The CAHU Monday Morning Report

	AB 1600	(Beall D)  Health care coverage: mental health services.
		Introduced: 1/4/2010
		Status: 8/26/2010-Assembly Rule 77 suspended. Senate amendments concurred in. To enrollment.
		Location: 8/26/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Under existing law, a health care service plan contract and a health insurance policy are required to provide coverage for the diagnosis and treatment of severe mental illnesses of a person of any age. Existing law does not define "severe mental illnesses" for this purpose but describes it as including several conditions. This bill would expand this coverage requirement for certain health care service plan contracts and health insurance policies issued, amended, or renewed on or after January 1, 2011, to include the diagnosis and treatment of a mental illness of a person of any age and would define mental illness for this purpose as a mental disorder defined in the Diagnostic and Statistical Manual of Mental Disorders IV, including substance abuse but excluding nicotine dependence and specified diagnoses defined in the manual, subject to regulatory revision, as specified. The bill would specify that this requirement does not apply to a health care benefit plan, contract, or health insurance policy with the Board of Administration of the Public Employees' Retirement System unless the board elects to purchase a plan, contract, or policy that provides mental health coverage. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose		Craig Gussin

	AB 1602	(John A. Perez D)  California Health Benefit Exchange.
		Introduced: 1/4/2010
		Status: 8/25/2010-In Assembly. Concurrence in Senate amendments pending. May be considered on or after August 27 pursuant to Assembly Rule 77. Assembly Rule 77 suspended. Senate amendments concurred in. To enrollment.
		Location: 8/25/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law provides various programs to provide health care coverage to persons with limited financial resources, including the Medi-Cal program and the Healthy Families Program. Existing law provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of its provisions a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. This bill would enact the California Patient Protection and Affordable Care Act, and would, contingent on the enactment of SB 900, which would create the California Health Benefit Exchange (the Exchange), specify the powers and duties of the board governing the Exchange relative to determining eligibility for enrollment in the Exchange and arranging for coverage under qualified health plans, and would require the board to facilitate the purchase of qualified health plans through the Exchange by qualified individuals and qualified small employers by January 1, 2014. The bill would create the California Health Trust Fund as a continuously appropriated fund and would make the implementation of these provisions contingent on a determination by the board that sufficient financial resources exist or will exist in the fund, as specified. The bill would enact other related provisions. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose as Drafted		Harry Thal

	AB 1759	(Blumenfield D)  Health care coverage: premium rates.
		Introduced: 2/8/2010
		Status: 8/25/2010-Senate amendments concurred in. To enrollment.
		Location: 8/25/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of its provisions a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits a health care service plan or a health insurer from changing its premium rates or applicable copayments or coinsurances or deductibles for group health care service plan contracts or group health insurance policies during specified time periods; however, changes to the premium rates or applicable copayments or coinsurances or deductibles are allowed when, among other things, the change is authorized or required in the group contract. This bill would require a health care service plan or health insurer that includes a provision in a group contract or policy that authorizes or requires a change in premium rates, copayments, coinsurances, or deductibles, to provide an additional disclosure that describes the circumstances under which a change may occur and that provides defined terms and examples of those circumstances, to be signed by the group contractholder or group policyholder and provided to the subscribers or insureds, as specified. Because a willful violation of those provisions would be a crime under the Knox-Keene Act, the bill would impose a state-mandated local program. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Support		Robert Donin

	AB 1825	(De La Torre D)  Maternity services.
		Introduced: 2/11/2010
		Status: 8/26/2010-Assembly Rule 77 suspended. Senate amendments concurred in. To enrollment.
		Location: 8/26/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law provides for the regulation of health insurers by the Department of Insurance. Under existing law, a health insurer that provides maternity coverage may not restrict inpatient hospital benefits, as specified, and is required to provide notice of the maternity services coverage. This bill would require health insurance policies issued, amended, or renewed on or after July 1, 2011, and prior to January 1, 2014, to provide coverage for maternity services, as defined and would require health insurance policies issued, amended, or renewed on or after January 1, 2014, to provide coverage for maternity services consistent with the federal Patient Protection and Affordable Care Act, as specified . The bill would also, until January 1, 2014, to the extent permitted under federal law, authorize certain individual health insurance policies to include an exclusionary period of up to 12 months on maternity services, as specified, and would require the insurer to provide a specified notice regarding that exclusionary period at the time of solicitation for the policy.

