California 2013-2014 Regular Session Status: Passed Senate

SB 780 — Health care coverage.

Last action — From Assembly without further action.

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

This bill died with 2013-2014 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This bill is no longer active — its legislative session has ended, so there is no live prognosis.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, 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 to submit a filing to the department at least 75 days prior to the termination date of its contract with a provider group or a general acute care hospital that includes the written notice the plan proposes to send to its affected enrollees. The filing is required to be reviewed and approved by the department prior to the notice being sent to the enrollees. Existing law also requires the plan to provide written notice to affected enrollees, as provided, prior to the termination date of a contract between the plan and a provider group or a general acute care hospital. A plan operating as a preferred provider organization is only required to send the written notice to all enrollees who reside within a 15-mile radius of a terminated hospital if it is a general acute care hospital. This bill would delete the requirements with regard to preferred provider organizations. The bill would change the timing of the 75-day filing to 30 days prior to the termination date for a contract between a health care service plan that is not a health maintenance organization and a provider group or general acute care hospital. The bill would distinguish between enrollees of an assigned group provider and enrollees of an unassigned group provider for purposes of whether the filing is required to be submitted to the department. The bill would also require that the plan send a department-approved written notice to the enrollees, whether or not a filing was required, when a provider group contract or a general acute care hospital contract is terminated. The bill would distinguish between the enrollees of an assigned or an unassigned provider group or general acute care hospital with regard to the timing of the consumer notice and method of delivery. With respect to the termination of a contract with an unassigned provider group or general acute care hospital, the bill would impose specified continued access to services requirements, billing requirements, and requirements to obtain information from the terminated provider group or general acute care hospital regarding enrollees who have services scheduled with the terminated provider group or general acute care hospital for after the termination date using a process agreed upon in the terminating contract. The bill would authorize the department to develop a standard format for the required notices. Because a willful violation of these requirements would be a crime, the bill would impose a state-mandated local program. Existing law provides for the regulation of health insurers by the Department of Insurance. Under existing law, a health insurer may contract with providers for alternative rates of payment. Existing law requires those insurers to file a policy with the department describing how the insurer facilitates the continuity of care for new insureds under group policies receiving services for an acute condition from a noncontracting provider. Existing law also requires those health insurers to, at the request of an insured, arrange for the completion of covered services by a terminated provider if the insured is undergoing treatment for certain conditions, as specified. This bill would require, among other things, a health insurer to submit a filing to the department, at least 30 days prior to the termination date of its contract with a provider group or a general acute care hospital to provide services at alternative rates of payment, that includes the written notice the insurer proposes to send to its insureds. The bill would require the filing to be reviewed and approved by the department prior to the notice being sent to the insureds. The bill would set a threshold for the number of insureds receiving health care services from a group provider within the preceding 12 months for purposes of whether the filing is required to be submitted to the department. The bill would also require that the health insurer send a department-approved written notice to specified insureds, whether or not a filing was required, when a provider group contract or a general acute care hospital contract is terminated, and would impose specified continued access to services requirements, billing requirements, and requirements to obtain information from the terminated provider group or general acute care hospital regarding insureds who have services scheduled with the terminated provider group or general acute care hospital for after the termination date using a process agreed upon in the terminating contract. The bill would authorize the department to develop a standard format for the required notices. Existing law requires disability insurance policies to include a disclosure form that contains specified information, including the principal benefits and coverage of the policy, the exceptions, reductions, and limitations that apply to the policy, and a statement, with respect to health insurance policies, describing how participation in the policy may affect the choice of physician, hospital, or health care providers, and describing the extent of financial liability that may be incurred if care is furnished by a nonparticipating provider. With respect to health insurance policies, this bill would require the disclosure form to include additional information, including conditions and procedures for cancellation, rescission, or nonrenewal, a description of the limitations on the insured's choice of provider, and, with respect to insurers that contract for alternate rates of payment, a statement describing the basic method of reimbursement made to its participating providers, as specified. The bill would also require the first page of the disclosure form for health insurance policies to include other specified information. The bill would require a health insurer, medical group, or participating provider that uses or receives financial bonuses or other incentives to provide a written summary of specified information to any requesting person. 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. From Assembly without further action.

