California 2011-2012 Regular Session Status: Passed Senate

SB 1285 — Hospital billing: emergency services and care.

Last action — Set, first hearing. Held in committee and under submission.

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

This bill died with 2011-2012 Regular Session. It reached “Passed Senate” 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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 provides for the licensure and regulation of health facilities by the State Department of Public Health and requires a licensed facility that maintains and operates an emergency department to provide emergency services and care to any person requesting the services or care for any condition in which the person is in danger of loss of life or serious injury or illness, as specified. Existing law requires hospitals to maintain a written policy regarding discount payments for financially qualified patients as well as a written charity care policy. Existing law requires a hospital to limit the expected payment for services it provides to certain low-income patients to the highest amount the hospital would expect to receive for providing services from a government-sponsored program of health benefits in which the hospital participates. 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 health care service plans, or their contracting medical providers, to reimburse providers for emergency services and care provided to their enrollees until the care results in stabilization of the enrollee. This bill would require a hospital with an out-of-network emergency utilization rate, as defined, of 50% or more to adjust its total billed charges for emergency services and care provided to a patient prior to stabilization to an amount no greater than 150% of the amount the hospital could expect to receive from Medicare for the services and care. The bill would specify that this provision does not apply to charges billed by emergency physicians, as defined, or to charges provided as treatment for an injury that is compensable for purposes of workers' compensation. The bill would also specify that its provisions do not apply if any other law requires the hospital to limit expected payment for the emergency services and care to a lesser amount, if a contract governs the total billed charges for the emergency services and care, or if a government program of health benefits, as specified, is the primary payer for the emergency services and care. The bill would require health care service plans or their contracting medical providers to reimburse hospitals in accordance with these provisions. Because a willful violation of that reimbursement requirement by a health care service plan or its contracting medical providers 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. Set, first hearing. Held in committee and under submission.

  2. Set, first hearing. Referred to APPR. suspense file.

  3. Read second time and amended. Re-referred to Com. on APPR.

  4. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 14. Noes 5.) (July 3).

  5. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  6. Set, first hearing. Hearing canceled at the request of author.

  7. From committee with author's amendments. Read second time and amended. Re-referred to Com. on HEALTH.

  8. Referred to Com. on HEALTH.

  9. In Assembly. Read first time. Held at Desk.

  10. Read third time. Passed. (Ayes 21. Noes 15. Page 3494.) Ordered to the Assembly.

  11. Read second time and amended. Ordered to third reading.

  12. From committee: Do pass as amended. (Ayes 5. Noes 2. Page 3445.) (May 7).

  13. Set for hearing May 7.

  14. From committee: Do pass and re-refer to Com. on APPR. (Ayes 5. Noes 3. Page 3306.) (April 25). Re-referred to Com. on APPR.

  15. Set for hearing April 25.

  16. Set, first hearing. Hearing canceled at the request of author.

  17. Set for hearing April 18.

  18. Re-referred to Com. on HEALTH.

  19. From committee with author's amendments. Read second time and amended. Re-referred to Com. on RLS.

  20. Referred to Com. on RLS.

  21. From printer. May be acted upon on or after March 25.

  22. Introduced. Read first time. To Com. on RLS. for assignment. To print.

Sponsors

  • Hernandez · Primary

Sponsorship breakdown

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1 sponsors · 0 co-sponsors · 121 not signed on · 4 voted No

Sponsors (1)

  • Hernandez

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

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

Passed 14 Yea · 5 Nay
Party YeaNayPresentNot Voting
Unaffiliated 14500
Total 14500
% of votes cast 74%26%0%0%
How each member voted (19)
Member Party Vote
Eng — Yea
Mitchell — Yea
Bonilla — Yea
Atkins — Yea
Gordon — Yea
Hayashi — Yea
Logue — Nay
Monning — Yea
Nestande — Yea
Pan — Yea
Silva — Nay
Ammiano — Yea
Mansoor — Nay
Smyth — Nay
Williams — Yea
Garrick — Nay
Bonnie Lowenthal — Yea
Roger Hernández — Yea
V. Manuel Pérez — Yea

