Newsom imasaina mabilu okhazikitsa miyezo yowunikira mapulani azaumoyo kuwunikira madandaulo oletsa oyang’anira ntchito – State of Reform

a Law Project Kuwonetsetsa kuwunikiranso pempho la wodwala kapena dokotala kuti alandire chithandizo chopitilira muyeso kapena kukanidwa chilolezo ndi mnzake wachipatala, idasainidwa ndi Bwanamkubwa Gavin Newsom pa Ogasiti 31.

Pezani zidziwitso zaposachedwa za mfundo za boma za gawo lazaumoyo zoperekedwa ku bokosi lanu.


Assembly Bell 1880, mothandizidwa ndi Asm. Joaquin Arambula (D – Fresno) amafuna njira ya Health Plan Use Management (UM) kuti awonetsetse kuti pempho la dongosolo laumoyo la kukana kudutsa UM pa mankhwala likuwunikiridwa ndi dokotala kapena katswiri wina wa zaumoyo yemwe “ali ndi chilolezo chopanda malire kapena chiphaso cha m’boma lililonse ndipo akuchita ntchito yapaderadera kapena yapadera yofanana ndi yachipatala, njira, kapena chithandizo chomwe chikuwunikiridwa.”

Biliyo ikufuna mapulani azaumoyo okhala ndi ma protocol a UM kuti asunge zambiri zokhudzana ndi ma protocolwo, kuphatikiza kuchuluka kwa zopempha zomwe dongosolo laumoyo limalandira. Biluyo ikufunanso mapulani azaumoyo kuti afotokoze zambiri izi, atapempha, ku Dipatimenti Yoyang’anira Zaumoyo (DMHC) kapena Commissioner wa California Department of Inshuwalansi (CDI).

Zosintha zanyumba ya Senate zomwe zidakhazikitsidwa lamuloli lisanasainidwe zikuphatikiza kusinthidwa kuti ziwonetsetse kuti dongosolo lililonse lazaumoyo limafunikira chilolezo kapena chithandizo chapang’onopang’ono chofunikira kuti chidziwitsochi chikhalepo kwa zaka zosachepera 10, kuti chipezeke ku Dubai Medical Center for Health kapena CDI pa pempho.

Malinga ndi Arambula, bilu iyi ithandiza kukonza njira yowunikira anzawo azachipatala komanso kulimbikitsa mwayi wopeza mankhwala opulumutsa moyo.

Udindo wa wolembayo umati, “Ma protocol a UM, monga Progressive Therapy, amalola ndondomeko ya inshuwalansi kuti iwonetsere mankhwala opangidwa ndi mankhwala opangidwa ndi ndalama zokhazokha popanda kuganizira zosowa zapadera za odwala.” “Popanda chitsogozo choyenera, UM imaika malire a wothandizira zaumoyo kuti azitha kulinganiza chisamaliro mogwirizana ndi zosoŵa za wodwala aliyense.” Kwa odwala matenda aakulu kapena aakulu, kutalikitsa chithandizo chosagwira ntchito ndi kuchedwetsa kupeza chithandizo choyenera kungayambitse kuwonjezereka kwa matenda, kulephera kugwira ntchito, ndi kuthekera kwa kupitilira kwa kulumala kosasinthika.

Wothandizira biluyo, bungwe la California Rheumatology Alliance (CRA), akuti biluyo ilimbikitsa zotsatira zabwino za thanzi kwa odwala pofuna wodwala kapena dokotala yemwe akupempha kukana pempho la UM kuti awonane ndi dokotala yemwe ali woyenerera ngati wodwala kuchiza. dokotala.

Chidule cha malamulo okhudza chithandizo cha CRA chimati: “Nthawi zambiri akatswiri a rheumatologists amawunikira kukana kwawo ndi madokotala omwe alibe chidziwitso chochiza rheumatologists.” “Ndikofunikira kuti dokotala akawunika kukana, amvetsetse momwe wodwalayo alili kuti apange chisankho chodziwikiratu ngati apiloyo iyenera kuperekedwa.”

Bungwe la Crohn’s & Colitis Foundation, yemwenso ndi wothandizira ndalamazo, ati ndalamazi zithandiza kuchepetsa ndalama zamaboma.

“… Popanda luso lapaderali, odwala akhoza kukhala pachiopsezo chokhala ndi mavuto aakulu ndipo amafuna chithandizo chatsopano chachipatala chomwe pamapeto pake chimabweretsa ndalama zowonjezera ku dongosolo. amawonjezera mtengo ku dongosolo” .

Mabungwe omwe akusemphana maganizo akuphatikizapo California Association of Health Plans (CAHP), Association of California Life and Health Insurance Companies (ACHIC), ndi American Health Insurance Plans (AHIP). Amanena kuti kuvomereza koyambirira komanso njira zamankhwala zotsatiridwa zimakulitsa chitetezo cha odwala.

“Pamafunika chithandizo chamankhwala chamankhwala kuti ayambe ndi mankhwala otetezeka komanso otsika mtengo asanayambe kupita kumankhwala ena okwera mtengo kapena owopsa,” ikutero chidule cha malamulo a mabungwe omwe amatsutsana nawo. “Chithandizo chopititsa patsogolo chimalimbikitsa opereka chithandizo ndi odwala kuti atenge njira yoyezera, yozikidwa pa umboni yomwe ikugwirizana ndi munthu payekha poyesa momwe wodwalayo amachitira ndi mankhwala osokoneza bongo asanamalize maphunziro apamwamba kwambiri komanso oopsa kwambiri.”

Mabungwe otsutsawo akuti biluyo ikweza mitengo yazithandizo zachipatala kwa ogula potengera mankhwala okwera mtengo, ngakhale mtundu wa generic woyenerera ukupezekanso.

Otsutsa amatsutsanso lamulo loti afotokoze zambiri ku DMHC ndi CDI, podziwa kuti kusungidwa kwa chidziwitso ichi kumapangitsa kuti pakhale zolemetsa za utsogoleri, komanso kuti “malangizo okhwima” ali kale.

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