		Organization	Position		Assigned
		CAHU	Oppose		Steve Snitchler

	AB 1826	(Huffman D)  Health care coverage: prescriptions.
		Introduced: 2/11/2010
		Status: 8/12/2010-In committee: Held under submission.
		Location: 8/12/2010-S. APPR.
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan contract or a health insurance policy covering prescription drug benefits to provide specified coverage to subscribers, enrollees, and insureds. This bill would require health care service plan contracts and health insurance policies that cover outpatient prescription drug benefits to provide coverage for a drug that has been prescribed for the treatment of pain and would prohibit those contracts and policies from requiring the subscriber, enrollee, or insured to first use another drug or product as specified . This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Paula Wilson

	AB 1868	(Jones D)  Insurance: life: disability: discretionary clauses.
		Introduced: 2/12/2010
		Status: 8/25/2010-Senate amendments concurred in. To enrollment.
		Location: 8/25/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law generally regulates life and disability insurance policies, and requires the Insurance Commissioner to disapprove any disability policy for issuance or delivery in this state in specified circumstances. This bill would provide that if a policy, contract, certificate, or agreement offered, issued, delivered, or renewed, whether or not in California, that provides or funds life insurance or disability insurance coverage for any California resident contains a provision that reserves discretionary authority to the insurer, or an agent of the insurer, to determine eligibility for benefits or coverage, to interpret the terms of the policy, contract, certificate, or agreement, or to provide standards of interpretation or review that are inconsistent with the laws of this state, that provision would be void and unenforceable. The bill would define the term "discretionary authority" for these purposes. This bill contains other related provisions.

		Organization	Position		Assigned
		CAHU	Oppose		Craig Gussin

	AB 1887	(Villines R)  Temporary high risk pool.
		Introduced: 2/16/2010
		Status: 6/29/2010-Chaptered by the Secretary of State, Chapter Number 32, Statutes of 2010
		Location: 6/29/2010-A. CHAPTERED
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act, requires the United States Secretary of Health and Human Services to establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals until January 1, 2014. Existing law authorizes the secretary to carry out this program directly or through contracts to eligible entities, including states, and requires that money made available pursuant to these provisions be used to establish a qualified high risk pool that meets certain requirements. This bill would establish the Federal Temporary High Risk Health Insurance Fund as a continuously appropriated fund to administer the qualified high risk pool required by federal law, thereby making an appropriation. The bill would repeal these provisions on January 1, 2020. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Support		Harry Thal

	AB 2042	(Feuer D)  Health care coverage: rate changes.
		Introduced: 2/17/2010
		Status: 8/25/2010-Senate amendments concurred in. To enrollment.
		Location: 8/25/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Under existing law, no change in premium rates or coverage in a health care service plan contract or a health insurance policy may become effective without prior written notification of the change to the contractholder or policyholder. Existing law prohibits a plan or insurer during the term of a group plan contract or policy from changing the rate of the premium, copayment, coinsurance, or deductible during specified time periods. This bill would prohibit a health care service plan or health insurer from altering the rates, as defined, that apply to individual health care service plan contracts or individual health insurance policies, or altering any benefits included in individual contracts or policies, more than once each calendar year, except as specified. Among those exceptions, the bill would provide that, if a brand name drug becomes available as a generic drug, the application of a lower cost-sharing rate for the generic drug would not constitute an alteration of benefits. The bill's provisions would apply to a new individual plan contract or policy issued to an enrollee or insured who transfers from another plan or policy, as specified, and would prohibit the issuance of new plan contracts or policies more often than annually. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose Unless Amended		Heinz Schuelmisler