  2. From committee without further action.

  3. Held under submission.

  4. Set, second hearing.

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

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

  7. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 13. Noes 6.) (June 24).

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

  9. Referred to Com. on HEALTH.

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

  11. Read third time. Passed. (Ayes 22. Noes 8. Page 2665.) Ordered to the Assembly.

  12. Read second time. Ordered to third reading.

  13. From committee: Do pass. (Ayes 5. Noes 1. Page 2645.) (January 23).

  14. Set for hearing January 23.

  15. Held in committee and under submission.

  16. Set for hearing May 23.

  17. Placed on APPR. suspense file.

  18. Set for hearing May 20.

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

  20. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 7. Noes 2. Page 792.) (May 1).

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

  22. Set for hearing May 1.

  23. Hearing postponed by committee.

  24. Set for hearing April 10.

  25. Referred to Com. on HEALTH.

  26. Read first time.

  27. From printer. May be acted upon on or after March 26.

  28. Introduced. To Com. on RLS. for assignment. To print.

Sponsors

  • Jackson · Primary

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 121 not signed on · 3 voted No

Sponsors (1)

  • Jackson

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 13 Yea · 6 Nay
Party YeaNayPresentNot Voting
Unaffiliated 12600
Democratic 1000
Total 13600
% of votes cast 68%32%0%0%
How each member voted (19)
Member Party Vote
Ammiano — Yea
Maienschein — Nay
Mansoor — Nay
Wagner — Nay
Bonilla — Yea
Lowenthal — Yea
Chesbro — Yea
Chávez — Nay
Nazarian — Yea
Pan — Yea
Ridley-Thomas — Yea
Rodriguez — Yea
Waldron — Nay
Wieckowski — Yea
Gomez — Yea
Jim Patterson — Nay
Lorena Gonzalez — Yea
Roger Hernández — Yea
Bonta, Mia Democratic Yea

Official roll call →

3rd Reading

Passed 22 Yea · 8 Nay · 9 Other
Party YeaNayPresentNot Voting
Unaffiliated 20808
Democratic 2001
Total 22809
% of votes cast 56%21%0%23%
How each member voted (39)
Member Party Vote
Block — Yea
Hernandez — Yea
Leno — Yea
Lieu — Not Voting
Wright — Not Voting
Correa — Not Voting
Evans — Yea
Wyland — Nay
Fuller — Nay
Galgiani — Not Voting
Hancock — Yea
Hill — Yea
Hueso — Yea
Huff — Nay
Cannella — Nay
Knight — Nay
Mitchell — Yea
De León — Yea
Lara — Yea
Liu — Yea
Monning — Yea
Anderson — Nay
Beall — Yea
Corbett — Yea
Nielsen — Not Voting
Pavley — Yea
Roth — Not Voting
Steinberg — Yea
Torres — Yea
Vidak — Nay
Walters — Not Voting
Wolk — Yea
DeSaulnier — Yea
Yee — Yea
Beth Gaines — Not Voting
Bill Berryhill — Nay
Calderon, Lisa Democratic Not Voting
Jackson, Corey A. Democratic Yea
Padilla, Stephen C. Democratic Yea

Official roll call →

Do pass.

Passed 5 Yea · 1 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 4101
Democratic 1000
Total 5101
% of votes cast 71%14%0%14%
How each member voted (7)
Member Party Vote
Hill — Yea
Steinberg — Yea
Walters — Not Voting
De León — Yea
Lara — Yea
Beth Gaines — Nay
Padilla, Stephen C. Democratic Yea

Official roll call →

Subjects

healthcare health-insurance
Cross-referencing the record. Reading this bill against every other bill in the corpus by meaning, not keywords. Only the first open is slow. It’s instant for you after this. Matching · Ranking · Engrossing

