Bill Text: CA SB406 | 2019-2020 | Regular Session | Amended
Bill Title: Health care: omnibus bill.
Spectrum: Slight Partisan Bill (Democrat 7-3)
Status: (Passed) 2020-09-29 - Chaptered by Secretary of State. Chapter 302, Statutes of 2020. [SB406 Detail]
Download: California-2019-SB406-Amended.html
Corrected
January 06, 2020 |
Amended
IN
Senate
January 06, 2020 |
Introduced by Senator Pan |
February 20, 2019 |
LEGISLATIVE COUNSEL'S DIGEST
Existing federal law, the federal Patient Protection and Affordable Care Act (PPACA), enacts various health care coverage market reforms. The PPACA requires a state, using criteria and methods developed by the United States Secretary of Health and Human Services, to implement a risk adjustment program under which a charge is assessed on low actuarial risk plans and a payment is made to high actuarial risk plans. Existing federal law requires a qualified health plan to submit data relating to the risk adjustment program to the secretary. Existing state law requires any data submitted by a health care service plan or health insurer to the secretary for purposes of the risk adjustment program to also be concurrently submitted to the Department of Managed Health Care or the Department of Insurance in the same format.
This bill would require the
Department of Managed Health Care and the Department of Insurance to each prepare, in coordination with the other department, an annual summary report that describes the impact of the risk adjustment program on premium rates in this state. The bill would also require the reports to be posted on the departments’ respective internet websites no later than 7 months after the risk adjustment year.
Digest Key
Vote: MAJORITY Appropriation: NO Fiscal Committee: YES Local Program:Bill Text
The people of the State of California do enact as follows:
SECTION 1.
Section 1367.002 of the Health and Safety Code is repealed.To the extent required by federal law, a group or individual health care service plan contract issued, amended, renewed, or delivered on or after September 23, 2010, shall comply with Section 2713 of the federal Public Health Service Act (42 U.S.C. Sec. 300gg-13), as added by Section 1001 of the federal Patient Protection and Affordable Care Act (P.L. 111-148), and any rules or regulations issued under that section.
SEC. 2.
Section 1367.002 is added to the Health and Safety Code, to read:1367.002.
(a) A group or individual health care service plan contract shall, at a minimum, provide coverage for and shall not impose any cost-sharing requirements for all of the following:SEC. 3.
No reimbursement is required by this act pursuant to Section 6 of Article XIII B of the California Constitution because the only costs that may be incurred by a local agency or school district will be incurred because this act creates a new crime or infraction, eliminates a crime or infraction, or changes the penalty for a crime or infraction, within the meaning of Section 17556 of the Government Code, or changes the definition of a crime within the meaning of Section 6 of Article XIII B of the California Constitution.Any data submitted by a health care service plan to the United States Secretary of Health and Human Services, or the secretary’s designee, for purposes of the risk adjustment program described in Section 1343 of the federal Patient Protection and Affordable Care Act (42 U.S.C. Sec. 18063) shall be concurrently submitted to the department in the same format. The department shall use the information to monitor federal implementation of risk adjustment in the state and to ensure that health care service plans are in compliance with federal requirements related to risk adjustment.
The department, in coordination with the Department of Insurance, shall prepare an annual summary report that describes the impact of the risk adjustment program on premium rates in this state. The report shall be posted on the department’s internet website no later than seven months after the risk adjustment year.
Any data submitted by a health insurer to the United States Secretary of Health and Human Services, or the secretary’s designee, for purposes of the risk adjustment program described in Section 1343 of the federal Patient Protection and Affordable Care Act (42 U.S.C. Sec. 18063) shall be concurrently submitted to the department and in the same format. The department shall use the information to monitor federal implementation of risk adjustment in the state and to ensure that insurers are in compliance with federal requirements related to risk adjustment. The
department, in coordination with the Department of Managed Health Care, shall prepare an annual summary report that describes the impact of the risk adjustment program on premium rates in this state. The report shall be posted on the department’s internet website no later than seven months after the risk adjustment year.
CORRECTIONS:
Heading—Last amended date.