	AB 2110	(De La Torre D)  Health care coverage: premium payments: grace periods.
		Introduced: 2/18/2010
		Status: 8/30/2010-To inactive file on motion of Senator Romero.
		Location: 8/30/2010-S. INACTIVE FILE
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law provides for the regulation of disability insurers by the Department of Insurance and requires disability insurance policies to include a provision setting forth a grace period for making premium payments. Under existing law, that grace period must equal no less than 7 days for weekly premium policies, no less than 10 days for monthly premium policies, and no less than 31 days for all other policies. Existing law prohibits the Insurance Commissioner from approving a policy for issuance or delivery, and authorizes the commissioner to withdraw approval of the policy, if it fails to meet these requirements. This bill would require individual health care service plan contracts and individual health insurance policies issued, amended, or renewed on or after January 1, 2011, to provide a grace period of 50 days for the payment of premiums and would make an enrollee or insured who fails to pay the premium during that period liable for any medical costs incurred during the period, except as specified. The bill would require plans and insurers to provide specified notice of this grace period upon issuance, amendment, or renewal of an individual contract or policy. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose		Robert Donin

	AB 2345	(De La Torre D)  Health care coverage: preventive services.
		Introduced: 2/19/2010
		Status: 8/24/2010-Assembly Rule 77 suspended. Senate amendments concurred in. To enrollment.
		Location: 8/24/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms. With respect to plan years beginning on and after September 23, 2010, the act requires health insurance issuers to provide coverage, and not impose cost-sharing requirements, for certain preventive services. This bill would require health care service plan contracts and health insurance policies issued, amended, renewed, or delivered on or after September 23, 2010, to comply with the provisions of PPACA regarding coverage of, and cost-sharing for, preventive services and any rules or regulations issued pursuant to those provisions to the extent required under federal law. Because a willful violation of this requirement by a health care service plan would be a crime, the bill would impose a state-mandated local program. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Craig Gussin

	AB 2389	(Gaines R)  Health care coverage: health facilities: cost and quality information.
		Introduced: 2/19/2010
		Status: 8/31/2010-Action rescinded whereby the bill was re-referred to Com. On P.E.,R. & S.S. pursuant to Assembly Rule 77.2. To inactive file on motion of Assembly Member Gaines.
		Location: 8/31/2010-A. INACTIVE FILE
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits a contract between a plan or insurer and a health care provider from containing certain terms. This bill would prohibit a contract by or on behalf of a plan or insurer and a health care facility, as defined, to provide inpatient hospital services or ambulatory care services to subscribers and enrollees of the plan or policyholders and insureds of the insurer from containing a provision that restricts the ability of the plan or insurer to furnish information to subscribers or enrollees of the plan or policyholders or insureds of the insurer concerning the cost range of procedures at the facility or the quality of services performed by the facility , provided that, among other requirements, the cost information is limited to certain elective, uncomplicated procedures, the plan or insurer also discloses the location of its facility cost ranges and quality measurements and makes specified disclosures regarding those measurements and the cost information provided , and the plan or insurer provides affected facilities an opportunity to review the information prior to furnishing it to subscribers, enrollees, policyholders, or insureds, as specified . The bill would make a contractual provision inconsistent with the bill's requirements void and unenforceable.

		Organization	Position		Assigned
		CAHU	Support

	AB 2470	(De La Torre D)  Health care coverage: cancellation: rescission.
		Introduced: 2/19/2010
		Status: 8/31/2010-Senate amendments concurred in. To enrollment.
		Location: 8/31/2010-A. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care, and makes a willful violation of its provisions a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. Existing law prohibits the cancellation or nonrenewal of individual or group health benefit plans by a health care service plan or a health insurer except in specified circumstances, including for nonpayment of premiums or for fraud or misrepresentation, as specified, and gives an enrollee of a health care service plan contract a right to appeal a cancellation or nonrenewal to the Director of the Department of Managed Health Care. Existing law prohibits a plan or insurer from engaging in postclaims underwriting, as defined, and from rescinding an individual contract or policy for any reason, or canceling the contract or policy due to misrepresentation, as specified, after 24 months following issuance of the contract or policy. This bill would make that 24-month limit apply to all health care service plan contracts and health insurance policies and would consolidate various cancellation and nonrenewal provisions with respect to health care service plans . The bill would also prohibit a plan or insurer from rescinding a health care service plan contract or health insurance policy, or limiting any of the provisions of the contract or policy, once an enrollee or insured is covered under the contract or policy unless the plan or insurer can demonstrate that the enrollee or insured has performed an act or practice constituting fraud or made an intentional misrepresentation of material fact as prohibited by the terms of the contract or policy. The bill would require a plan or insurer to send a notice to the enrollee or subscriber or policyholder or insured at least 30 days prior to the effective date of the rescission containing specified information. The bill would modify the cancellation and nonrenewal appeal rights that apply to health care service plans and would make those appeal rights apply to health insurers and rescissions, as specified. The bill would require that coverage under the plan or policy shall continue pending the appeal. The bill would make other related changes and authorize the Director of the Department of Managed Health Care and the Insurance Commissioner to issue guidance to health care service plans and health insurers on compliance, as specified. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose		Harry Thal

