Scott Wiener
- Democratic
- Senator
- District 11
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 provides for the regulation of health insurers by the Department of Insurance. Existing law requires a health care service plan or health insurer that provides or arranges for the provision of hospital or physician services to comply with specified timely access to care requirements, including ensuring that its network has adequate capacity and availability of licensed health care providers to offer enrollees and insureds appointments that meet specified timeframes. Existing law authorizes the department director to take enforcement action against health care plans that fail to comply with these provisions, including assessing administrative penalties. This bill would require a health care service plan or health insurer to incorporate timely access to care standards into its quality assurance systems and incorporate specified processes. The bill would authorize the Department of Managed Health Care to develop methodologies to demonstrate appointment wait time compliance and averages. The bill would authorize the Department of Managed Health Care and the Department of Insurance to take compliance or disciplinary action, review and adopt standards concerning the availability of health care to ensure enrollees and insureds have timely access to care, and make recommendations to the Legislature if the Department of Managed Health Care or the Department of Insurance finds that health care service plans or health insurers and providers have difficulty meeting the standards the departments develop. The bill would require the director to consider, as an aggravating factor when assessing administrative penalties, if harm to an enrollee has occurred as a result of plan noncompliance. The bill would clarify that the timely access to care provisions do not alter requirements or standards for Medi-Cal managed care plans, except as specified. The bill would also make technical and conforming changes. By imposing new requirements on health care service plans, the willful violation of which would be a crime, the 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.
Chaptered by Secretary of State. Chapter 601, Statutes of 2022.
Approved by the Governor.
Enrolled and presented to the Governor at 3:30 p.m.
Assembly amendments concurred in. (Ayes 38. Noes 0. Page 5311.) Ordered to engrossing and enrolling.
Set for hearing August 29.
From committee: That the Assembly amendments be concurred in. (Ayes 7. Noes 0. Page 5248.)
From committee: Be re-referred to Com. on HEALTH pursuant to Senate Rule 29.10(d). (Ayes 5. Noes 0. Page 5112.) 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.
Read third time. Passed. (Ayes 75. Noes 0. Page 6179.) Ordered to the Senate.
Ordered to third reading.
Read third time and amended.
Read second time. Ordered to third reading.
From committee: Do pass. (Ayes 14. Noes 0.) (August 11).
August 3 set for first hearing. Placed on suspense file.
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 12. Noes 0.) (June 28).
From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.
In Assembly. Read first time. Held at Desk.
Read third time. Passed. (Ayes 29. Noes 0. Page 2776.) Ordered to the Assembly.
Read second time. Ordered to third reading.
Withdrawn from committee.
Ordered to second reading.
From committee: Do pass and re-refer to Com. on JUD. (Ayes 9. Noes 0. Page 2738.) (January 10). Re-referred to Com. on JUD.
From committee with author's amendments. Read second time and amended. Re-referred to Com. on B., P. & E.D.
Set for hearing January 10.
April 5 set for first hearing canceled at the request of author.
Set for hearing April 5.
From committee with author's amendments. Read second time and amended. Re-referred to Com. on B., P. & E.D.
Referred to Coms. on B., P. & E.D. and JUD.
From printer. May be acted upon on or after February 14.
Introduced. Read first time. To Com. on RLS. for assignment. To print.
| Bill Text Versions | Format |
|---|---|
| SB225 | HTML |
| 01/14/21 - Introduced | |
| 03/02/21 - Amended Senate | |
| 01/03/22 - Amended Senate | |
| 06/16/22 - Amended Assembly | |
| 06/30/22 - Amended Assembly | |
| 08/18/22 - Amended Assembly | |
| 09/01/22 - Enrolled | |
| 09/27/22 - Chaptered |
| Document | Format |
|---|---|
| 04/01/21- Senate Business, Professions and Economic Development | |
| 01/06/22- Senate Business, Professions and Economic Development | |
| 01/13/22- Sen. Floor Analyses | |
| 06/24/22- Assembly Health | |
| 08/01/22- Assembly Appropriations | |
| 08/17/22- ASSEMBLY FLOOR ANALYSIS | |
| 08/19/22- ASSEMBLY FLOOR ANALYSIS | |
| 08/25/22- Senate Health | |
| 08/29/22- Sen. Floor Analyses |
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