BILL NUMBER: AB 171	ENROLLED
	BILL TEXT

	PASSED THE SENATE  AUGUST 27, 2009
	PASSED THE ASSEMBLY  AUGUST 31, 2009
	AMENDED IN SENATE  JULY 15, 2009
	AMENDED IN SENATE  JUNE 30, 2009
	AMENDED IN SENATE  MAY 28, 2009

INTRODUCED BY   Assembly Member Jones

                        JANUARY 29, 2009

   An act to add Section 654.3 to the Business and Professions Code,
and to add Section 1395.7 to the Health and Safety Code, relating to
dental services.



	LEGISLATIVE COUNSEL'S DIGEST


   AB 171, Jones. Dental services: credit.
   Existing law prohibits a healing arts licensee, including
physicians and surgeons, psychologists, acupuncturists, optometrists,
dentists, podiatrists, and chiropractic practitioners, from
referring a person for certain health care services if the licensee
has a financial interest, as defined, with the person or entity that
receives the referral. Existing law provides specified exemptions
from this prohibition. Under existing law, a violation of the
provisions governing referrals is a crime.
   This bill would prohibit a dentist, or an employee or agent of
that dentist, from arranging for or establishing credit extended by a
3rd party for a patient without first providing a written notice and
a written treatment plan, as specified, and would prohibit that
arrangement or establishment of credit with regard to a patient who
has been administered or is under the influence of general
anesthesia, conscious sedation, or nitrous oxide. The bill would
prohibit a dentist, or employee or agent of a dentist, from charging
treatment not yet rendered or costs not yet incurred to an open-end
credit extended by a 3rd party that is arranged for or established in
the dental office without first providing the patient with specified
information regarding the treatment and services to be rendered and
ensuring the patient's receipt of the treatment plan. The bill would
require a dentist to refund to the lender any payment received
through credit extended by a third party, as specified, for treatment
that has not been rendered or costs that have not been incurred
within 15 business days of the patient's request. The bill would
subject a person who willfully violates these provisions to specified
civil liability. Because a violation of these provisions would be a
crime, this bill would impose a state-mandated local program.
   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.
   This bill would require a staff-model dental health care service
plan, as defined, that arranges for or establishes credit extended by
a 3rd party to establish and comply with policies and procedures
that ensure compliance with the bill's provisions and to establish
and comply with policies and procedures that ensure that, within 15
business days of an enrollee's request, the plan refunds to a lender
any payment received through that credit for treatment that has not
been rendered or costs that have not been incurred. The bill would
also require a staff-model dental health care service plan that
directly extends credit or establishes a payment plan to establish
and comply with policies and procedures that ensure that, within 15
business days of an enrollee's request, the plan refunds to the
enrollee any payment received through that credit or payment plan for
treatment that has not been rendered or costs that have not been
incurred.
   Because a willful violation of these requirements would be 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.


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

  SECTION 1.  Section 654.3 is added to the Business and Professions
Code, to read:
   654.3.  (a) A dentist, or an employee or agent of a dentist, shall
not charge treatment or costs to an open-end credit, that is
extended by a third party and that is arranged for or established in
a dental office, before the date upon which the treatment is rendered
or costs are incurred, without first providing the patient a list of
the treatment and services to be rendered, the estimated costs of
the treatment and services, and which treatment and services are
being charged in advance of rendering or incurring of costs, and
ensuring that the patient has received the treatment plan required by
subdivision (d).
   (b) A dentist shall, within 15 business days of a patient's
request, refund to the lender any payment received through a credit
extended by a third party that is arranged for or established in a
dental office for treatment that has not been rendered or costs that
have not been incurred.
   (c) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit extended by a third party for a
patient without first providing the following written notice, on one
page in at least 14-point type, and obtaining a signature from the
patient:


