will require:
HMOs and health insurers to make sure that provider directories are accurate and up-to-date.
That the state Department of Managed Healthcare and the Department of Insurance review the adequacy of physician networks, accessibility by geography and physician-to-patient ratios every time it conducts an on-site survey. Currently, these criteria are only reviewed once, when the plan is initially licensed.
“Lack of access to care in many regions of California is a serious problem because some health plans don’t provide big enough networks of physicians for their patients,” said Dr. Luther Cobb, a surgeon at Mad River Community Hospital in Arcata and on staff at St. Joseph Hospital in Eureka. “AB 2586 will put a stop to this and give regulators more effective ways to regularly monitor the availability of health coverage in local markets.”
Dr. Cobb is a member of the California Medical Association’s (CMA) Executive Committee. The CMA is sponsoring AB 2586.
LAKE COUNTY – Lake Family Resource Center is offering the American Lung Association “Freedom from Smoking” tobacco cessation program beginning Feb. 12 in Clearlake and on Feb. 23 in Kelseyville.
“Freedom from Smoking”, the leading smoking cessation program in the United States for over 25 years, shows participants how to quit smoking for good in a supportive setting.
Participants meet weekly in small groups so everyone attending gets personal attention.
No two smokers are alike; the program helps everyone create their own quit plan. Because support of others is important while quitting, participating with a group who understands the challenges helps at a time when support is most needed.
Spring is a great time to make changes in your life and you’ll be more successful at quitting smoking by being with other people who have decided to quit smoking, too.
The Clearlake classes will take place at LakeFRC, 14264 Austin Drive (across from Burns Valley School), from 10 a.m. to noon.
The Kelseyville classes will take place at LakeFRC, 4325 Main St., from 5:30 p.m. to 7:30 p.m. Both programs run seven weeks, with two classes during “Quit Week.”
The program is FREE and includes all program materials and refreshments.
For more information and to register for the classes call Glenn Koeppel or Joy Swetnam, Lake Family Resource Center, at 707-279-0563 or email