California 2011-2012 Regular Session Status: Passed Assembly

AB 1579 — Dental coverage: noncontracting providers: assignment of benefits.

Last action — In committee: Set, first hearing. Hearing canceled at the request of author.

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  1. ✓
    Introduced
  2. ✓
    In Committee
  3. 3
    Passed Assembly
  4. 4
    Passed Senate
  5. 5
    To Executive
  6. 6
    Enacted

This bill died with 2011-2012 Regular Session. It reached “Passed Assembly” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.

This bill is no longer active — its legislative session has ended, so there is no live prognosis. It would have to be reintroduced in the current session to move again.

Summary

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 authorizes licensed nonphysician providers that contract with a medical group, physician, or independent practice association to provide services to health care service plan enrollees to directly bill the plan for services rendered under certain circumstances. Existing law requires group health care service plans to authorize and permit assignment of a Medi-Cal beneficiary's right to reimbursement for covered services to the State Department of Health Care Services, except as specified. Existing law provides for the direct payment of group insurance medical benefits by a health insurer to the person or persons furnishing or paying for hospitalization or medical or surgical aid, as specified. This bill would require a health care service plan or health insurer that pays a contracting dental provider directly for covered services rendered to an enrollee or insured to also pay a noncontracting dental provider directly for covered services rendered to an enrollee or insured where the provider submits a written assignment of benefits signed by the enrollee or insured or the legal representative thereof, as specified. The bill would specify that a plan or insurer's payment pursuant to this provision discharges the plan or insurer's obligation with respect to the amount paid. The bill would also require a noncontracting dental provider to disclose to the enrollee or insured or the legal representative thereof that the provider is a noncontracting provider prior to accepting an assignment of benefits, and to provide additional specified written notices to the enrollee or insured or the legal representative thereof, including a written notice of the estimated full cost of the planned treatment and the estimated amount of those costs payable by the enrollee or insured. The bill would also prohibit a provider from collecting from an enrollee or insured any amount over the enrollee's or insured's estimated cost, and would require the provider to refund any overpayment to the enrollee or insured. Because a willful violation of the bill's requirements with respect to health care service plans 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.

Bill Text

Action History

  1. In committee: Set, first hearing. Hearing canceled at the request of author.

  2. Referred to Com. on HEALTH.

  3. In Senate. Read first time. To Com. on RLS. for assignment.

  4. Read third time. Passed. Ordered to the Senate. (Ayes 74. Noes 1. Page 4822.)

  5. Read second time. Ordered to third reading.

  6. From committee: Do pass. (Ayes 16. Noes 0.) (May 9).

  7. From committee: Do pass and re-refer to Com. on APPR. (Ayes 19. Noes 0.) (April 24). Re-referred to Com. on APPR.

  8. Re-referred to Com. on HEALTH.

  9. From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.

  10. In committee: Set, first hearing. Hearing canceled at the request of author.

  11. Re-referred to Com. on HEALTH.

  12. From committee chair, with author's amendments: Amend, and re-refer to Com. on HEALTH. Read second time and amended.

  13. Referred to Com. on HEALTH.

  14. From printer. May be heard in committee March 4.

  15. Read first time. To print.

Sponsors

  • Campos · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 121 not signed on

Sponsors (1)

  • Campos

Co-sponsors (0)

None.

Not signed on (121)

121 members have not signed on to this bill.

Show all 121 →

"Not signed on" means a member has not sponsored or co-sponsored this bill — it does not imply opposition. Members flagged Voted No have a recorded No vote on this bill.

Whip count is in markup. Polling the chamber and every recorded vote this session. Only the first open is slow. It’s instant for you after this. Calling the roll · Tallying · Engrossing

