Bill Text: CA AB1578 | 2013-2014 | Regular Session | Amended
Bill Title: Health: The California Health Benefit Review Program.
Spectrum: Partisan Bill (Democrat 4-0)
Status: (Engrossed - Dead) 2014-09-02 - In Assembly. [AB1578 Detail]
Download: California-2013-AB1578-Amended.html
BILL NUMBER: AB 1578 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 19, 2014
AMENDED IN ASSEMBLY MAY 27, 2014
AMENDED IN ASSEMBLY APRIL 28, 2014
INTRODUCED BY Assembly Member Pan
(Principal coauthor: Assembly Member Ting)
(Coauthor: Assembly Member Gordon)
(Coauthor: Senator Lieu)
JANUARY 30, 2014
An act to amend Section 12025 of the Government Code,
relating to services contracts. An act to amend
Sections 127660, 127662, 127664, and 127665 of the Health and Safety
Code, relating to health, and declaring the urgency thereof, to take
effect immediately.
LEGISLATIVE COUNSEL'S DIGEST
AB 1578, as amended, Pan. Online database: expenditures:
service contracts. Health: The California Health
Benefit Review Program.
Existing law establishes the California Health Benefit Review
Program to assess legislation that proposes to mandate or repeal a
mandated health benefit or service, as defined. Existing law requests
the University of California, to provide the analysis to the
appropriate policy and fiscal committees of the Legislature within 60
days after receiving a request for the analysis. Existing law also
requests that the university report to the Governor and the
Legislature on the implementation of the program by January 1, 2014.
This bill would request the University of California to include
essential health benefits and the impact on the California Health
Benefit Exchange in the analysis prepared under the program. The bill
would further request that the University of California assess
legislation that impacts health insurance benefit design, cost
sharing, premiums, and other health insurance topics. The bill would
request that the university provide the analysis to the appropriate
policy and fiscal committees of the Legislature not later than 60
days, or in a manner and pursuant to a timeline agreed to by the
Legislature and the program, after receiving the request, as
specified. The bill would also extend the date by which the
university is requested to report to the Governor and the Legislature
on the implementation program until January 1, 2016.
Existing law establishes the Health Care Benefits Fund to support
the university in implementing the program. Existing law imposes an
annual charge on health care service plans and health insurers, as
specified, to be deposited into the fund. Existing law prohibits the
total annual assessment pursuant to that provision from exceeding
$2,000,000. Under existing law, the fund and the program are repealed
as of June 30, 2015.
This bill would extend until June 30, 2016, the operative date of
the program and the fund, including the annual charge on health care
service plans and health insurers. The bill would repeal the
above-described provisions as of June 30, 2016.
This bill would declare that it is to take effect immediately as
an urgency statute.
Existing law requires the Financial Information System for
California (FISCal) to include a state budget transparency component
that allows the public to have access, on an Internet Web site, to
specified information for each General Fund and federal fund
expenditure. Existing law requires, upon full implementation of the
FISCal Project for state departments and agencies that are utilizing
the full functionality of the FISCal system, specified information
regarding contracts for services in the amount of $5,001 or more to
be made available to the public on the FISCal Project Internet Web
site in a format that allows for searching and sorting by specified
categories.
This bill would specify additional categories for searching and
sorting on the FISCal Project Internet Web site, including the
funding source for the contract and information about personal
services contracts.
The bill would require the Department of Finance to compile
information under the categories on the FISCal Project Internet Web
site in an annual Personal Services Contractor Expenditure Budget to
accompany the Governor's Budget.
Vote: majority 2/3 . Appropriation:
no. Fiscal committee: yes. State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 127660 of the Health
and Safety Code is amended to read:
127660. (a) The Legislature hereby requests the University of
California to establish the California Health Benefit Review Program
to assess legislation proposing to mandate a benefit or service, as
defined in subdivision (c), (d), and
legislation proposing to repeal a mandated benefit or service, as
defined in subdivision (d), (e), and to
prepare a written analysis with relevant data on the following:
(1) Public health impacts, including, but not limited to, all of
the following:
(A) The impact on the health of the community, including the
reduction of communicable disease and the benefits of prevention such
as those provided by childhood immunizations and prenatal care.
