Ed Hernandez
- Democratic
Author
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 a health care service plan and a health insurer that provides services at alternative rates of payment, at the request of an enrollee or insured, to provide the completion of services by a terminated provider if the enrollee or insured is undergoing a course of treatment for one of any specified conditions, including a serious chronic condition, as defined, at the time of the contract or policy termination. Existing law also requires a health care service plan to provide for the completion of covered services by a nonparticipating provider to a newly covered enrollee who, at the time his or her coverage became effective, was receiving services from that provider for one of any specified conditions. Existing law requires a health care service plan to provide a disclosure form regarding the benefits, services, and terms of a plan contract and requires the disclosure form to include a description of how an enrollee can request continuity of care under the provisions described above. This bill would require a health care service plan to include notice of the process to obtain continuity of care in its disclosure form and in any evidence of coverage issued after January 1, 2018. The bill would also require a plan to provide a written copy of this information to its contracting providers and provider groups, and a copy to its enrollees upon request. The bill would require a plan and health insurer to include notice of the availability of the right to request completion of covered services as part of, to accompany, or to be sent simultaneously with any termination of coverage notice sent under specified circumstances. Existing law requires a health care service plan and a health insurer to arrange for the completion of covered services by a nonparticipating provider for one of any specified conditions for a newly covered enrollee or a newly covered insured under an individual health care service plan contract or an individual health insurance policy if, at the time his or her coverage became effective, the newly covered enrollee or newly covered insured was receiving services from that nonparticipating provider for a specified condition and whose prior coverage was withdrawn from the market between December 1, 2013, and March 31, 2014, inclusive, as specified. This bill would delete the requirement that coverage was withdrawn from the market between December 1, 2013, and March 31, 2014, inclusive, thereby extending the requirement described above to any prior coverage that was withdrawn from the market, and would specify that, for purposes of these provisions, withdrawn from the market includes circumstances when a health benefit plan is withdrawn from any portion of a market. Because a willful violation of these requirements by a health care service plan would, in part, be a crime, this bill would impose a state-mandated local program. The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement. This bill would provide that no reimbursement is required by this act for a specified reason.
Approved by the Governor.
Chaptered by Secretary of State. Chapter 481, Statutes of 2017.
Enrolled and presented to the Governor at 3 p.m.
From committee: Be re-referred to Com. on HEALTH pursuant to Senate Rule 29.10(d). (Ayes 4. Noes 0. Page 2982.) Re-referred to Com. on HEALTH.
Re-referred to Com. on RLS. pursuant to Senate Rule 29.10(d).
In Senate. Concurrence in Assembly amendments pending.
Assembly amendments concurred in. (Ayes 38. Noes 0. Page 3004.) Ordered to engrossing and enrolling.
From committee: That the Assembly amendments be concurred in. (Ayes 9. Noes 0. Page 3026.)
Read third time. Passed. (Ayes 61. Noes 8. Page 3488.) Ordered to the Senate.
Read second time. Ordered to third reading.
Read second time and amended. Ordered to second reading.
From committee: Do pass as amended. (Ayes 12. Noes 3.) (September 11).
Read second time and amended. Re-referred to Com. on APPR.
From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 10. Noes 0.) (August 29).
Ordered to third reading.
Re-referred to Coms. on HEALTH and APPR. pursuant to Assembly Rule 77.2.
Read third time and amended. (Ayes 53. Noes 18. Page 2689.)
Ordered to third reading.
From inactive file.
Notice of intention to remove from inactive file given by Assembly Member Calderon.
Ordered to inactive file on request of Assembly Member Bonta.
From consent calendar on motion of Assembly Member Bonta.
Read second time. Ordered to consent calendar.
From committee: Do pass. Ordered to consent calendar. (Ayes 15. Noes 0.) (July 11).
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 39. Noes 0. Page 1072.) Ordered to the Assembly.
Read second time. Ordered to consent calendar.
From committee: Do pass. Ordered to consent calendar. (Ayes 8. Noes 0. Page 974.) (May 3).
Set for hearing May 3.
April 26 set for first hearing canceled at the request of author.
Set for hearing April 26.
From printer. May be acted upon on or after February 11.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB133 | HTML |
| 01/11/17 - Introduced | |
| 08/21/17 - Amended Assembly | |
| 08/30/17 - Amended Assembly | |
| 09/12/17 - Amended Assembly | |
| 09/20/17 - Enrolled | |
| 10/04/17 - Chaptered |
| Document | Format |
|---|---|
| No related documents. |
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