California 2015-2016 Regular Session Status: Enacted

SB 137 — Health care coverage: provider directories.

Last action — Chaptered by Secretary of State. Chapter 649, Statutes of 2015.

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

This bill has been enacted into law. Introduced January 26, 2015. Enacted.

Prognosis

Likely to advance 70% · moderate confidence

Where this bill stands today.

Odds of enactment

High

How often bills like it became law.

  • Enacted

    Current position in the legislative process.

  • 1 sponsor

    1 primary, 0 co-sponsors signed on.

  • Cleared a recorded vote

    Passed 8 recorded votes so far.

Prognosis reads this bill's own signals — stage, sponsorship breadth, committee status, recorded votes and cross-state momentum. Odds come from a model trained on which bills have become law.

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. A willful violation of the act is a crime. Existing law requires a health care service plan to provide a list of contracting providers within a requesting enrollee's or prospective enrollee's general geographic area. Existing law also provides for the regulation of health insurers by the Insurance Commissioner. Existing law requires health insurers subject to regulation by the commissioner to provide group policyholders with a current roster of institutional and professional providers under contract to provide services at alternative rates. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. One of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed health care plans. This bill, commencing July 1, 2016, would require a health care service plan, and a health insurer that contracts with providers for alternative rates of payment, to publish and maintain a provider directory or directories with information on contracting providers that deliver health care services to the plan's enrollees or the health insurer's insureds, and would require the plan or health insurer to make an online provider directory or directories available on the plan or health insurer's Internet Web site, as specified. This bill would require the Department of Managed Health Care and the Department of Insurance to develop uniform provider directory standards. The bill would require a health care service plan or health insurer to take appropriate steps to ensure the accuracy of the information contained in the plan or health insurer's directory or directories, and would require the plan or health insurer, at least annually, to review and update the entire provider directory or directories for each product offered, as specified. The bill would require a plan or insurer, at least weekly, to update its online provider directory or directories, and would require a plan or insurer, at least quarterly, to update its printed provider directory or directories. The bill would require a health care service plan or health insurer to reimburse an enrollee or insured for any amount beyond what the enrollee or insured would have paid for in-network services, if the enrollee or insured reasonably relied on the provider directory, as specified. The bill would authorize a plan or health insurer to delay payment or reimbursement owed to a provider or provider group, as specified, if the provider or provider group fails to respond to the plan's or health insurer's attempts to verify the provider's or provider group's information. By placing additional requirements on health care service plans, the violation of which is 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. Chaptered by Secretary of State. Chapter 649, Statutes of 2015.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 4:45 p.m.

  4. Assembly amendments concurred in. (Ayes 38. Noes 2. Page 2751.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 69. Noes 9. Page 3096.) Ordered to the Senate.

  7. Ordered to third reading.

  8. Read third time and amended.

  9. Read second time. Ordered to third reading.

  10. Read second time and amended. Ordered to second reading.

  11. From committee: Do pass as amended. (Ayes 12. Noes 2.) (August 27).

  12. August 19 set for first hearing. Placed on APPR. suspense file.

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

  14. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 17. Noes 2.) (July 14).

  15. July 7 hearing postponed by committee.

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

  17. Referred to Com. on HEALTH.

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

  19. Read third time. Passed. (Ayes 35. Noes 0. Page 1290.) Ordered to the Assembly.

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

  21. From committee: Do pass as amended. (Ayes 6. Noes 0. Page 1148.) (May 28).

  22. Set for hearing May 28.

  23. May 4 hearing: Placed on APPR. suspense file.

  24. Set for hearing May 4.

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

  26. From committee: Do pass as amended and re-refer to Com. on APPR. (Ayes 8. Noes 0. Page 650.) (April 15).

  27. Set for hearing April 15.

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

  29. Referred to Com. on HEALTH.

  30. From printer. May be acted upon on or after February 26.

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

Sponsors

  • Hernandez · Primary

Sponsorship breakdown

Export CSV (upgrade) →

1 sponsors · 0 co-sponsors · 121 not signed on · 8 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

