ICYMI: Sen. Appropriations Committee fiscal analysis of SB 349 finds measure “likely to substantially increase the cost of providing dialysis care” and that cost increases “would impact Medi-Cal.”

For Immediate Release:  May 18, 2017
Contact: Kathy Fairbanks, 916-443-0872

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Sen. Appropriations Committee fiscal analysis of SB 349 finds measure “likely to substantially increase the cost of providing dialysis care” and that cost increases “would impact Medi-Cal.

Broad coalition of doctors, nurses, patients and dialysis providers opposed to SB 349 says bill is dangerous for dialysis patients.

Sacramento, CA – The Senate Appropriations Committee analysis of SB 349 (Lara-dialysis clinic staffing ratio bill) released earlier this week says the measure will significantly increase the cost of providing dialysis care, and that the measure would likely increase costs to Medi-Cal.  At the same time, the analysis references a UC Davis study that found “it is not clear what the potential clinical benefit to patients would be from the increase in staff to patient ratios in the bill.”

According to the committee analysis, “to the extent that chronic dialysis clinics have difficulty meeting the required staff to patient ratios, it is possible that patients would seek treatment in emergency departments and/or hospital inpatient dialysis units.”

The Senate Appropriations committee analysis reinforces what the broad coalition of doctors, nurses, technicians, patients, clinics and others who oppose the bill have been saying: SB 349 will hurt, not help dialysis patients, and the bill comes at great cost to Medi-Cal and our overall health care system.

Here are excerpts from the analysis:

  • “By imposing staffing requirements that exceed current practices in chronic dialysis clinics, the bill will increase the costs to operate those clinics. This is likely to increase Medi-Cal managed care payments to chronic dialysis clinics, but the size of the cost increase is unknown.”
  • “… it is likely to substantially increase the costs of providing dialysis care, as staff costs are a significant portion of the overall cost to provide health care services in clinical settings.”
  • “Given that the operators of chronic dialysis clinics are not likely to be able to pass along cost increases to Medicare, Medi-Cal fee-for-service, or (significantly) to private health insurers, clinic operators may attempt to pass along their cost increases to Medi-Cal managed care plans. Whether they would be successful in doing so is unknown.”
  • To the extent that chronic dialysis clinics have difficulty meeting the required staff to patient ratios, it is possible that patients would seek treatment in emergency departments and/or hospital inpatient dialysis units. Receiving dialysis in those settings is likely to be substantially more expensive than receiving dialysis in a clinic. Any such increases in the cost to provide dialysis would impact Medi-Cal. The extent of that impact is unknown and will depend on the ability of the chronic dialysis clinic industry to consistently meet the requirements of the bill.”
  • “According to a study performed by researchers at UC Davis … expanding state-specific regulation of chronic dialysis clinics beyond federal requirements would be of uncertain marginal value. It is not clear what the potential clinical benefit to patients would be from the increase in staff to patient ratios in the bill.”

About SB 349:

SB 349 would mandate rigid staffing ratios at dialysis clinics and a 45 minute “empty chair” transition time between patient appointments. Doctors, nurses, and dialysis clinics warn the bill will be dangerous for patients by reducing the number of treatment slots available, thus reducing access to dialysis at a time when demand is growing rapidly in California. Even one missed appointment increases patient mortality by 30%.

Further, SB 349 is unnecessary. Federal data collected by the Centers for Medicare & Medicaid Services (CMS) show that California dialysis clinics outperform other states in both quality and patient satisfaction, including states with mandated ratios in place.

On May 15, SB 349 was voted onto suspense file and held in committee because of the fiscal impact the measure will have on Medi-Cal and the general fund. The committee is expected to hear suspense bills with fiscal items later this month.

Visit our website to learn more about the provisions that will be dangerous for patients.

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2017-05-18T18:30:49+00:00 May 18th, 2017|Press Release|