Votes

AB 1579 CAMPOS Assembly Third Reading

Passed 74 Yea · 1 Nay · 5 Other
Party YeaNayPresentNot Voting
Unaffiliated 71105
Republican 2000
Democratic 1000
Total 74105
% of votes cast 93%1%0%6%
How each member voted (80)
Member Party Vote
Halderman — Yea
Butler — Yea
Feuer — Yea
Furutani — Yea
Gorell — Yea
Huber — Yea
Fong — Yea
Carter — Yea
Allen — Yea
Alejo — Yea
Cedillo — Yea
Williams — Yea
Portantino — Yea
John A. Pérez — Yea
Mitchell — Yea
Fuentes — Yea
Gatto — Yea
Gordon — Yea
Campos — Yea
Bonilla — Yea
Hagman — Yea
Hall — Yea
Fletcher — Not Voting
Atkins — Not Voting
Harkey — Yea
Hayashi — Yea
Hueso — Yea
Jeffries — Yea
Beall — Yea
Block — Yea
Chesbro — Yea
Donnelly — Nay
Knight — Yea
Mendoza — Yea
Miller — Yea
Monning — Yea
Morrell — Yea
Nielsen — Yea
Norby — Not Voting
Pan — Yea
Perea — Not Voting
Skinner — Yea
Smyth — Yea
Torres — Yea
Valadao — Not Voting
Wieckowski — Yea
Achadjian — Yea
Ammiano — Yea
Blumenfield — Yea
Bradford — Yea
Brownley — Yea
Buchanan — Yea
Hill — Yea
Huffman — Yea
Lara — Yea
Logue — Yea
Ma — Yea
Mansoor — Yea
Nestande — Yea
Olsen — Yea
Silva — Yea
Solorio — Yea
Swanson — Yea
Wagner — Yea
Conway — Yea
Cook — Yea
Eng — Yea
Davis — Yea
Dickinson — Yea
Galgiani — Yea
Garrick — Yea
Yamada — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Bonnie Lowenthal — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea
Calderon, Lisa Democratic Yea
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea

Official roll call →

Do pass.

Passed 16 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Democratic 1000
Unaffiliated 15001
Total 16001
% of votes cast 94%0%0%6%
How each member voted (17)
Member Party Vote
Mitchell — Yea
Gatto — Yea
Hall — Yea
Harkey — Yea
Lara — Yea
Nielsen — Yea
Campos — Yea
Davis — Yea
Donnelly — Not Voting
Solorio — Yea
Wagner — Yea
Blumenfield — Yea
Bradford — Yea
Hill — Yea
Norby — Yea
Fuentes — Yea
Calderon, Lisa Democratic Yea

Official roll call →

Do pass and be re-referred to the Committee on Appropriations.

Passed 19 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 19000
Total 19000
% of votes cast 100%0%0%0%
How each member voted (19)
Member Party Vote
Garrick — Yea
Gordon — Yea
Hayashi — Yea
Mitchell — Yea
Bonilla — Yea
Atkins — Yea
Ammiano — Yea
Monning — Yea
Nestande — Yea
Pan — Yea
Smyth — Yea
Logue — Yea
Mansoor — Yea
Silva — Yea
Williams — Yea
Eng — Yea
Bonnie Lowenthal — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does AB 1579 do?
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 authorizes licensed nonphysician providers that contract with a medical group, physician, or independent practice association to provide services to health care service plan enrollees to directly bill the plan for services rendered under certain circumstances. Existing law requires group health care service plans to authorize and permit assignment of a Medi-Cal beneficiary's right to reimbursement for covered services to the State Department of Health Care Services, except as specified. Existing law provides for the direct payment of group insurance medical benefits by a health insurer to the person or persons furnishing or paying for hospitalization or medical or surgical aid, as specified. This bill would require a health care service plan or health insurer that pays a contracting dental provider directly for covered services rendered to an enrollee or insured to also pay a noncontracting dental provider directly for covered services rendered to an enrollee or insured where the provider submits a written assignment of benefits signed by the enrollee or insured or the legal representative thereof, as specified. The bill would specify that a plan or insurer's payment pursuant to this provision discharges the plan or insurer's obligation with respect to the amount paid. The bill would also require a noncontracting dental provider to disclose to the enrollee or insured or the legal representative thereof that the provider is a noncontracting provider prior to accepting an assignment of benefits, and to provide additional specified written notices to the enrollee or insured or the legal representative thereof, including a written notice of the estimated full cost of the planned treatment and the estimated amount of those costs payable by the enrollee or insured. The bill would also prohibit a provider from collecting from an enrollee or insured any amount over the enrollee's or insured's estimated cost, and would require the provider to refund any overpayment to the enrollee or insured. Because a willful violation of the bill's requirements with respect to health care service plans 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.
Who sponsors AB 1579?
AB 1579 is sponsored by Campos.
What is the current status of AB 1579?
This bill died with 2011-2012 Regular Session. It reached “Passed Assembly” and never advanced before the session ended, so it can no longer move — a new version would have to be reintroduced in the current session.
Where can I track AB 1579?
Track AB 1579 free on One Click Politics — get push/email alerts when it moves.

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