BILL ANALYSIS Ó
SENATE COMMITTEE ON APPROPRIATIONS
Senator Ricardo Lara, Chair
2015 - 2016 Regular Session
AB 1831 (Low) - Health care coverage: prescription drugs:
refills
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|Version: June 9, 2016 |Policy Vote: HEALTH 9 - 0 |
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|Urgency: No |Mandate: Yes |
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|Hearing Date: August 11, 2016 |Consultant: Brendan McCarthy |
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*********** ANALYSIS ADDENDUM - SUSPENSE FILE ***********
The following information is revised to reflect amendments
adopted by the committee on August 11, 2016
Bill
Summary: AB 1831 would require health insurers and health plans
to provide coverage for early refills of prescription topical
ophthalmic products (eye drops).
Fiscal
Impact:
Minor costs to review health insurer filings and take
enforcement actions, as necessary, by the Department of
AB 1831 (Low) Page 1 of
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Insurance (Insurance Fund).
Minor costs to review health plan filings and take enforcement
actions, as necessary, by the Department of Managed Health
Care (Managed Care Fund).
Ongoing costs of about $200,000 per year for increased
utilization of covered topical ophthalmic products by Medi-Cal
beneficiaries (General Fund and federal funds). The California
Health Benefits Review Program analyzed a prior version of the
bill that would have required early refills at 70% of
predicted use days. Based on the current version of the bill,
which requires early refills at 76% - 77% of predicted days,
the costs to the Medi-Cal program are likely to be about
one-half of the previously projected costs.
Minor costs to the CalPERS due to increased prescription drug
benefit costs (various funds). Similar to the costs projected
for the Medi-Cal program, the costs of the current bill are
likely to be about one-half of the previously projected costs.
No state cost to subsidize health care coverage through
Covered California is anticipated. Under federal law, any new
mandated health benefit that exceeds the benefits in the
state's essential health benefits benchmark plan would be a
state responsibility. In other words, to the extent that the
state imposes a new benefit mandate that exceeds the essential
health benefits benchmark, the state would be responsible for
paying for the cost to subsidize that benefit for those
individuals who are receiving subsidized coverage through
Covered California. Because this bill does not mandate a new
benefit, but only change the terms of an existing benefit
(prescription drugs), the bill is not expected to result in
the state being responsible for subsidizing coverage.
Author
Amendments: Make a clarifying change.
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