California 2015-2016 Regular Session Status: Enacted

SB 542 — Workers' compensation: medical provider networks: fee schedules.

Last action — Chaptered by Secretary of State. Chapter 542, Statutes of 2015.

Track this bill free

No card. One bill, free forever — alerts when it moves.

  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 February 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 6 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

(1) Existing law establishes a workers' compensation system, administered by the Administrative Director of the Division of Workers' Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Existing law authorizes an insurer, employer, or entity that provides physician network services to establish or modify a medical provider network for the provision of medical treatment to injured employees, and requires the administrative director to contract with individual physicians or an independent medical review organization to perform independent medical reviews. This bill would clarify that those independent medical reviews are medical provider network independent medical reviews. The bill would make related and conforming changes. (2) Existing law requires every medical provider network to post, and update quarterly, a roster of treating physicians in the medical provider network on its Internet Web site. This bill would require every medical provider network to post on its Internet Web site information about how to contact the medical provider network contact and medical access assistants, and also information about how to obtain a copy of any notification regarding the medical provider network that is required to be given to an employee by regulations adopted by the administrative director. (3) Existing law requires an insurer, employer, or entity that provides physician network services to submit a plan for the medical provider network to the administrative director to be approved for a period of 4 years. Commencing January 1, 2014, existing approved plans are deemed approved for a period of 4 years from their most recent application or modification approval date. This bill would provide that, commencing January 1, 2016, a modification that updates an entire medical provider network plan to bring the plan into full compliance with applicable laws would be deemed approved for a period of 4 years from the modification approval date. The bill would provide that the expiration of the medical provider network's current 4-year approval period will not change if a modification does not update a medical provider network plan to bring the plan into full compliance with applicable laws. (4) Existing law requires an insurer, employer, or entity that provides physician network services to file continuity of care policies. Existing law requires an insurer, employer, or entity that provides physician network services to provide completion of treatment by a terminated provider if at the time of the employer-employee contract's termination, the injured employee was receiving services from that provider for various conditions, as specified. This bill would instead require medical provider networks to file continuity of care policies. The bill would require an employer or its claims administrator to provide for the completion of treatment by a terminated provider under specified circumstances. The bill would also define an "entity that provides physician network services" for the purposes described above to mean a medical network licensed by a designated government department or a legal entity that offers medical management and physician network services within California. (5) Existing law requires the administrative director to adopt an official medical fee schedule that establishes reasonable maximum fees paid for specified medical services related to workers' compensation. Existing law also requires the administrative director to adopt a schedule for payment of home health care services that are not covered by a Medicare fee schedule and are not otherwise covered by the official medical fee schedule. Existing law requires this fee schedule to be based on the maximum service hours and fees set forth in provisions of law governing in-home supportive services. This bill would authorize, rather than require, the fee schedule to be based on either the maximum service hours and fees set forth in provisions of state law governing in-home supportive services or other state or federal home health care services fee schedules, as specified.

Bill Text

Action History

  1. Chaptered by Secretary of State. Chapter 542, Statutes of 2015.

  2. Approved by the Governor.

  3. Enrolled and presented to the Governor at 9:30 a.m.

  4. Assembly amendments concurred in. (Ayes 39. Noes 0. Page 2658.) Ordered to engrossing and enrolling.

  5. In Senate. Concurrence in Assembly amendments pending.

  6. Read third time. Passed. (Ayes 79. Noes 0. Page 2688.) Ordered to the Senate.

  7. Ordered to third reading.

  8. Read third time and amended.

  9. Ordered to third reading.

  10. From consent calendar on motion of Assembly Member Cristina Garcia.

  11. Read second time. Ordered to consent calendar.

  12. From committee: Do pass. Ordered to consent calendar. (Ayes 17. Noes 0.) (August 19).

  13. From committee: Do pass and re-refer to Com. on APPR. with recommendation: To consent calendar. (Ayes 13. Noes 0.) (July 8). Re-referred to Com. on APPR.

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

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

  16. Referred to Com. on INS.

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

  18. Read third time. Passed. (Ayes 37. Noes 0. Page 930.) Ordered to the Assembly.

  19. Read second time. Ordered to third reading.

  20. From committee: Be ordered to second reading pursuant to Senate Rule 28.8.

  21. Set for hearing May 4.

  22. From committee: Do pass and re-refer to Com. on APPR. (Ayes 5. Noes 0. Page 729.) (April 22). Re-referred to Com. on APPR.

