BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 361
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          ASSEMBLY THIRD READING
          AB 361 (Lowenthal) 
          As Amended May 14, 2009
          Majority vote 

           INSURANCE           10-0                                        
           
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          |Ayes:|Coto, Garrick, Blakeslee, |     |                          |
          |     |                          |     |                          |
          |     |Charles Calderon, Carter, |     |                          |
          |     |Feuer, Hayashi, Nava,     |     |                          |
          |     |Niello, Torres            |     |                          |
          |-----+--------------------------+-----+--------------------------|
          |     |                          |     |                          |
           ----------------------------------------------------------------- 
           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.

          3)Specifies that the restriction on rescission or modification  
            does not impede medical provider network contracts, nor does  
            it impede an employer from transferring an employee into a  
            medical provider network.

           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.









                                                                  AB 361
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           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.

          2)Related law.  AB 1324 (De La Torre), Chapter 702, Statutes of  
            2007, 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 Assembly Insurance 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.  The author and the employer  
            community have agreed to have further discussions to refine  
            the language beyond the clarifying amendment that was adopted  
            in the Assembly Insurance Committee.  The recent floor  
            amendments are a part of that process.

          4)The recent floor amendments are intended to ensure that the  
            existing medical provider network arrangements are not  
            adversely impacted by the bill.  However, these amendments are  
            not intended to allow the employer to use that fact that it  
            should have referred the employee to the medical provider  
            network if out of network services were actually performed  
            based on a prior approval.
           

          Analysis Prepared by  :    Mark Rakich / INS. / (916) 319-2086


                                                                FN: 0000686








                                                                  AB 361
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