BILL NUMBER: AB 591 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY APRIL 15, 2009
INTRODUCED BY Assembly Member De La Torre
FEBRUARY 25, 2009
An act to amend Section 754 of add Section
1385.5 to the Health and Safety Code, and to amend Section 754 of,
and to add Section 10113.96 to, the Insurance Code, relating to
insurance.
LEGISLATIVE COUNSEL'S DIGEST
AB 591, as amended, De La Torre. Referral fees.
Insurance: referral fees: health plans and insurance: filings.
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. Existing law also provides for
the regulation of health insurers by the Department of Insurance.
This bill would require health care service plans and health
insurers to annually file with the Director of the Department of
Managed Health Care or the Insurance Commissioner a list of their
plan contracts or health insurance policies offered, issued, or
outstanding in this state in the previous calendar year, including
the form number and marketing name for those contracts or policies.
The bill would require the departments to use those form numbers and
marketing names when tracking the associated plans and contracts or
insurers and policies.
Because a willful violation of the bill's requirements with
respect to health care service plans would be a crime, the bill would
impose a state-mandated local program.
Under existing law, it is unlawful for a person to solicit,
receive, offer, or pay a referral fee for the referral of an
individual for the furnishing of services or goods for which the
person knows or should have known that whole or partial reimbursement
is or may be made by an insurer. Existing law makes a violation of
those provisions a misdemeanor, punishable by a fine not to exceed
$1,000 for each violation.
This bill would increase that penalty to $5,000 for each
violation. By increasing the penalties for 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.
Vote: majority. Appropriation: no. Fiscal committee: no
yes . State-mandated local program: no
yes .
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1385.5 is added to the
Health and Safety Code , to read:
1385.5. (a) A health care service plan shall, by June 30 of each
year, file with the department a list of its plan contracts offered
or issued or outstanding in this state as of the end of the previous
calendar year. This list shall identify each type of contract by form
number and marketing name, if used.
(b) The department shall use the form number and marketing name
provided pursuant to subdivision (a) when tracking the associated
health care service plan contract or health care service plan under
this chapter.
(c) The filing required by this section shall be in addition to
the annual filing required under Section 1358.225.
SECTION 1. SEC. 2. Section 754 of
the Insurance Code is amended to read:
754. (a) It is unlawful for any person to solicit, receive,
offer, or pay any referral fee for the referral of an individual for
the furnishing of services or goods for which the person knows or
should have known that whole or partial reimbursement is or may be
made, directly or indirectly, by any insurer. As used in this
section, a referral fee is a fee paid by a person furnishing goods or
services to another in return for the referral of an individual to
that person for the furnishing of services or goods. It includes any
referral fee, kickback, bribe, or rebate, whether made directly or
indirectly, overtly or covertly, or in cash or in kind. This
subdivision does not apply to any of the following:
(1) Discounts or similar reductions in prices.
(2) Referral fees between attorneys if legal services are provided
pursuant to a contingency fee arrangement if any referral fee is
consistent with the Rules of Professional Conduct of the State Bar of
California.
(b) This section applies to all forms of insurance covering a
motor vehicle, including commercial and personal lines, and
comprehensive coverage, property damage coverage, collision coverage,
and liability coverage.
(c) A violation of this section is a misdemeanor punishable by a
fine not to exceed five thousand dollars ($5,000) for each violation.
Proceedings to enforce this section may be brought by any district
attorney or other prosecuting attorney.
SEC. 3. Section 10113.96 is added to the
Insurance Code , to read:
10113.96. (a) A health insurer shall, by June 30 of each year,
file with the commissioner a list of its health insurance polices
offered or issued or outstanding in this state as of the end of the
previous calendar year. This list shall identify each type of policy
by form number and marketing name, if used.
(b) The department shall use the form number and marketing name
provided pursuant to subdivision (a) when tracking the associated
health insurance policy or health insurer under this part.
(c) The filing required by this section shall be in addition to
the annual filing required under Section 10192.13.
SEC. 4. 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.