BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 361
                                                                  Page  1

          Date of Hearing:   April 22, 2009

                           ASSEMBLY COMMITTEE ON INSURANCE
                                   Joe Coto, Chair
                   AB 361 (Lowenthal) - As Amended:  April 13, 2009
           
          SUBJECT  :   Workers' compensation

           SUMMARY  :   Precludes an employer from refusing to pay for  
          workers' compensation medical treatment services if the employer  
          has approved those services prior to the time the medical  
          provider treated the claimant.  Specifically,  this bill :  

          1)Provides that, regardless of whether the employer has  
            established a medical provider network, an employer that  
            authorizes medical treatment cannot rescind or modify the  
            approval after the services are provided.

          2)States that nothing in the above rules can be construed to  
            expand or alter the benefits available under, or the terms and  
            conditions of, any contract.

           EXISTING LAW  :

          1)Establishes a comprehensive system of workers' compensation  
            benefits for workers injured during employment, including  
            medical treatment benefits.

          2)Prohibits, in the context of health insurance, a health plan  
            or insurer from rescinding or modifying an authorization for  
            medical services after the services are rendered.

           FISCAL EFFECT  :   Undetermined.

           COMMENTS  :   

           1)Purpose  .  The author introduced this bill at the request of  
            the California Chiropractic Association, which reports that  
            many of its members have experienced billing problems when  
            billing for services that had been previously approved by the  
            appropriate payor.  While the problem in the market was raised  
            by chiropractors, the solution properly applies to any  
            workers' compensation medical treatment services that have  
            been properly pre-approved.









                                                                  AB 361
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           2)Related law  .  Last Session, the Legislature passed, and the  
            Governor signed, AB 1324 (De La Torre).  AB 1324 established  
            in the health insurance context the same rule proposed here  
            for the workers' compensation system.  The principles are the  
            same:  if the responsible party authorizes a medical provider  
            to treat a patient, then it is inappropriate for that same  
            party to decline to pay for the treatment once it has been  
            provided.

           3)Employer Concerns  .  Employers have expressed concerns to the  
            Author and Committee staff that the bill may have unintended  
            consequences.  The concern that was expressed was that the  
            language might unintentionally preclude the employer from  
            modifying or reversing its decision for services not yet  
            rendered.  Despite agreeing to propose language, as of the  
            preparation of this analysis, language had not been proposed  
            by those expressing concerns.  However, the author has agreed  
            in principle to clarify the bill's provisions.  One option to  
            clarify this point would be to add the phrase "after the  
            medical treatment has been provided" on page 2, line 7, after  
            the word "authorization."

           REGISTERED SUPPORT / OPPOSITION :   

           Support 
           
          American Federation of State, Municipal, and County Employees  
          (AFSCME)
          Association for Los Angeles Deputy Sheriffs
          California Applicants' Attorneys Association
          California Chiropractic Association (CCA)
          California Medical Association (CMA)
          California Nurses Association/National Nurses Organizing  
          Committee
          California State Employees Association (CSEA)
          CSAC-EIA California Joint Powers Authority 
          Glendale City Employees Association
          Los Angeles Probation Officers' Union, AFSCME, Local 685
          Orange County Professional Firefighters' Association
          Organization of SMUD Employees
          Riverside Sheriffs' Association 
          San Bernardino Public Employees Association
          Santa Rosa City Employees Association

           Opposition 








                                                                 AB 361
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          Association of California Insurance Companies (ACIC)
          California Association of Joint Powers Authorities (unless  
          amended)
           
          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086