BILL ANALYSIS                                                                                                                                                                                                    



                                                                  AB 361
                                                                  Page  1

          CONCURRENCE IN SENATE AMENDMENTS
          AB 361 (Bonnie Lowenthal)
          As Amended  September 2, 2009
          Majority vote
           
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          |ASSEMBLY:  |77-0 |(May 18, 2009)  |SENATE: |33-6 |(September 4,  |
          |           |     |                |        |     |2009)          |
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           Original Committee Reference:    INS.  

           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.  

           The Senate amendments  add a provision that clarifies that:  

           1)Nothing in this bill shall be construed to render a provider  
            who is being reimbursed pursuant to an approval described in  
            the bill the treating physician primarily responsible for  
            rendering opinions concerning compensability.

          2)An employer may revise or rescind an approval involving a  
            series of or treatments or services with respect to treatments  
            or services that have not yet been provided.

           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.

           AS PASSED BY THE ASSEMBLY  , this bill:

          1)Provided 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.









                                                                  AB 361
                                                                  Page  2

          2)Stated 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.

           FISCAL EFFECT  :  Undetermined, but unlikely to have any  
          measurable impact.

           COMMENTS  :  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 employer or  
          insurer.  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.  


           Analysis Prepared by  :  Mark Rakich / INS. / (916) 319-3958FN:  
          0003031