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Members of the influential Assembly Health Committee voted 12-4 to support Berg’s AB 2842, which would prohibit agents from using bait-and-switch techniques or other come-ons to sell policies and products to Medicare recipients.
“Believe me, seniors like myself get all sorts of solicitations from insurance agents for various insurance products,” said Berg, D-Eureka. “Seniors must have rights when they are dealing with Medicare and other insurance products. We have a lot of people out there trying to get at their money.”
Under the bill, insurance agents have to be up-front about their desire to sell something. They have to identify themselves as agents, and they can’t make an appointment to talk about Medicare Part D coverage and then use the time to sell other insurance products or services, unless those other products were mentioned when the appointment is made.
This is in keeping with other California law that requires agents to give seniors advance notice of a sales call so that seniors aren’t caught off guard without time to consult with family or other advisors.
Many seniors have come to rely on the help of insurance agents to help them through the maze-like system of Medicare law. Advising seniors on Medicare products is a growing industry. Berg’s bill takes aim at agents using tactics that take advantage of seniors and their pocketbooks by enrolling them in inappropriate plans.
“There are serious consequences for seniors who end up enrolled in the wrong plan,” said Berg. “Creating parameters for insurance agents will help seniors make informed choices regarding one of their most precious resources, their health care.”
In most cases, once seniors enroll in unneeded Medicare plans, they can not back out until the next annual open enrollment period. Being on fixed incomes to begin with, unwanted premiums can put a severe strain on a senior’s budget.
The bill is similar to a Maine law passed last year, and California will be the second state to institute this type of reform.
Berg, who chairs the Assembly Committee on Aging and Long-Term Care, is considered the Assembly’s key policy advocate on senior issues. This year, she has introduced a trio of bills that seek to regulate insurance agents and financial advisors.
AB 2842 now goes to the Assembly Appropriations Committee.
Visit Berg's Web site at http://democrats.assembly.ca.gov/members/a01/.
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Assembly Bill 2887, by Berg, D-Eureka, requires an existing state-funded health program called Every Woman Counts to provide digital mammograms. Current law requires the program only to pay for analog images of the common breast cancer test.
The Assembly Health Committee approved the bill late Tuesday on a 12-3 vote.
“Early detection is the key to survival,” said Berg. “As a breast cancer survivor, I can personally testify that quality screening is absolutely vital.”
To qualify for the Every Woman Counts program, a woman must be 40 or older, a California resident, and meet income eligibility requirements.
“The state needs to pay for new mammogram technology,” said Berg. “As always, the law needs to catch up with new technology.”
Breast cancer is one of the most commonly diagnosed cancers among American women, according to the Centers for Disease Control and Prevention. In 2004, the CDC reported that 182,772 women were diagnosed with breast cancer and 40,954 women died from the disease.
The Susan G. Komen For the Cure is the sponsor of this bill. The bill is one of their legislative priorities for this year.
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The bill would allow qualified aged, blind or disabled individuals to obtain IHSS services at their own expense.
Under existing law, Medi-Cal provides funding for the IHSS program, under which (either through employment by the recipient or through contract by the county) qualified, aged, blind, and disabled persons receive services enabling them to remain in their own homes. Counties are responsible for the administration of the IHSS program.
SB 1599 would require the Department of Social Services (DSS) to establish the “Project for California Independence,” which would authorize certain individuals who are not currently eligible financially to receive in-home supportive services to purchase those services.
The bill would require the Project to be conducted in any county that chooses to participate, and would require DSS to develop eligibility guidelines for individuals wishing to purchase services and to consult informally with designated entities.
Wiggins said that even though California has an increasing number of aged persons, the state has no plan designed to address the health care needs of these individuals. The IHSS program is limited to persons who meet a means test that excludes lower-middle-class individuals and families.
According to the Legislative Analyst’s Office, the number of Californians 65 years of age and older will increase by 2.4 percent per year between 2004 and 2010, which will result in an increase of more than 604,000 people in this age group in just six years. The state Department of Finance projects that the number of Californians over 65 years of age, which was 3,627,284 in 2000, will have grown to at least 4,526,578 by 2010.
“This explosion in our aging population will devastate California’s health care delivery system unless action is taken to improve our ability to provide low-cost personal care services as an alternative to acute care and nursing home stays,” Wiggins said. “Unique public-private partnerships should be created to effectively and efficiently deliver services to this population.
“California has developed the In-Home Supportive Services delivery system that is, by virtue of its ubiquity and cost-effectiveness, uniquely qualified to help deal with this growing aging population,” Wiggins added. “The IHSS delivery system is a publicly-funded program aimed at reducing costs by allowing people to be cared for in their own home. Making these types of services available to other Californians who do not qualify for Medi-Cal is an appropriate benefit and justification for the taxpayers, who have paid into the creation of this infrastructure.”
Wiggins argued that persons who meet the requirements of the bill – that is, they are aged, blind or disabled and have incomes below 300 percent of the federal poverty level – should be allowed to purchase IHSS services, “an economical way for them to stay in their own homes, rather than move to settings that allow less independence and cost more.”
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From the time you enter the emergency department until the nurse has completed the initial screening, you’ll wait an average of 18 minutes, according to John Severs, RN, BSN, director of the emergency department. Severs says the average time spent in emergency from door-to-discharge is three hours, which is equal to the national average.
“Our goal is to get people in, treated and out of the emergency department within two hours,” says Severs. “We’ll keep working on it until we get there.”
One major advance is new equipment in the emergency department that tests the blood for heart attack markers – and gives positive results within 15 minutes and completely rules out a heart attack in two hours. It used to take eight hours.
Elevated blood levels of cardiac troponin 1 are highly indicative of a heart attack. If the initial test shows normal (negative), the test is run twice more within two hours. If all tests come back normal, it’s nearly 100 percent certain there’s no heart attack, Sever explains.
“Before, we couldn’t take the chance. So we would fly patients with cardiac symptoms to St. Helena Hospital for emergency cardiac evaluation,” he said. “Now, we know quickly when tests are negative, allowing us to safely keep patients here for observation and referral to the cardiologist.”
Not only is that less expensive, Sever notes, but it is easier on the patient and the family.
Severs’ team continuously audits patient records to find out how the process screening and treatment process needs improvement.
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