	AB 2533	(Fuentes D)  Health care coverage: quality rating.
		Introduced: 2/19/2010
		Status: 8/13/2010-Failed Deadline pursuant to Rule 61(b)(14). (Last location was INACTIVE FILE on 8/5/2010)
		Location: 8/13/2010-S. DEAD
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. Existing law makes a willful violation of the act's requirements a crime. Existing law provides for the regulation of health insurers by the Department of Insurance. This bill would expand these provisions to apply to quality rating, as defined, utilized by the plan or insurer with respect to a particular physician, provider, medical group, or individual practice association. The bill would also require the department filings to be made immediately upon adoption of the policies and procedures and within 30 days of making any changes to the policies and procedures. The bill would modify the required content of the filings, as specified, and would require a plan or insurer that submitted a filing prior to January 1, 2011, to update the filing by March 31, 2011, to comply with the bill's requirements and to reflect the plan's or insurer's current policies and procedures . This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Heinz Schuelmisler

	AB 2578	(Jones D)  Health care coverage: rate approval.
		Introduced: 2/19/2010
		Status: 8/31/2010-Read third time, passage refused. (Ayes 16. Noes 19.)
		Location: 8/30/2010-S. THIRD READING
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene Act), provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of insurers by the Department of Insurance, including health insurers. Existing law makes the violation of a final order by the Insurance Commissioner relating to rates imposed by certain insurers, other than health insurers, subject to assessment of a civil penalty and makes the willful violation by those insurers of specified rate provisions a misdemeanor. Under existing law, no change in premium rates or coverage in a health care service plan or a health insurance policy may become effective without prior written notification of the change to the contractholder or policyholder. Existing law prohibits a plan and insurer during the term of a group plan contract or policy from changing the rate of the premium, copayment, coinsurance, or deductible during specified time periods. This bill would require approval by the Department of Managed Health Care or the Department of Insurance of an increase in the amount of the premium, copayment, coinsurance obligation, deductible, and other charges under health care service plan contracts or health insurance policies, other than Medicare supplement , dental-only , or vision-only contracts or policies. The bill would require a plan or insurer to submit to the Department of Managed Health Care or the Department of Insurance, respectively, an application for a rate increase that would be effective on or after January 1, 2012, and would require review of the application in accordance with regulations that each department would be required to adopt no later than January 1, 2012. The bill would subject a rate increase that became effective January 1, 2010, to December 31, 2011, inclusive, to review by the appropriate department. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose		Robert Donin

	AB 2717	(Skinner D)  Insurance: agents and brokers: senior designation: use.
		Introduced: 2/19/2010
		Status: 8/25/2010-Enrolled and to the Governor at 2:50 p.m.
		Location: 8/25/2010-A. ENROLLED
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law provides that a broker or agent may not use a senior designation unless he or she has met certain conditions, including, but not limited to, that the broker or agent has been granted the right and is currently authorized to use the senior designation by the organization that issues the designation, and the senior designation has been approved by the Insurance Commissioner for use by brokers and agents in the sale of insurance to seniors, as provided. This bill would require that the commissioner approve a senior designation only if the organization that issues the designation satisfies specified requirements, including, but not limited to, accreditation standards, education and examination requirements, and having minimum standards and procedures regarding disciplining the organization's designees for improper or unethical conduct. This bill contains other related provisions.

