SB 406

Bill Subjects

Abstract

(1) Existing federal law, the Patient Protection and Affordable Care Act (PPACA) , enacts various health care market reforms. 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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a group or individual health care service plan contract or health insurance policy issued, amended, renewed, or delivered on or after September 23, 2010, to comply with the requirements of the PPACA, and any rules or regulations issued under the PPACA, that require a group health plan and health insurance issuer offering group or individual health insurance coverage to, at a minimum, provide coverage for specified preventive services, and prohibits the plan or health insurance issuer from imposing any cost-sharing requirements for those preventive services. Existing law also prohibits a plan or health insurer offering group or individual coverage from imposing lifetime or annual limits on the dollar value of benefits for a participant, beneficiary, or insured. Existing law requires a plan and a health insurance issuer to comply with those provisions to the extent required by federal law. This bill would delete the requirement that a health care service plan or a health insurer comply with the requirement to cover preventive health services without cost sharing to the extent required by federal law, and would instead require a group or individual nongrandfathered health care service plan contract or health insurance policy to, at a minimum, provide coverage for specified preventive services without any cost-sharing requirements for those preventive services, thereby indefinitely extending those requirements. The bill would also delete the requirement that a health care service plan or a health insurer comply with the prohibition on lifetime or annual limits to the extent required by federal law, and would instead prohibit an individual or group health care service plan contract or health insurance policy from establishing lifetime or annual limits on the dollar value of any covered benefits for an enrollee or insured, whether provided in network or out of network, thereby indefinitely extending the prohibitions on lifetime or annual limits, except as specified. Because a willful violation of these provisions by a health care service plan would be a crime, the bill would impose a state-mandated local program. (2) Existing law authorizes the State Registrar, a local registrar, or a county recorder to furnish a certified copy of a birth, death, marriage, or military service record to an authorized person, as defined, who submits a written, faxed, or digitized image request accompanied by a notarized statement sworn under penalty of perjury that the applicant is an authorized person. Existing law, until January 1, 2021, authorizes the official to accept an electronic request and an electronic acknowledgment if the request for a certified copy of a birth, death, or marriage record is made electronically and the electronic acknowledgment verifies the identity of the applicant using a multilayered remote identity proofing process. This bill would extend the above-described authorization for an electronic request and an electronic acknowledgment to January 1, 2022. By expanding the crime of perjury, the bill would impose a state-mandated local program. (3) Existing law requires the State Department of Health Care Services to license and regulate facilities that provide residential nonmedical services to adults who are recovering from problems related to alcohol, drug, or alcohol and drug misuse or abuse, and who need alcohol, drug, or alcohol and drug recovery treatment or detoxification services. Existing law also requires the department to implement a voluntary certification procedure for alcohol and other drug treatment recovery services. Existing law requires all programs certified and licensed by the department to disclose, among other things, ownership or control of, or financial interest in, a recovery residence, as defined. Existing law requires the department to conduct a site visit to investigate an allegation of an operating unlicensed alcoholism or drug abuse recovery or treatment facility and issue a notice to cease providing services under specified conditions. The bill would require the department to take action against an unlicensed facility that is disclosed as a recovery residence pursuant to these disclosure requirements. The bill would authorize the department to refer a substantiated complaint against a recovery residence to other enforcement entities as appropriate under state or federal law. The bill would make a technical change to refer to licensed facilities in these requirements. (4) Existing law, the California Organic Products Act of 2003, requires the Secretary of Food and Agriculture, county agricultural commissioners, and the Director of the State Department of Public Health to enforce state and federal laws governing the production, labeling, and marketing of organic products, as specified. Under existing law, all persons who handle or sell at retail organic products must keep accurate records that include specified information, which includes, if applicable, the registration numbers issued pursuant to state law, of all suppliers and other persons who sell, purchase, or otherwise transfer organic products, subject to specified exceptions. This bill would rename the act as the California Organic Food and Farming Act. The bill would remove the requirement that the registration numbers issued pursuant to state law be included in the required records. (5) Existing law establishes the Health Care Benefits Fund to support the University of California's implementation of the California Health Benefit Review Program. Existing law imposes an annual charge on health care service plans and health insurers, as specified, to be deposited into the fund. Under existing law, the fund and the program became inoperative on July 1, 2020, and are repealed as of January 1, 2021. This bill would extend the operation of the program and the fund, and would authorize the continued assessment of the annual charge on health care service plans and health insurers for that purpose. This bill would make these provisions inoperative on July 1, 2022, and would repeal them as of January 1, 2023. (6) Existing federal law establishes the Program of All-Inclusive Care for the Elderly (PACE) , which provides specified services for older individuals at a PACE center so that they may continue living in the community. Federal law authorizes states to implement PACE as a Medicaid state option. Existing state law establishes the California Program of All-Inclusive Care for the Elderly (PACE program) to provide community-based, risk-based, and capitated long-term care services as optional services under the state's Medi-Cal State Plan. Existing law generally requires an adult day health care center or home health agency to be licensed by the State Department of Public Health, which is required to obtain a criminal record clearance for specified individuals that own or are employed by the adult day health care center or home health agency. Under existing law, an adult day health care center or a home health agency that has been approved by the State Department of Health Care Services to exclusively serve PACE participants is exempt from licensure by the State Department of Public Health. This bill would require the State Department of Health Care Services to obtain a criminal record clearance for the administrator, program director, and fiscal officer of an adult day health care center before approving the center to exclusively serve PACE participants or individuals being assessed for the PACE program. To qualify for approval as a home health agency that exclusively serves PACE participants or individuals being assessed for the PACE program, the bill would require an owner or administrator of a home health agency to submit electronic fingerprint images to the Department of Justice for the furnishing of the person's criminal record to the State Department of Health Care Services. (7) 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. (8) This bill would declare that it is to take effect immediately as an urgency statute.