  23. Set for hearing April 22.

  24. Re-referred to Com. on L. & I.R.

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

  26. Referred to Com. on RLS.

  27. From printer. May be acted upon on or after March 29.

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

Sponsors

  • Mendoza · Primary

Sponsorship breakdown

Export CSV (upgrade) →

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

Sponsors (1)

  • Mendoza

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 SB542 Mendoza Concurrence

Passed 39 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 36001
Democratic 3000
Total 39001
% of votes cast 98%0%0%3%
How each member voted (40)
Member Party Vote
Anderson — Yea
Bates — Yea
Hernandez — Yea
Hertzberg — Yea
Lara — Yea
Leyva — Yea
Nielsen — Yea
Vidak — Yea
Fuller — Yea
Glazer — Yea
Hill — Yea
Pan — Yea
Allen — Yea
De León — Yea
Runner — Yea
Cannella — Yea
Mitchell — Not Voting
Galgiani — Yea
Hancock — Yea
Beall — Yea
Block — Yea
Hueso — Yea
Huff — Yea
Leno — Yea
Liu — Yea
Mendoza — Yea
Monning — Yea
Moorlach — Yea
Morrell — Yea
Pavley — Yea
Roth — Yea
Wieckowski — Yea
Wolk — Yea
Hall — 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 542 Mendoza Senate Third Reading By DALY

Passed 79 Yea · 0 Nay · 1 Other
Party YeaNayPresentNot Voting
Unaffiliated 71000
Republican 4001
Democratic 4000
Total 79001
% of votes cast 99%0%0%1%
How each member voted (80)
Member Party Vote
Brown — Yea
Harper — Yea
Kim — Yea
Linder — Yea
Maienschein — Yea
Nazarian — Yea
Olsen — Yea
Ridley-Thomas — Yea
Thurmond — Yea
Weber — Yea
Eggman — Yea
Daly — Yea
Gatto — Yea
Cooper — Yea
Salas — Yea
Mayes — Yea
Frazier — Yea
Burke — Yea
Gomez — Yea
Gordon — Yea
Jones-Sawyer — Yea
Campos — Yea
Levine — Yea
Low — Yea
McCarty — Yea
Gray — Yea
Medina — Yea
Melendez — Yea
Atkins — Yea
Chang — Yea
Bonilla — Yea
Mullin — Yea
Lopez — Yea
O'Donnell — Yea
Chau — Yea
Chiu — Yea
Chu — Yea
Chávez — Yea
Cooley — Yea
Dababneh — Yea
Dodd — Yea
Obernolte — Yea
Perea — Yea
Rendon — Yea
Achadjian — Yea
Alejo — Yea
Baker — Yea
Bigelow — Yea
Bloom — Yea
Brough — Yea
Rodriguez — Yea
Steinorth — Yea
Wagner — Yea
Waldron — Yea
Wilk — Yea
Williams — Yea
Holden — Yea
Mathis — Yea
Quirk — Yea
Santiago — Yea
Ting — Yea
Wood — Yea
Hadley — Yea
Beth Gaines — Yea
Cristina Garcia — Yea
Eduardo Garcia — Yea
Jim Patterson — Yea
Lorena Gonzalez — Yea
Mark Stone — Yea
Roger Hernández — Yea
Travis Allen — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gipson, Mike A. Democratic Yea
Irwin, Jacqui Democratic Yea
Dahle, Megan Republican Yea
Gallagher, James Republican Not Voting
Grove, Shannon Republican Yea
Jones, Brian W. Republican Yea
Lackey, Tom Republican Yea

Official roll call →

Do pass. To Consent Calendar.

Passed 17 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 13000
Democratic 2000
Republican 2000
Total 17000
% of votes cast 100%0%0%0%
How each member voted (17)
Member Party Vote
Bigelow — Yea
Bloom — Yea
Quirk — Yea
Weber — Yea
Eggman — Yea
Daly — Yea
Gomez — Yea
Holden — Yea
Chang — Yea
Rendon — Yea
Wagner — Yea
Wood — Yea
Eduardo Garcia — Yea
Bonta, Mia Democratic Yea
Calderon, Lisa Democratic Yea
Gallagher, James Republican Yea
Jones, Brian W. Republican Yea

Official roll call →

Do pass and be re-referred to the Committee on [Appropriations] with recommendation: To Consent Calendar

Passed 13 Yea · 0 Nay
Party YeaNayPresentNot Voting
Unaffiliated 11000
Democratic 1000
Republican 1000
Total 13000
% of votes cast 100%0%0%0%
How each member voted (13)
Member Party Vote
Mayes — Yea
Rodriguez — Yea
Cooley — Yea
Frazier — Yea
Gatto — Yea
Gonzalez — Yea
Cooper — Yea
Dababneh — Yea
Daly — Yea
Beth Gaines — Yea
Travis Allen — Yea
Calderon, Lisa Democratic Yea
Grove, Shannon Republican Yea