(B) The impact on the health of the community, including diseases
and conditions where gender and racial disparities in outcomes are
established in peer-reviewed scientific and medical literature.
(C) The extent to which the benefit or service reduces premature
death and the economic loss associated with disease.
(2) Medical impacts, including, but not limited to, all of the
following:
(A) The extent to which the benefit or service is generally
recognized by the medical community as being effective in the
screening, diagnosis, or treatment of a condition or disease, as
demonstrated by a review of scientific and peer reviewed medical
literature.
(B) The extent to which the benefit or service is generally
available and utilized by treating physicians.
(C) The contribution of the benefit or service to the health
status of the population, including the results of any research
demonstrating the efficacy of the benefit or service compared to
alternatives, including not providing the benefit or service.
(D) The extent to which mandating or repealing the benefits or
services would not diminish or eliminate access to currently
available health care benefits or services.
(3) Financial impacts, including, but not limited to, all of the
following:
(A) The extent to which the coverage or repeal of coverage will
increase or decrease the benefit or cost of the benefit or service.
(B) The extent to which the coverage or repeal of coverage will
increase the utilization of the benefit or service, or will be a
substitute for, or affect the cost of, alternative benefits or
services.
(C) The extent to which the coverage or repeal of coverage will
increase or decrease the administrative expenses of health care
service plans and health insurers and the premium and expenses of
subscribers, enrollees, and policyholders.
(D) The impact of this coverage or repeal of coverage on the total
cost of health care.
(E) The potential cost or savings to the private sector, including
the impact on small employers as defined in paragraph (1) of
subdivision (l) of Section 1357, the Public Employees' Retirement
System, other retirement systems funded by the state or by a local
government, individuals purchasing individual health insurance, and
publicly funded state health insurance programs, including the
Medi-Cal program and the Healthy Families Program.
(F) The extent to which costs resulting from lack of coverage or
repeal of coverage are or would be shifted to other payers, including
both public and private entities.
(G) The extent to which mandating or repealing the proposed
benefit or service would not diminish or eliminate access to
currently available health care benefits or services.
(H) The extent to which the benefit or service is generally
utilized by a significant portion of the population.
(I) The extent to which health care coverage for the benefit or
service is already generally available.
(J) The level of public demand for health care coverage for the
benefit or service, including the level of interest of collective
bargaining agents in negotiating privately for inclusion of this
coverage in group contracts, and the extent to which the mandated
benefit or service is covered by self-funded employer groups.
(K) In assessing and preparing a written analysis of the financial
impact of legislation proposing to mandate a benefit or service and
legislation proposing to repeal a mandated benefit or service
pursuant to this paragraph, the Legislature requests the University
of California to use a certified actuary or other person with
relevant knowledge and expertise to determine the financial impact.
(4) The impact on essential health benefits, as defined in Section
1367.005 and Section 10112.27 of the Insurance Code, and the impact
on the California Health Benefit Exchange.
(b) The Legislature further requests that the California Health
Benefits Review Program assess legislation that impacts health
insurance benefit design, cost sharing, premiums, and other health
insurance topics.
(b)
(c) The Legislature requests that the University of
California provide every analysis to the appropriate policy and
fiscal committees of the Legislature not later than 60 days
days, or in a manner and pursuant to a timeline agreed
to by the Legislature and the California Health Benefits Review
Program, after receiving a request made pursuant to Section
127661. In addition, the Legislature requests that the university
post every analysis on the Internet and make every analysis available
to the public upon request.
(c)
(d) As used in this section, "legislation proposing to
mandate a benefit or service" means a proposed statute that requires
a health care service plan or a health insurer, or both, to do any of
the following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
(d)
(e) As used in this section, "legislation proposing to
repeal a mandated benefit or service" means a proposed statute that,
if enacted, would become operative on or after January 1, 2008, and
would repeal an existing requirement that a health care service plan
or a health insurer, or both, do any of the following:
(1) Permit a person insured or covered under the policy or
contract to obtain health care treatment or services from a
particular type of health care provider.
(2) Offer or provide coverage for the screening, diagnosis, or
treatment of a particular disease or condition.
(3) Offer or provide coverage of a particular type of health care
treatment or service, or of medical equipment, medical supplies, or
drugs used in connection with a health care treatment or service.