   "Credit for Dental Services
   The attached application and information is for a credit card/line
of credit or loan to help you finance your dental treatment. You
should know that:
   You are applying for a ____ credit card/line of credit or a ____
loan for $____.
   You do not have to apply for the credit card/line of credit or
loan. You may pay your dentist for dental treatment in another
manner.
   This credit card/line of credit or loan is not a payment plan with
the dental office; it is credit with [name of company issuing the
credit card/line of credit or loan]. Your dentist does not work for
this company.
   Before applying for this credit card/line of credit or loan, you
have the right to a written treatment plan from your dentist that
includes the anticipated treatment to be provided and the estimated
costs of each service.
   If you are approved for a credit card/line of credit, your dentist
can only charge treatment and lab costs to that credit card/line of
credit when you get the treatment or the dentist incurs costs unless
your dentist has first given you a list of treatments that you are
paying for in advance and the cost for each treatment or service.
   You have the right to receive a credit to your credit card/line of
credit or loan account refunded for any costs charged to the credit
card/line of credit or loan for treatment that has not been rendered
or costs that your dentist has not incurred. Your dentist must refund
the amount of the charges to the lender within 15 business days of
your request, after which the lender will credit your account.
   Please read carefully the terms and conditions of this credit
card/line of credit or loan, including any promotional offers.
   You may be required to pay interest on the amount charged to the
credit card/line of credit or the amount of the loan. If you miss a
payment or do not pay on time, you may have to pay a penalty and/or a
higher interest rate.
   If you do not pay the money that you owe the company that provides
you with a credit card/line of credit or loan, your missed payments
can appear on your credit report and could hurt your credit rating.
You could also be sued.
   [Patient's Signature]"


   (d) A dentist shall give a patient a written treatment plan prior
to arranging for or establishing credit extended by a third party.
The treatment plan shall include each anticipated service to be
provided and the estimated cost of each service. If a patient is
covered by a private or government dental benefit plan or dental
insurance, from which the dentist takes assignment of benefits, the
treatment plan shall indicate the patient's private or
government-estimated share of cost for each service. If the dentist
does not take assignment of benefits from a patient's dental benefit
plan or insurance, the treatment plan shall indicate that the
treatment may or may not be covered by a patient's dental benefit or
insurance plan, and that the patient has the right to confirm dental
benefit or insurance information from the patient's plan, insurer, or
employer before beginning treatment.
   (e) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit extended by a third party for a
patient with whom the dentist, or an employee or agent of that
dentist, communicates primarily in a language other than English that
is one of the Medi-Cal threshold languages, unless the written
notice information required by subdivision (c) is also provided in
that language.
   (f) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit that is extended by a third party for
a patient who has been administered or is under the influence of
general anesthesia, conscious sedation, or nitrous oxide.
   (g) A patient who suffers any damage as a result of the use or
employment by any person of a method, act, or practice that willfully
violates this section may seek the relief provided by Chapter 4
(commencing with Section 1780) of Title 1.5 of Part 4 of Division 3
of the Civil Code.
   (h) The rights, remedies, and penalties established by this
article are cumulative, and shall not supersede the rights, remedies,
or penalties established under other laws.
   (i) For purposes of this section, the following definitions shall
apply:
   (1) "Dentist" includes, but is not limited to, a dental
corporation, as defined in Section 1800.
   (2) "Open-end credit" means credit extended by a creditor under a
plan in which the creditor reasonably contemplates repeated
transactions, the creditor may impose a finance charge from time to
time on an outstanding unpaid balance, and the amount of credit that
may be extended to the debtor during the term of the plan (up to any
limit set by the creditor) is generally made available to the extent
that any outstanding balance is repaid.
   (3) "Patient" includes, but is not limited to, the patient's
parent or other legal representative.
  SEC. 2.  Section 1395.7 is added to the Health and Safety Code, to
read:
   1395.7.  (a) A staff-model dental health care service plan that
arranges for or establishes credit extended by a third party shall
establish and comply with policies and procedures that ensure that
its dentists, employees, and agents, and employees or agents of its
dentists, comply with Section 654.3 of the Business and Professions
Code.
   (b) A staff-model dental health care service plan that arranges
for or establishes credit extended by a third party shall establish
and comply with policies and procedures that ensure that, within 15
business days of an enrollee's request, the plan refunds to a lender
any payment received through that credit for treatment that has not
been rendered or costs that have not been incurred.
   (c) A staff-model dental health care service plan that directly
extends credit or establishes a payment plan shall, at a minimum,
establish and comply with policies and procedures that ensure that,
within 15 business days of an enrollee's request, the plan refunds to
the enrollee any payment received through that credit or payment
plan for treatment that has not been rendered or costs that have not
been incurred.
   (d) For purposes of this section, the following definitions shall
apply:
   (1) "Staff-model dental health care service plan" means a
specialized health care service plan that contracts to provide
coverage for dental care services and that retains dentists as
employees to care for its enrollees.
   (2) "Enrollee" includes, but is not limited to, an enrollee's
parent or other legal representative.
  SEC. 3.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.