Official roll call →

3rd Reading

Passed 37 Yea · 0 Nay · 2 Other
Party YeaNayPresentNot Voting
Unaffiliated 34002
Democratic 3000
Total 37002
% of votes cast 95%0%0%5%
How each member voted (39)
Member Party Vote
Anderson — Yea
Bates — Yea
Block — Yea
Huff — Yea
Lara — Yea
Leyva — Yea
Monning — Yea
Pan — Yea
Pavley — Yea
Vidak — Yea
Cannella — Yea
Hill — Yea
Allen — Yea
Mitchell — Yea
De León — Yea
Runner — Yea
Fuller — Not Voting
Galgiani — Yea
Hall — Yea
Hancock — Yea
Hernandez — Yea
Hertzberg — Yea
Hueso — Yea
Beall — Yea
Leno — Yea
Liu — Not Voting
Mendoza — Yea
Moorlach — Yea
Morrell — Yea
Nielsen — Yea
Roth — 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 →

Subjects

healthcare labor
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 542 do?
(1) Existing law establishes a workers' compensation system, administered by the Administrative Director of the Division of Workers' Compensation, to compensate an employee for injuries sustained in the course of his or her employment. Existing law authorizes an insurer, employer, or entity that provides physician network services to establish or modify a medical provider network for the provision of medical treatment to injured employees, and requires the administrative director to contract with individual physicians or an independent medical review organization to perform independent medical reviews. This bill would clarify that those independent medical reviews are medical provider network independent medical reviews. The bill would make related and conforming changes. (2) Existing law requires every medical provider network to post, and update quarterly, a roster of treating physicians in the medical provider network on its Internet Web site. This bill would require every medical provider network to post on its Internet Web site information about how to contact the medical provider network contact and medical access assistants, and also information about how to obtain a copy of any notification regarding the medical provider network that is required to be given to an employee by regulations adopted by the administrative director. (3) Existing law requires an insurer, employer, or entity that provides physician network services to submit a plan for the medical provider network to the administrative director to be approved for a period of 4 years. Commencing January 1, 2014, existing approved plans are deemed approved for a period of 4 years from their most recent application or modification approval date. This bill would provide that, commencing January 1, 2016, a modification that updates an entire medical provider network plan to bring the plan into full compliance with applicable laws would be deemed approved for a period of 4 years from the modification approval date. The bill would provide that the expiration of the medical provider network's current 4-year approval period will not change if a modification does not update a medical provider network plan to bring the plan into full compliance with applicable laws. (4) Existing law requires an insurer, employer, or entity that provides physician network services to file continuity of care policies. Existing law requires an insurer, employer, or entity that provides physician network services to provide completion of treatment by a terminated provider if at the time of the employer-employee contract's termination, the injured employee was receiving services from that provider for various conditions, as specified. This bill would instead require medical provider networks to file continuity of care policies. The bill would require an employer or its claims administrator to provide for the completion of treatment by a terminated provider under specified circumstances. The bill would also define an "entity that provides physician network services" for the purposes described above to mean a medical network licensed by a designated government department or a legal entity that offers medical management and physician network services within California. (5) Existing law requires the administrative director to adopt an official medical fee schedule that establishes reasonable maximum fees paid for specified medical services related to workers' compensation. Existing law also requires the administrative director to adopt a schedule for payment of home health care services that are not covered by a Medicare fee schedule and are not otherwise covered by the official medical fee schedule. Existing law requires this fee schedule to be based on the maximum service hours and fees set forth in provisions of law governing in-home supportive services. This bill would authorize, rather than require, the fee schedule to be based on either the maximum service hours and fees set forth in provisions of state law governing in-home supportive services or other state or federal home health care services fee schedules, as specified.
Who sponsors SB 542?
SB 542 is sponsored by Mendoza.
What is the current status of SB 542?
This bill has been enacted into law. Introduced February 26, 2015. Enacted.
Where can I track SB 542?
Track SB 542 free on One Click Politics — get push/email alerts when it moves.

Make your voice heard on SB 542

Find the representatives who decide this bill and tell them where you stand — for yourself, or mobilize your whole list in one click with One Click Politics advocacy software.

Find my representatives → Run a campaign

Stay ahead of SB 542

Last checked for changes 3 months ago · updated continuously

One Click Politics tracks every bill in Congress and all 50 states.

Track this bill →