SEC. 2. Section 127662 of the Health
and Safety Code is amended to read:
127662. (a) In order to effectively support the University of
California and its work in implementing this chapter, there is hereby
established in the State Treasury, the Health Care Benefits Fund.
The university's work in providing the bill analyses shall be
supported from the fund.
(b) For fiscal years 2010-11 to 2014-15,
2015-16, inclusive, each health care service plan, except a
specialized health care service plan, and each health insurer, as
defined in Section 106 of the Insurance Code, shall be assessed an
annual fee in an amount determined through regulation. The amount of
the fee shall be determined by the Department of Managed Health Care
and the Department of Insurance in consultation with the university
and shall be limited to the amount necessary to fund the actual and
necessary expenses of the university and its work in implementing
this chapter. The total annual assessment on health care service
plans and health insurers shall not exceed two million dollars
($2,000,000).
(c) The Department of Managed Health Care and the Department of
Insurance, in coordination with the university, shall assess the
health care service plans and health insurers, respectively, for the
costs required to fund the university's activities pursuant to
subdivision (b).
(1) Health care service plans shall be notified of the assessment
on or before June 15 of each year with the annual assessment notice
issued pursuant to Section 1356. The assessment pursuant to this
section is separate and independent of the assessments in Section
1356.
(2) Health insurers shall be noticed of the assessment in
accordance with the notice for the annual assessment or quarterly
premium tax revenues.
(3) The assessed fees required pursuant to subdivision (b) shall
be paid on an annual basis no later than August 1 of each year. The
Department of Managed Health Care and the Department of Insurance
shall forward the assessed fees to the Controller for deposit in the
Health Care Benefits Fund immediately following their receipt.
(4) "Health insurance," as used in this subdivision, does not
include Medicare supplement, vision-only, dental-only, or CHAMPUS
supplement insurance, or hospital indemnity, accident-only, or
specified disease insurance that does not pay benefits on a fixed
benefit, cash payment only basis.
SEC. 3. Section 127664 of the Health
and Safety Code is amended to read:
127664. The Legislature requests the University of California to
submit a report to the Governor and the Legislature by January 1,
2014, 2016, regarding the
implementation of this chapter. This report shall be submitted
in compliance with Section 9795 of the Government Code.
SEC. 4. Section 127665 of the Health
and Safety Code is amended to read:
127665. This chapter shall remain in effect until June 30,
2015, 2016, and shall be repealed as of
that date, unless a later enacted statute that becomes operative on
or before June 30, 2015, 2016, deletes
or extends that date.
SEC. 5. This act is an urgency statute necessary
for the immediate preservation of the public peace, health, or safety
within the meaning of Article IV of the Constitution and shall go
into immediate effect. The facts constituting the necessity are:
In order to ensure that the University of California is provided
with sufficient advance notice regarding the continuing duties of the
university to plan and carry out the necessary research and analysis
requested pursuant to this act, it is necessary that this act take
effect immediately.
SECTION 1. Section 12025 of the Government Code
is amended to read:
12025. (a) Upon full implementation of the Financial Information
System for California (FISCal) Project for state departments and
agencies that are utilizing the full functionality of the FISCal
system, information regarding contracts for services in the amount of
five thousand one dollars ($5,001) or more shall be made available
to the public on the FISCal Project Internet Web site in a format
that allows for searching and sorting by the following categories:
(1) A description of the contract and the services being
purchased.
(2) A description of the personal services contract and services
being purchased.
(3) The name of the agency, department, or division contracting
for the services.
(4) The name of the contractor and any and all subcontractors,
unless otherwise exempt from disclosure.
(5) The effective date and expiration date of the contract.
(6) The annual amounts paid or to be paid under the contract, to
the contractor, in all fiscal years during which the contract will be
in effect, by funding source.
(7) The original amount of the contract and the total projected
cost of the contract, or maximum cost the contract is prohibited from
exceeding, for all fiscal years during which the contract will be in
effect, by funding source.
(8) The acquisition method.
(b) The Department of Finance shall compile the information listed
in paragraphs (2) to (8), inclusive, of subdivision (a) in an annual
Personal Services Contractor Expenditure Budget accompanying the
Governor's Budget.
