BILL NUMBER: AB 1296	AMENDED
	BILL TEXT

	AMENDED IN ASSEMBLY  APRIL 19, 2007
	AMENDED IN ASSEMBLY  APRIL 9, 2007

INTRODUCED BY   Assembly Member Torrico

                        FEBRUARY 23, 2007

   An act to add Section 22854.5 to the Government Code, relating to
public employee health benefits.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 1296, as amended, Torrico. Public employee health benefits:
disclosures.
   The Public Employees' Medical and Hospital Care Act requires the
Board of Administration of the Public Employees' Retirement System to
approve health benefit plans for certain public employees and
annuitants, and authorizes the board to contract with carriers
offering health benefit plans. The act sets forth certain criteria
the board may take into account when considering a contract with an
entity seeking to provide health care benefits or services, and
allows the board to require specified documents from that entity.
   This bill would require a health benefit plan or contract, or
entities offering services relating to the administration of health
benefit plans, to disclose to the Board of Administration of the
Public Employees' Retirement System the cost, utilization, and actual
 provider  claim payments on behalf of each member
and annuitant for  all  health care services
rendered  by hospitals  , including the allowance amounts
for services billed. The bill would deem this information
confidential, subject to evidentiary trade secret protections, and
exempt from the California Public Records Act, as specified.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Section 22854.5 is added to the Government Code, to
read:
   22854.5.  (a) A health benefit plan or contract, or an entity
offering services relating to the administration of health benefit
plans to employees and annuitants, shall disclose to the board and
staff the cost, utilization, and actual  provider 
claim payments on behalf of each member and annuitant for 
all health care services rendered   health care services
rendered by hospitals  , including the  provider
 contract allowance amounts for services billed for each
individual  health care provider   hospital
 .
   (b) The member and annuitant health care services cost,
utilization, and payment information shall be deemed confidential
information and protected in accordance with the federal Health
Insurance Portability and Accountability Act of 1996 (42 U.S.C. Sec.
300gg) and the final regulations issued pursuant to the act by the
United States Department of Health and Human Services (45 C.F.R.
Parts 160 and 164). As such, information provided to the board and
staff shall not include individual member or annuitant identifying
information.
   (c) The  provider   hospital  contract
allowance amounts and payments shall be deemed to be confidential
trade secret information in accordance with subdivision (d) of
Section 3426.1 of the Civil Code and Section 1060 of the Evidence
Code.
   (d) The board shall not disclose the member and annuitant health
care services cost, utilization, and payment information or provider
contract allowance amounts to any other carrier or entity, and shall
not make that information available to the public.
   (e) The member and annuitant health care services cost,
utilization, and payment information and the provider contract
allowance amounts shall be exempt from disclosure under the
California Public Records Act (Chapter 3.5 (commencing with Section
6250) of Division 7 of Title 1) pursuant to subdivision (k) of
Section 6254.