		Organization	Position		Assigned
		CAHU	Support

	SB 56	(Alquist D)  Health plans: joint ventures.
		Introduced: 1/20/2009
		Status: 8/25/2010-Senate concurs in Assembly amendments. (Ayes 21. Noes 10.) To enrollment.
		Location: 8/25/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law creates various health benefits programs, including the Medi-Cal program, administered by the State Department of Health Care Services, and the County Medical Services Program. Existing law, the Knox-Keene Health Care Service Plan Act of 1975, administered by the Department of Managed Health Care, provides for the licensure and regulation of health care service plans. This bill would authorize certain local initiative health plans, county-organized health plans, and the County Medical Services Program governing board to form joint ventures that consist of contractual relationships to pool risk or share networks, or both, or to provide for the joint or coordinated offering of health plans to individuals and groups. The bill would require all joint ventures established pursuant to the above provisions to meet all of the requirements of the Knox-Keene Health Care Service Plan Act of 1975.

		Organization	Position		Assigned
		CAHU	Watch		Paula Wilson

	SB 227	(Alquist D)  Health care coverage: temporary high risk pool.
		Introduced: 2/23/2009
		Status: 6/29/2010-Chaptered by the Secretary of State, Chapter Number 31, Statutes of 2010
		Location: 6/29/2010-S. CHAPTERED
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act, requires the United States Secretary of Health and Human Services to establish a temporary high risk health insurance pool program to provide health insurance coverage for eligible individuals until January 1, 2014. Existing law authorizes the secretary to implement this program directly or through contracts with eligible entities, including the states, and requires that federal money made available pursuant to these provisions be used to establish a qualified high risk pool that meets certain requirements. This bill would require MRMIB to enter into an agreement with the federal Department of Health and Human Services to administer a temporary high risk pool to provide health coverage, until January 1, 2014, to specified individuals who have preexisting conditions, consistent with the federal Patient Protection and Affordable Care Act. The bill would repeal these provisions on January 1, 2020. The bill would also appropriate $761,000,000 from the Federal Trust Fund to MRMIB for the purposes of these provisions. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Support If Amended		Craig Gussin

	SB 316	(Alquist D)  Health care coverage: disclosures.
		Introduced: 2/25/2009
		Status: 7/2/2010-Failed Deadline pursuant to Rule 61(b)(13). (Last location was HEALTH on 2/11/2010)
		Location: 7/2/2010-A. DEAD
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of disability insurers by the Department of Insurance. Existing law requires health care service plans and disability insurers, and their employees or agents, when presenting a p lan contract or policy for examination or sale to an individual purchaser or to the representative of a group consisting of 25 or fewer individuals, to make a written disclosure of the ratio of premium costs to health services paid, in the case of health care service plans, or of incurred claims to earned premiums, in the case of disability insurers, for the preceding year, as specified. This bill would instead require that this disclosure be made when presenting a plan contract or policy for examination or sale to an individual purchaser or to the representative of a group consisting of 50 or fewer individuals. The bill would make other technical, nonsubstantive changes. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Craig Gussin

	SB 810	(Leno D)  Single-payer health care coverage.
		Introduced: 2/27/2009
		Status: 8/23/2010-Assembly Rule 69(d) suspended.
		Location: 8/16/2010-A. THIRD READING
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law does not provide a system of universal health care coverage for California residents. Existing law provides for the creation of various programs to provide health care services to persons who have limited incomes and meet various eligibility requirements. These programs include the Healthy Families Program administered by the Managed Risk Medical Insurance Board, and the Medi-Cal program administered by the State Department of Health Care Services. Existing law provides for the regulation of health care service plans by the Department of Managed Health Care and health insurers by the Department of Insurance. This bill would establish the California Healthcare System to be administered by the newly created California Healthcare Agency under the control of a Healthcare Commissioner appointed by the Governor and subject to confirmation by the Senate. The bill would make all California residents eligible for specified health care benefits under the California Healthcare System, which would, on a single-payer basis, negotiate for or set fees for health care services provided through the system and pay claims for those services. The bill would provide that a resident of the state with a household income, as specified, at or below 200% of the federal poverty level would be eligible for the type of benefits provided under the Medi-Cal program. The bill would require the commissioner to seek all necessary waivers, exemptions, agreements, or legislation to allow various existing federal, state, and local health care payments to be paid to the California Healthcare System, which would then assume responsibility for all benefits and services previously paid for with those funds. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Oppose		Steven Lindsay