Frequently asked questions

What does SB 780 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 requires a health care service plan to submit a filing to the department at least 75 days prior to the termination date of its contract with a provider group or a general acute care hospital that includes the written notice the plan proposes to send to its affected enrollees. The filing is required to be reviewed and approved by the department prior to the notice being sent to the enrollees. Existing law also requires the plan to provide written notice to affected enrollees, as provided, prior to the termination date of a contract between the plan and a provider group or a general acute care hospital. A plan operating as a preferred provider organization is only required to send the written notice to all enrollees who reside within a 15-mile radius of a terminated hospital if it is a general acute care hospital. This bill would delete the requirements with regard to preferred provider organizations. The bill would change the timing of the 75-day filing to 30 days prior to the termination date for a contract between a health care service plan that is not a health maintenance organization and a provider group or general acute care hospital. The bill would distinguish between enrollees of an assigned group provider and enrollees of an unassigned group provider for purposes of whether the filing is required to be submitted to the department. The bill would also require that the plan send a department-approved written notice to the enrollees, whether or not a filing was required, when a provider group contract or a general acute care hospital contract is terminated. The bill would distinguish between the enrollees of an assigned or an unassigned provider group or general acute care hospital with regard to the timing of the consumer notice and method of delivery. With respect to the termination of a contract with an unassigned provider group or general acute care hospital, the bill would impose specified continued access to services requirements, billing requirements, and requirements to obtain information from the terminated provider group or general acute care hospital regarding enrollees who have services scheduled with the terminated provider group or general acute care hospital for after the termination date using a process agreed upon in the terminating contract. The bill would authorize the department to develop a standard format for the required notices. Because a willful violation of these requirements would be a crime, the bill would impose a state-mandated local program. Existing law provides for the regulation of health insurers by the Department of Insurance. Under existing law, a health insurer may contract with providers for alternative rates of payment. Existing law requires those insurers to file a policy with the department describing how the insurer facilitates the continuity of care for new insureds under group policies receiving services for an acute condition from a noncontracting provider. Existing law also requires those health insurers to, at the request of an insured, arrange for the completion of covered services by a terminated provider if the insured is undergoing treatment for certain conditions, as specified. This bill would require, among other things, a health insurer to submit a filing to the department, at least 30 days prior to the termination date of its contract with a provider group or a general acute care hospital to provide services at alternative rates of payment, that includes the written notice the insurer proposes to send to its insureds. The bill would require the filing to be reviewed and approved by the department prior to the notice being sent to the insureds. The bill would set a threshold for the number of insureds receiving health care services from a group provider within the preceding 12 months for purposes of whether the filing is required to be submitted to the department. The bill would also require that the health insurer send a department-approved written notice to specified insureds, whether or not a filing was required, when a provider group contract or a general acute care hospital contract is terminated, and would impose specified continued access to services requirements, billing requirements, and requirements to obtain information from the terminated provider group or general acute care hospital regarding insureds who have services scheduled with the terminated provider group or general acute care hospital for after the termination date using a process agreed upon in the terminating contract. The bill would authorize the department to develop a standard format for the required notices. Existing law requires disability insurance policies to include a disclosure form that contains specified information, including the principal benefits and coverage of the policy, the exceptions, reductions, and limitations that apply to the policy, and a statement, with respect to health insurance policies, describing how participation in the policy may affect the choice of physician, hospital, or health care providers, and describing the extent of financial liability that may be incurred if care is furnished by a nonparticipating provider. With respect to health insurance policies, this bill would require the disclosure form to include additional information, including conditions and procedures for cancellation, rescission, or nonrenewal, a description of the limitations on the insured's choice of provider, and, with respect to insurers that contract for alternate rates of payment, a statement describing the basic method of reimbursement made to its participating providers, as specified. The bill would also require the first page of the disclosure form for health insurance policies to include other specified information. The bill would require a health insurer, medical group, or participating provider that uses or receives financial bonuses or other incentives to provide a written summary of specified information to any requesting person. 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 780?
SB 780 is sponsored by Jackson.
What is the current status of SB 780?
This bill died with 2013-2014 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 780?
Track SB 780 free on One Click Politics — get push/email alerts when it moves.

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