Bill Text: CA AB2389 | 2009-2010 | Regular Session | Amended

NOTE: There are more recent revisions of this legislation. Read Latest Draft

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Bill Title: Health care coverage: health facilities: cost and

Spectrum: Partisan Bill (Republican 1-0)

Status: (Engrossed - Dead) 2010-08-31 - Re-referred to Com. on P.E.,R. & S.S. pursuant to Assembly Rule 77.2. Action rescinded whereby the bill was re-referred to Com. on P.E.,R. & S.S. pursuant to Assembly Rule 77.2. (Page 6934.) To inactive file on motion of Assembly Member Charles Calderon. [AB2389 Detail]

Download: California-2009-AB2389-Amended.html

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BILL NUMBER: AB 2389	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  MAY 24, 2010
	AMENDED IN ASSEMBLY  MAY 20, 2010
	AMENDED IN ASSEMBLY  APRIL 8, 2010

INTRODUCED BY   Assembly Member Gaines

                        FEBRUARY 19, 2010

   An act to add Section 1367.49 to the Health and Safety Code, and
to add Section 10133.64 to the Insurance Code, relating to health
care coverage.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 2389, as amended, Gaines. Health care coverage: provider
contracts.
   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 licensed hospital, as defined, or any other licensed
health care facility, as defined, owned by a licensed hospital 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 hospital or
licensed health care facility or the quality of services performed
by the hospital or facility. The bill would make a contractural
provision inconsistent with this requirement void and unenforceable.

   Vote: majority. Appropriation: no. Fiscal committee: no.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 1367.49 is added to the Health and Safety Code,
to read:
   1367.49.  (a) A contract issued, amended, renewed, or delivered on
or after January 1, 2011, by or on behalf of a health care service
plan and a licensed hospital or any other licensed health care
facility owned by a licensed hospital to provide inpatient hospital
services or ambulatory care services to subscribers and enrollees of
the plan shall not contain any provision that restricts the ability
of the health care service plan to furnish information to subscribers
or enrollees of the plan concerning the cost  range  of
procedures at the hospital or the licensed health care facility or
the quality of services performed by the hospital or facility.
   (b) Any contractural provision inconsistent with this section
shall be void and unenforceable.
   (c) For purposes of this section, the following definitions apply:

   (1) "Licensed hospital" has the same meaning as set forth in
Section 4028 of the Business and Professions Code.
   (2) "Licensed health care facility" means any institution or
health facility, other than a long-term health care facility as
defined pursuant to Section 1418, licensed by the State Department of
Public Health to deliver or furnish health care services.
   (d) Section 1390 shall not apply for purposes of this section.
  SEC. 2.  Section 10133.64 is added to the Insurance Code, to read:
   10133.64.  (a) A contract issued, amended, renewed, or delivered
on or after January 1, 2011, by or on behalf of a health insurer and
a licensed hospital or any other licensed health care facility owned
by a licensed hospital to provide inpatient hospital services or
ambulatory care services to policyholders and insureds of the insurer
shall not contain any provision that restricts the ability of the
health insurer to furnish information to policyholders or insureds
concerning the cost  range  of procedures at the hospital or
the licensed health care facility or the quality of services
provided by the hospital or facility.
   (b) Any contractural provision inconsistent with this section
shall be void and unenforceable.
   (c) For purposes of this section, the following definitions apply:

   (1) "Licensed hospital" has the same meaning as set forth in
Section 4028 of the Business and Professions Code.
   (2) "Licensed health care facility" means any institution or
health facility, other than a long-term health care facility as
defined pursuant to Section 1418 of the Health and Safety Code,
licensed by the State Department of Public Health to deliver or
furnish health care services.