California continues to be a national leader in healthcare price and transparency initiatives. For the 2017 legislative term, Assembly member Wood introduced legislation (AB 595) that would require insurance companies to receive approval from the Department of Managed Health Care before they can merge or acquire other health plans. In addition, Senator Monning introduced legislation (SB 538) that would prohibit providers and health plans from including certain anticompetitive terms, such as gag clauses and payment rate setting for nonparticipating hospital affiliates, in their contracts. Finally, Senator Hernandez introduced a pharmaceutical price transparency bill (SB 17) which would require public and private purchasers of health care and health care coverage be given advance notice of price increases for the costs of prescription drugs.
In past legislative terms, California legislation sought to provide additional processes and structures to improve healthcare price transparency and, in effect, lower costs. In September 2016, Governor Brown signed a bill that requires health insurers to notify their policyholders when regulators think their price hikes are too high (SB 908), and a bill that protects patients from out-of-network provider surprise bills (AB 72). Other proposed legislation sought to reduce healthcare costs by requiring insurance carriers to provide a minimum value of 60%; and by clarifying family and individual family member cost sharing.
Overall, California remains an active participant in the initiative to reduce healthcare costs and improve price transparency. Californias legislation and regulation aligns with similarly active and progressive states by focusing on pharmaceutical costs and stakeholder transparency measures.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare. We currently cover bills from the 2017-2018 legislative term and key statutes from each state. Search the database for specific bills, statutes or cases by using keyword, key issue category, and/or jurisdiction.