California Acts of the 2014 Legislative Session
SB 857, Chapter 31
BILL NUMBER: SB 857 CHAPTERED 06/20/14 CHAPTER 31 FILED WITH SECRETARY OF STATE JUNE 20, 2014 APPROVED BY GOVERNOR JUNE 20, 2014 PASSED THE SENATE JUNE 15, 2014 PASSED THE ASSEMBLY JUNE 15, 2014 AMENDED IN ASSEMBLY JUNE 12, 2014 INTRODUCED BY Committee on Budget and Fiscal Review JANUARY 9, 2014 An act to amend Section 56.36 of the Civil Code, to amend Sections 6254 and 100504 of the Government Code, to amend Sections 1280.15, 1341.45, 1399.861, 11833.02, 11833.04, 120955, 128200, 128205, 128210, 128215, 128225, 128230, 128235, 130200, and 136030 of, to amend and renumber Sections 130201, 130202, 130203, 130204, and 130205 of, to add Sections 1347.5, 1368.05, 1374.76, 120962, 121451, 121452, and 131058 to, and to repeal and add Section 136000 of, the Health and Safety Code, to amend Sections 10965.15, 12693.70, 12739.61, and 12739.78 of, to add Sections 10112.35, 12699.15, 12699.64, 12701, 12710.2, and 12739.79 to, and to repeal Part 6.3 (commencing with Section 12695), Part 6.4 (commencing with Section 12699.50), and Part 6.5 (commencing with Section 12700) of Division 2 of, the Insurance Code, to add Section 19548.2 to the Revenue and Taxation Code, and to amend Sections 4061, 5897, 14043.38, 14132.275, 14132.277, 14154, 14165.50, 15800, 15801, 15803, 15804, and 15805 of, to amend the heading of Chapter 2 (commencing with Section 15810) of Part 3.3 of Division 9 of, to amend, repeal, and add Sections 15810, 15811, 15826, 15832, and 15840 of, to add Sections 14005.22, 14005.225, 14104.35, 14131.11, 14132.915, 14148.65, 14148.67, 15802.5, 15806, 15814, 15818, 15827, 15833, 15835, 15839, 15841, 15847, 15847.3, 15847.5, 15847.7, 15848, and 15848.5 to, and to add Chapter 3 (commencing with Section 15850) and Chapter 4 (commencing with Section 15870) to Part 3.3 of Division 9 of, the Welfare and Institutions Code, relating to health, and making an appropriation therefor, to take effect immediately, bill related to the budgetLEGISLATIVE COUNSEL'S DIGEST SB 857, Committee on Budget and Fiscal Review. Health.
(1) Existing law establishes the Office of Health Information Integrity within the California Health and Human Services Agency to ensure the enforcement of state law mandating the confidentiality of medical information, as defined, and to impose administrative fines on providers of health care for the unauthorized use of medical information.
This bill would transfer the duty to impose administrative fines on providers of health care for the unauthorized use of medical information to the State Department of Public Health, and would make other conforming changes.
(2) Existing law establishes the California Health Benefit Exchange for the purpose of facilitating the enrollment of qualified individuals and small employers in qualified health plans. Existing law authorizes the board of the California Health Benefit Exchange to adopt emergency regulations until January 1, 2016. Under existing law, emergency regulations remain in effect for no more than 180 days, except as specified, and may be readopted for 2 additional 90-day periods.
This bill would allow more than 2 readoptions of those emergency regulations until January 1, 2017, and would allow the emergency regulations adopted by the board to remain in effect for 2 years, as specified.
(3) Existing law, as of July 1, 2012, transferred the Office of Patient Advocate from the Department of Managed Health Care to the California Health and Human Services Agency, to provide assistance to, and advocate on behalf of, individuals served by health care service plans regulated by the Department of Managed Health Care, insureds covered by health insurers regulated by the Department of Insurance, and individuals who receive or are eligible for other health care coverage in California, including coverage available through the Medi-Cal program, the California Health Benefit Exchange, the Healthy Families Program, or any other county or state health care program. The duties of the office, include, but are not limited to, compiling an annual publication, to be made available on the office's Internet Web site, of a quality of care report card, rendering assistance to consumers regarding procedures, rights, and responsibilities related to the filing of complaints, grievances, and appeals, and coordinating and working with other government and nongovernment patient assistance programs and health care ombudsperson programs.
