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 actualproviderclaim payments on behalf of each member and annuitant forallhealth 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 actualproviderclaim payments on behalf of each member and annuitant forall health care services renderedhealth care services rendered by hospitals , including theprovidercontract allowance amounts for services billed for each individualhealth care providerhospital . (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) Theproviderhospital 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.