Official roll call →

3rd Reading

Passed 21 Yea · 15 Nay · 4 Other
Party YeaNayPresentNot Voting
Unaffiliated 201403
Democratic 1100
Republican 0001
Total 211504
% of votes cast 53%38%0%10%
How each member voted (40)
Member Party Vote
Yee — Yea
Wolk — Yea
Wyland — Not Voting
Lowenthal — Yea
De León — Yea
Rubio — Yea
Negrete McLeod — Nay
Fuller — Nay
Cannella — Nay
Runner — Not Voting
Hancock — Yea
Harman — Nay
Huff — Nay
Leno — Yea
Liu — Yea
Price — Yea
Anderson — Nay
Corbett — Yea
Correa — Nay
DeSaulnier — Yea
Dutton — Nay
Simitian — Yea
Vargas — Yea
Alquist — Yea
Blakeslee — Nay
Hernandez — Yea
Kehoe — Yea
Lieu — Yea
Pavley — Yea
Steinberg — Yea
Walters — Nay
Wright — Not Voting
Emmerson — Nay
Evans — Yea
Beth Gaines — Nay
Bill Berryhill — Nay
La Malfa — Nay
Calderon, Lisa Democratic Nay
Padilla, Stephen C. Democratic Yea
Strickland, Tony Republican Not Voting

Official roll call →

Do pass as amended.

Passed 5 Yea · 2 Nay
Party YeaNayPresentNot Voting
Unaffiliated 5200
Total 5200
% of votes cast 71%29%0%0%
How each member voted (7)
Member Party Vote
Dutton — Nay
Walters — Nay
Alquist — Yea
Kehoe — Yea
Lieu — Yea
Price — Yea
Steinberg — Yea

Official roll call →

Do pass, but re-refer to the Committee on Appropriations.

Passed 5 Yea · 3 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 5301
Total 5301
% of votes cast 56%33%0%11%
How each member voted (9)
Member Party Vote
Harman — Nay
Hernandez — Yea
De León — Yea
Rubio — Yea
DeSaulnier — Yea
Anderson — Nay
Blakeslee — Nay
Wolk — Not Voting
Alquist — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 1285 do?
Existing law provides for the licensure and regulation of health facilities by the State Department of Public Health and requires a licensed facility that maintains and operates an emergency department to provide emergency services and care to any person requesting the services or care for any condition in which the person is in danger of loss of life or serious injury or illness, as specified. Existing law requires hospitals to maintain a written policy regarding discount payments for financially qualified patients as well as a written charity care policy. Existing law requires a hospital to limit the expected payment for services it provides to certain low-income patients to the highest amount the hospital would expect to receive for providing services from a government-sponsored program of health benefits in which the hospital participates. 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 health care service plans, or their contracting medical providers, to reimburse providers for emergency services and care provided to their enrollees until the care results in stabilization of the enrollee. This bill would require a hospital with an out-of-network emergency utilization rate, as defined, of 50% or more to adjust its total billed charges for emergency services and care provided to a patient prior to stabilization to an amount no greater than 150% of the amount the hospital could expect to receive from Medicare for the services and care. The bill would specify that this provision does not apply to charges billed by emergency physicians, as defined, or to charges provided as treatment for an injury that is compensable for purposes of workers' compensation. The bill would also specify that its provisions do not apply if any other law requires the hospital to limit expected payment for the emergency services and care to a lesser amount, if a contract governs the total billed charges for the emergency services and care, or if a government program of health benefits, as specified, is the primary payer for the emergency services and care. The bill would require health care service plans or their contracting medical providers to reimburse hospitals in accordance with these provisions. Because a willful violation of that reimbursement requirement by a health care service plan or its contracting medical providers 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 SB 1285?
SB 1285 is sponsored by Hernandez.
What is the current status of SB 1285?
This bill died with 2011-2012 Regular Session. It reached “Passed Senate” 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 SB 1285?
Track SB 1285 free on One Click Politics — get push/email alerts when it moves.

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