This bill would revise and recast those provisions by transferring the direct consumer assistance activities that had previously been conferred on the office to the Department of Managed Health Care to be carried out in partnership with community-based consumer assistance organizations for the purposes of serving health care consumers, as provided. The bill would instead require the office, among other things, to provide assistance to, and advocate on behalf of, health care consumers, and would instead make the goal of the office to coordinate amongst, provide assistance to, and collect data from, all of the state agency consumer assistance or patient assistance programs and call centers, to better enable health care consumers to access the health care services to which they are eligible under the law. The duties of the office would include, but not be limited to, producing a baseline review and annual report to be made publically available on the office's Internet Web site by July 1, 2015, and annually thereafter, of health care consumer or patient assistance help centers, call centers, ombudsperson, or other assistance centers operated by the Department of Managed Health Care, the State Department of Health Care Services (DHCS), the Department of Insurance, and the Exchange, and including certain minimum information, and collecting, tracking, and analyzing data on problems and complaints by, and questions from, consumers about health care coverage for the purpose of providing public information about problems faced and information needed by consumers in obtaining coverage and care. This bill would also make conforming changes.
(4) Existing federal law requires a health insurance issuer that offers group or individual health insurance coverage that provides both medical and surgical benefits and mental health or substance use disorder benefits to establish parity in the terms and conditions applicable to medical and mental health benefits, as specified.
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 requires a health care service plan contract that provides hospital, medical, or surgical coverage to provide coverage for the diagnosis and medically necessary treatment of severe mental illnesses under the same terms and conditions applied to other medical conditions, as specified.
This bill would require large group, small group, and individual health care service plan contracts to provide covered mental health and substance use disorder benefits in compliance with the provisions of federal law governing mental health parity no later than January 1, 2015. Because a willful violation of that requirement would be a crime, the bill would impose a state-mandated local program.
(5) Under existing law, DHCS is responsible for licensing and certifying alcoholism and drug abuse recovery and treatment programs and facilities, including both residential and nonresidential programs. Existing law requires the department to charge a fee for the licensure or certification of these facilities and to establish fee scales using different capacity levels, categories based on measures other than program capacity, or any other category or classification that the department deems necessary or convenient to maintain an effective and equitable fee structure. Existing law requires the department to submit proposed new fees or fee changes to the Legislature for approval, as specified, and prohibits new fees or fee changes without legislative approval.
This bill would require the department to issue a provider bulletin setting forth the approved fee structure and, on an annual basis, to publish the fee structure on the department's Internet Web site.
Existing law authorizes the department to implement the licensing and certification provisions for alcoholism and drug abuse recovery and treatment programs and facilities through emergency regulations.
This bill would remove the authorization for emergency regulations and would require the department to adopt regulations through the Administrative Procedure Act. The bill would authorize the department to implement new fees or fee changes by means of provider bulletins or similar action and to supersede the existing licensing and certification fees until the department amends the regulations. The bill would also require the department to notify and consult with interested parties and appropriate stakeholders regarding new fees or fee changes.
(6) Existing law requires the State Public Health Officer to establish, and authorizes him or her to administer, a program to provide drug treatments to persons infected with HIV, to the extent that state and federal funds are appropriated. Existing law requires the State Department of Public Health to determine a person whose adjusted gross income does not exceed $50,000 per year to be financially eligible to receive services under this program, as specified. Existing law authorizes the State Department of Public Health to subsidize certain cost-sharing requirements for persons otherwise eligible for the AIDS Drug Assistance Program (ADAP) with non-ADAP drug coverage by paying for prescription drugs included on the ADAP formulary, as specified.
This bill would additionally authorize the department...
