Union officials in California are pushing forward on a ballot measure for November 2018 that would require dialysis providers that operate in the state to refund commercial insurers any revenue that is greater than 15% more than the cost of care.

Service Employees International Union-United Healthcare Workers West (SEIU), which sponsors the measure, reported that it has collected more than 25% of the required 365,880 signatures needed to have the ballot initiative qualify for the Nov. 6, 2018 ballot. More than 66,000 Californians receive dialysis treatments, according to the union.

The SEIU filed two ballot initiatives on Aug. 9 with the California Attorney General for the November 2018 election. Both initiatives are similar to legislation introduced earlier this year about dialysis-related issues.

  • Limiting dialysis profits was covered in the Fair Pricing for Dialysis Act (AB-251) that would require dialysis clinics to spend at least 85% of revenue on direct patient care. Clinics would have to issue rebates to payers for any charges that exceed 115% of the average treatment cost in the state.
  • Establishing patient-staff ratios in dialysis clinics operating in California was introduced earlier this year as the Dialysis Patient Safety Act (SB-349). The chief sponsor, Ricardo Lara (D-Calif.), agreed to table the bill in October before a full vote by the House and Senate, but indicated he would work with the union to have the ratios placed on a ballot measure if dialysis providers and legislators could not reach a compromise plan. The act also called for annual state inspections of dialysis facilities and require minimum transition times between dialysis sessions.

The union must collect 365,880 signatures for each initiative by mid-April 2018 to qualify for the ballot in November 2018. – by Mark E. Neumann