Unfinished Business SB137 Hernandez Concurrence

Passed 38 Yea · 2 Nay
Party YeaNayPresentNot Voting
Unaffiliated 35200
Democratic 3000
Total 38200
% of votes cast 95%5%0%0%
How each member voted (40)
Member Party Vote
Anderson — Yea
Beall — Yea
Block — Yea
Hernandez — Yea
Huff — Yea
Leno — Yea
Monning — Yea
Pan — Yea
Fuller — Yea
Hill — Yea
Cannella — Yea
Allen — Yea
Mitchell — Yea
De León — Yea
Runner — Yea
Galgiani — Yea
Glazer — Yea
Hall — Yea
Hancock — Yea
Hertzberg — Yea
Bates — Nay
Hueso — Yea
Lara — Yea
Leyva — Yea
Liu — Yea
Mendoza — Yea
Moorlach — Yea
Morrell — Nay
Nielsen — Yea
Pavley — Yea
Roth — Yea
Vidak — Yea
Wieckowski — Yea
Wolk — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Yea

Official roll call →

SB 137 Hernandez Senate Third Reading By WOOD

Passed 69 Yea · 9 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 62702
Democratic 4000
Republican 3200
Total 69902
% of votes cast 86%11%0%3%
How each member voted (80)
Member Party Vote
Achadjian — Yea
Alejo — Yea
Baker — Yea
Brough — Nay
Brown — Yea
Harper — Nay
Maienschein — Yea
Mathis — Nay
Mayes — Yea
Perea — Yea
Wagner — Yea
Waldron — Yea
Williams — Yea
Chau — Yea
Eggman — Yea
Dababneh — Yea
Gatto — Yea
Campos — Yea
Chávez — Yea
Cooper — Yea
Salas — Yea
Jones-Sawyer — Yea
Bonilla — Yea
Low — Yea
Bigelow — Yea
Medina — Yea
Nazarian — Yea
Obernolte — Yea
Rendon — Yea
Mullin — Yea
Gray — Yea
Dodd — Yea
O'Donnell — Yea
Frazier — Yea
Gomez — Yea
Lopez — Yea
Hadley — Yea
Holden — Yea
Levine — Yea
Linder — Yea
McCarty — Yea
Ridley-Thomas — Yea
Burke — Yea
Bloom — Yea
Chang — Yea
Chiu — Yea
Cooley — Yea
Daly — Yea
Rodriguez — Yea
Santiago — Yea
Thurmond — Yea
Weber — Yea
Wilk — Yea
Atkins — Yea
Chu — Yea
Kim — Not Voting
Melendez — Nay
Olsen — Not Voting
Quirk — Yea
Steinorth — Yea
Ting — Yea
Wood — Yea
Gordon — Yea
Beth Gaines — Nay
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Nay
Lorena Gonzalez — Yea
Mark Stone — Yea
Roger Hernández — Yea
Travis Allen — Nay
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gipson, Mike A. Democratic Yea
Irwin, Jacqui Democratic Yea
Dahle, Megan Republican Nay
Gallagher, James Republican Yea
Grove, Shannon Republican Nay
Jones, Brian W. Republican Yea
Lackey, Tom Republican Yea

Official roll call →

Do pass as amended.

Passed 12 Yea · 2 Nay · 3 Other
Party YeaNayPresentNot Voting
Unaffiliated 10102
Democratic 2000
Republican 0101
Total 12203
% of votes cast 71%12%0%18%
How each member voted (17)
Member Party Vote
Bloom — Yea
Nazarian — Yea
Weber — Yea
Eggman — Yea
Chang — Not Voting
Holden — Yea
Bigelow — Nay
Quirk — Yea
Rendon — Yea
Wagner — Not Voting
Wood — Yea
Gomez — Yea
Eduardo Garcia — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gallagher, James Republican Not Voting
Jones, Brian W. Republican Nay

Official roll call →

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

Passed 17 Yea · 2 Nay
Party YeaNayPresentNot Voting
Democratic 1000
Republican 0200
Unaffiliated 16000
Total 17200
% of votes cast 89%11%0%0%
How each member voted (19)
Member Party Vote
Maienschein — Yea
Santiago — Yea
Thurmond — Yea
Wood — Yea
Gomez — Yea
Burke — Yea
Bonilla — Yea
Chiu — Yea
Chávez — Yea
Nazarian — Yea
Ridley-Thomas — Yea
Rodriguez — Yea
Steinorth — Yea
Waldron — Yea
Gonzalez — Yea
Roger Hernández — Yea
Bonta, Mia Democratic Yea
Lackey, Tom Republican Nay
Patterson, Joe Republican Nay

