Bill Text: CA SB1159 | 2015-2016 | Regular Session | Amended

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

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Bill Title: California Health Care Cost, Quality, and Equity Data

Spectrum: Partisan Bill (Democrat 1-0)

Status: (Passed) 2016-09-27 - Chaptered by Secretary of State. Chapter 727, Statutes of 2016. [SB1159 Detail]

Download: California-2015-SB1159-Amended.html

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BILL NUMBER: SB 1159	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  AUGUST 19, 2016
	AMENDED IN ASSEMBLY  AUGUST 15, 2016
	AMENDED IN ASSEMBLY  JUNE 30, 2016
	AMENDED IN SENATE  MAY 31, 2016
	AMENDED IN SENATE  MARCH 28, 2016

INTRODUCED BY   Senator Hernandez

                        FEBRUARY 18, 2016

   An act to add Chapter 8 (commencing with Section 127670) to Part 2
of Division 107 of, and to repeal the heading of Chapter 8 (formerly
commencing with Section 127670) of Part 2 of Division 107 of, the
Health and Safety Code, relating to health care.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 1159, as amended, Hernandez. California Health Care Cost,
Quality, and Equity  Transparency Database.  
Data Atlas. 
   Existing law establishes health care coverage programs to provide
health care to segments of the population meeting specified criteria
who are otherwise unable to afford health care coverage and provides
for the licensure and regulation of health insurers and health care
service plans.
   This bill would require the California Health and Human Services
Agency to research the options for developing a cost, quality, and
equity  transparency database.   data atlas.
 The bill would require the research to include certain topics,
including, among others, identification of key data submitters and a
comparative analysis of potential models used in other states. The
bill would authorize the agency to enter into contracts or agreements
to conduct the research and would require the agency to make the
results of the research available to the public no later than March
1, 2017, by submitting a report to the Assembly and Senate Committees
on Health.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


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

  SECTION 1.  (a) It is the intent of the Legislature in enacting
this act that  cost and quality   cost, quality,
and equity  data be made available and to encourage health care
service plans, health insurers, and providers to develop innovative
approaches, services, and programs that may have the potential to
deliver health care that is both cost effective and responsive to the
needs of  all  enrollees, including recognizing the
diversity of California and the impact of social determinants of
health.
   (b) It is further the intent of the Legislature that a cost,
quality, and equity  transparency database  
data atlas  be utilized in California to inform efforts to:
   (1) Assess California health care needs and available resources.
   (2) Contain the cost of health care services and coverage.
   (3) Improve the quality and medical appropriateness of health
care.
   (4) Eliminate or reduce health disparities and address the social
determinants of health.
   (5) Increase the transparency of health care costs and the
relative efficiency with which care is delivered.
   (6) Promote the use of disease management, wellness, prevention,
and other innovative programs to keep people healthy, reduce
disparities and costs,  increase competition,  and improve
health outcomes for all populations.
   (7) Assess the value and encourage the efficient utilization of
prescription drugs and technology.
   (8) Reduce unnecessary, inappropriate, and wasteful health care.
   (9) Educate consumers in the use of health care information.
  SEC. 2.  The heading of Chapter 8 (formerly commencing with Section
127670) of Part 2 of Division 107 of the Health and Safety Code, as
amended by Section 230 of Chapter 183 of the Statutes of 2004, is
repealed.
  SEC. 3.  Chapter 8 (commencing with Section 127670) is added to
Part 2 of Division 107 of the Health and Safety Code, to read:
      CHAPTER 8.  CALIFORNIA HEALTH CARE COST, QUALITY, AND EQUITY
 TRANSPARENCY DATABASE   DATA ATLAS 


   127670.  (a) The California Health and Human Services Agency shall
research the options for developing a cost, quality, and equity
 transparency database   data atlas  that
is consistent with paragraph (9) of subdivision (b) of Section 56.10
of the Civil Code. This research shall include all of the following:
   (1) Identification of key data submitters, including health care
service plans, specialized health care service plans, insurers
licensed to provide health insurance, as defined in Section 106 of
the Insurance Code, suppliers, as defined in paragraph (3) of
subdivision (b) of Section 1367.50, providers, as defined in
paragraph (2) of subdivision (b) of Section 1367.50, self-insured
employers, multiemployer self-insured plans that are responsible for
paying for health care services provided to beneficiaries, and trust
administrators for multiemployer self-insured plans.
   (2) A comparative analysis of potential models used in other
states and an assessment of the extent to which information in
addition to the following should be included in the cost, quality,
and equity  transparency database:   data atlas:

   (A)  Utilization data   Data  from the
health care service plans' and insurers' medical, dental, and
pharmacy claims or, in the case of entities that do not use claims
data, including, but not limited to, integrated delivery systems,
encounter data consistent with the core set of data elements for data
submission proposed by the All-Payer Claims Database Council, the
University of New Hampshire, and the National Association of Health
Data Organizations.
   (B) Pricing information for health care items, services, and
medical and surgical episodes of care gathered from allowed charges
for covered health care items and services or, in the case of
entities that do not use or produce individual claims, price
information that is the best possible proxy to pricing information
for health care items, services, and medical and surgical episodes of
care available in lieu of actual cost data to allow for meaningful
comparisons of provider prices and treatment costs.
   (C) Information sufficient to determine the impacts of social
determinants of health, including age, gender, race, ethnicity,
limited English proficiency, sexual orientation and gender identity,
ZIP Code, and any other factors for which there is peer-reviewed
evidence. 
   (D) Clinical data from health care service plans, integrated
delivery systems, hospitals, and clinics, or any combination thereof,
that is not included in the core set of data elements for data
submission proposed by the All-Payer Claims Database Council and the
National Association of Health Data Organizations. 
   (3) An assessment of types of governance structures that
incorporate representatives of health care stakeholders and experts,
including, but not limited to, representatives of data submitters and
representatives of purchasers, such as businesses, organized labor,
and consumers.
   (4) Recommendations on potential funding approaches to support the
activities of the cost, quality, and equity  transparency
database   data atlas  that recognize federal and
state confidentiality of medical information laws.
   (5) An assessment on the extent to which the cost, quality, and
equity  transparency database   data atlas 
could be developed in conjunction with existing public or private
activities, including an assessment of the trade-offs associated with
housing the  database   atlas  inside or
outside of state government.
   (6) Consultation with a broad spectrum of health care stakeholders
and experts, including, but not limited to, representatives of
purchasers, such as organized labor, consumers, and businesses.
   (b) The agency may enter into contracts or agreements to conduct
the research described in subdivision (a).
   (c) (1) The agency shall make the results of the research
described in subdivision (a) available to the public no later than
March 1, 2017, by submitting a report to the Assembly and Senate
Committees on Health.
   (2) Pursuant to Section 10231.5 of the Government Code, this
subdivision shall become inoperative on January 1, 2021.
   (d) The agency may use federal funds for the purpose of this
section.