	SB 890	(Alquist D)  Health care coverage.
		Introduced: 1/21/2010
		Status: 8/31/2010-Re-referred to Com. On HEALTH. From committee: That the Assembly amendments be concurred in. (Ayes 6. Noes 2.) Senate concurs in Assembly amendments. (Ayes 21. Noes 11.) To enrollment.
		Location: 8/31/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act, on and after January 1, 2014, requires a health insurance issuer offering health insurance coverage in the individual or group market to accept every employer and individual in the state that applies for that coverage, as specified, and requires issuers in the individual and small group markets to ensure that the coverage includes a specified essential benefits package. The act requires an essential health benefits package to provide coverage in one of 5 levels based on actuarial value, as specified. This bill would eliminate the 18-month requirement and would require plans and insurers to allow an individual to transfer to another individual contract or policy without medical underwriting on the annual renewal date of his or her contract or policy. Commencing July 1, 2011, the bill would require plans and insurers to categorize all products offered in the individual market into 5 tiers according to actuarial value, as specified, and would require plans and insurers to disclose this value and other information in certain disclosure forms. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Neutral		Robert Donin

	SB 900	(Alquist D)  California Health Benefit Exchange.
		Introduced: 1/26/2010
		Status: 8/24/2010-Senate concurs in Assembly amendments. (Ayes 22. Noes 13.) To enrollment.
		Location: 8/24/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act, requires each state to, by January 1, 2014, establish an American Health Benefit Exchange that makes available qualified health plans to qualified individuals and qualified employers, as specified, and meets certain other requirements. Existing law provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and the regulation of health insurers by the Department of Insurance. This bill would, contingent on the enactment and operation of AB 1602, establish the California Health Benefit Exchange (the Exchange) within state government. The bill would require the Exchange to be governed by a board composed of the Secretary of California Health and Human Services, or his or her designee, and 4 other members appointed by the Governor and the Legislature in a specified manner and would enact other related provisions with respect to the governance of the Exchange. The bill would also require the board of the exchange, or the California Health and Human Services Agency, if a majority of the board has not been appointed, to apply for and receive federal funds for purposes of establishing the Exchange. This bill contains other related provisions.

		Organization	Position		Assigned
		CAHU	Oppose Unless Amended		Paula Wilson

	SB 961	(Wright D)  Health care coverage: cancer treatment.
		Introduced: 2/5/2010
		Status: 8/25/2010-Senate concurs in Assembly amendments. (Ayes 29. Noes 5.) To enrollment.
		Location: 8/25/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. Existing law requires health care service plan contracts and health insurance policies to provide coverage for all generally medically accepted cancer screening tests and requires those plans and policies to also provide coverage for the treatment of breast cancer. Existing law imposes various requirements on contracts and policies that cover prescription drug benefits. This bill, until January 1, 2015, would require health care service plan contracts and health insurance policies that provide coverage for cancer chemotherapy treatment to provide coverage for a prescribed, orally administered, nongeneric cancer medication, as specified. The bill would require a health care service plan or health insurer to review the percentage cost share, as defined, for oral nongeneric cancer medications and intravenous or injected nongeneric cancer medications and to apply the lower of the 2 as the cost-sharing provision for oral nongeneric cancer medications. The bill would limit increases in cost sharing for nongeneric cancer medications, as specified. The bill would specify that its provisions do not apply to health care service plan contracts or health insurance policies that do not provide coverage for prescription drugs. The bill would specify that its provisions do not apply to a health care benefit plan, contract, or health insurance policy with the Board of Administration of the Public Employees' Retirement System. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Steve Snitchler