Official roll call →

3rd Reading

Passed 35 Yea · 0 Nay · 5 Other
Party YeaNayPresentNot Voting
Unaffiliated 33004
Democratic 2001
Total 35005
% of votes cast 88%0%0%13%
How each member voted (40)
Member Party Vote
Anderson — Yea
Block — Yea
Hueso — Yea
Leyva — Yea
Mendoza — Yea
Nielsen — Not Voting
Roth — Yea
Fuller — Not Voting
Galgiani — Yea
Glazer — Yea
Hernandez — Yea
Hertzberg — Yea
Hill — Yea
Cannella — Yea
Lara — Yea
Leno — Yea
Allen — Yea
Mitchell — Yea
De León — Yea
Moorlach — Yea
Morrell — Yea
Pan — Yea
Pavley — Yea
Wolk — Yea
Runner — Not Voting
Hall — Yea
Hancock — Yea
Bates — Not Voting
Beall — Yea
Huff — Yea
Liu — Yea
Monning — Yea
Vidak — Yea
Wieckowski — Yea
Beth Gaines — Yea
Bill Berryhill — Yea
Mark Stone — Yea
Jackson, Corey A. Democratic Yea
McGuire, Mike Democratic Yea
Nguyen, Stephanie Democratic Not Voting

Official roll call →

Do pass as amended

Passed 6 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 6001
Total 6001
% of votes cast 86%0%0%14%
How each member voted (7)
Member Party Vote
Hill — Yea
Leyva — Yea
Lara — Yea
Bates — Not Voting
Beall — Yea
Mendoza — Yea
Nielsen — Yea

Official roll call →

Placed on suspense file

Passed 7 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 7000
Total 7000
% of votes cast 100%0%0%0%
How each member voted (7)
Member Party Vote
Bates — Yea
Hill — Yea
Lara — Yea
Mendoza — Yea
Nielsen — Yea
Beall — Yea
Leyva — Yea

Official roll call →

Subjects

healthcare health-insurance
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Frequently asked questions

What does SB 137 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. A willful violation of the act is a crime. Existing law requires a health care service plan to provide a list of contracting providers within a requesting enrollee's or prospective enrollee's general geographic area. Existing law also provides for the regulation of health insurers by the Insurance Commissioner. Existing law requires health insurers subject to regulation by the commissioner to provide group policyholders with a current roster of institutional and professional providers under contract to provide services at alternative rates. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. One of the methods by which Medi-Cal services are provided is pursuant to contracts with various types of managed health care plans. This bill, commencing July 1, 2016, would require a health care service plan, and a health insurer that contracts with providers for alternative rates of payment, to publish and maintain a provider directory or directories with information on contracting providers that deliver health care services to the plan's enrollees or the health insurer's insureds, and would require the plan or health insurer to make an online provider directory or directories available on the plan or health insurer's Internet Web site, as specified. This bill would require the Department of Managed Health Care and the Department of Insurance to develop uniform provider directory standards. The bill would require a health care service plan or health insurer to take appropriate steps to ensure the accuracy of the information contained in the plan or health insurer's directory or directories, and would require the plan or health insurer, at least annually, to review and update the entire provider directory or directories for each product offered, as specified. The bill would require a plan or insurer, at least weekly, to update its online provider directory or directories, and would require a plan or insurer, at least quarterly, to update its printed provider directory or directories. The bill would require a health care service plan or health insurer to reimburse an enrollee or insured for any amount beyond what the enrollee or insured would have paid for in-network services, if the enrollee or insured reasonably relied on the provider directory, as specified. The bill would authorize a plan or health insurer to delay payment or reimbursement owed to a provider or provider group, as specified, if the provider or provider group fails to respond to the plan's or health insurer's attempts to verify the provider's or provider group's information. By placing additional requirements on health care service plans, the violation of which is 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 137?
SB 137 is sponsored by Hernandez.
What is the current status of SB 137?
This bill has been enacted into law. Introduced January 26, 2015. Enacted.
Where can I track SB 137?
Track SB 137 free on One Click Politics — get push/email alerts when it moves.

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