	SB 1088	(Price D)  Health care coverage: dependents.
		Introduced: 2/17/2010
		Status: 8/25/2010-Senate concurs in Assembly amendments. (Ayes 23. Noes 11.) To enrollment.
		Location: 8/25/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the federal Patient Protection and Affordable Care Act, requires a health insurance issuer issuing group or individual coverage that provides dependent coverage of children to continue to make that coverage available for an adult child until the child attains 26 years of age with respect to plan years beginning on or after September 23, 2010. Regulations promulgated under that provision require issuers to provide certain dependents who have lost or been denied coverage an opportunity to enroll, as specified. This bill would prohibit the limiting age for dependent children covered by health care service plan contracts and health insurance policies from being less than 26 years of age with respect to plan or policy years beginning on or after September 23, 2010, except for certain group contracts and policies for plan or policy years beginning before January 1, 2014, as specified. The bill would require plans and insurers to provide certain dependents who have lost or been denied coverage an opportunity to enroll, as specified. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Harry Thal

	SB 1163	(Leno D)  Health care coverage: denials: premium rates.
		Introduced: 2/18/2010
		Status: 8/31/2010-Re-referred to Com. On HEALTH. From committee: That the Assembly amendments be concurred in. (Ayes 6. Noes 2.) Senate concurs in Assembly amendments. (Ayes 21. Noes 14.) To enrollment.
		Location: 8/31/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care and makes a willful violation of the act a crime. Existing law also provides for the regulation of health insurers by the Department of Insurance. This bill would require a health care service plan that offers coverage in the group market and a health insurer that offers health care coverage in the individual or group market to provide an applicant to whom it denies coverage or enrollment , as specified, or offers coverage at a rate higher than the standard rate or standard employee risk rate with the specific reason or reasons for that decision in writing. With respect to both health insurers and health care service plans issuing individual or group policies or contracts, the bill would require that the reasons for a denial or a higher than standard rate be stated in clear, easily understandable language. The bill would require notice of a change to the premium rate of coverage to be provided at least 60 days prior to the effective date of the change. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Harry Thal

	SB 1166	(Simitian D)  Personal information: privacy.
		Introduced: 2/18/2010
		Status: 8/19/2010-Senate concurs in Assembly amendments. (Ayes 31. Noes 4. Page 4647.) To enrollment.
		Location: 8/19/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law requires any agency, and any person or business conducting business in California, that owns or licenses computerized data that includes personal information, as defined, to disclose in specified ways, any breach of the security of the system or data, as defined, following discovery or notification of the security breach, to any California resident whose unencrypted personal information was, or is reasonably believed to have been, acquired by an unauthorized person. This bill would require any agency, person, or business that is required to issue a security breach notification pursuant to existing law to fulfill certain additional requirements pertaining to the security breach notification, as specified. This bill contains other related provisions.

		Organization	Position		Assigned
		CAHU	Support		Dan White

	SB 1283	(Steinberg D)  Health care coverage: grievance system.
		Introduced: 2/19/2010
		Status: 8/26/2010-Senate concurs in Assembly amendments. (Ayes 23. Noes 11.) To enrollment.
		Location: 8/26/2010-S. ENROLLMENT
		2Year Dead Desk Policy Fiscal Floor Desk Policy Fiscal Floor Conf. Conc. Enrolled Vetoed Chaptered 1st House 2nd House
		Summary: Existing law, the Knox-Keene Health Care Service Plan Act of 1975, provides for the licensure and regulation of health care service plans by the Department of Managed Health Care. A willful violation of the act constitutes a crime. Existing law requires every health care service plan to establish and maintain a grievance system approved by the department under which enrollees and subscribers may submit a grievance to the plan. Existing law authorizes a subscriber or enrollee to submit his or her grievance to the department for review after completing the grievance process or after having participated in that process for at least 30 days. Existing law requires the department to send a written notice of the final disposition of the grievance to an enrollee or subscriber within 30 days of receiving the request for review, unless the director determines that additional time is reasonably necessary to fully review the grievance. This bill would, upon a determination by the director that, do to extraordinary circumstances, additional time is necessary to review a grievance, set forth the procedures that would apply to the department with regard to the review of that grievance and the payment of specified costs by the department. Upon a failure of a health care service plan to comply with a request from the department for information related to the grievance, the bill would authorize the department to impose an administrative fine on that plan, pursuant to specified procedures, as determined by the department. This bill contains other related provisions and other existing laws.

		Organization	Position		Assigned
		CAHU	Watch		Robert Donin

Total Measures: 26

Total Tracking Forms: 26