BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                   AB 137|
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                                 THIRD READING


          Bill No:  AB 137
          Author:   Portantino (D)
          Amended:  8/6/12 in Senate
          Vote:     21

           
           SENATE HEALTH COMMITTEE  :  9-0, 6/27/12
          AYES:  Hernandez, Harman, Alquist, Anderson, Blakeslee, De 
            León, DeSaulnier, Rubio, Wolk
           
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8

           ASSEMBLY FLOOR  :  71-0, 1/26/12 - See last page for vote


           SUBJECT  :    Health care coverage:  mammographies

           SOURCE  :     Author


           DIGEST  :    This bill provides that individual or group 
          policies of health insurance shall be deemed to provide 
          coverage for mammographies for screening or diagnostic 
          purposes upon referral of a participating nurse 
          practitioner, participating certified nurse-midwife, 
          participating physician assistant, or participating 
          physician, as specified.

           ANALYSIS  :    

          Under existing law, an individual or group policy of 
          disability insurance that is issued, amended, delivered, or 
          renewed on or after January 1, 2000, is deemed to provide 
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          specified coverage based upon age for mammography for 
          screening or diagnostic purposes upon referral by a 
          participating nurse practitioner, participating certified 
          nurse-midwife, or participating physician, providing care 
          to the patient and operating within the scope of practice 
          provided under existing law.

          This bill provides that individual or group policies of 
          health insurance shall be deemed to provide coverage for 
          mammographies for screening or diagnostic purposes upon 
          referral of a participating nurse practitioner, 
          participating certified nurse-midwife, participating 
          physician assistant, or participating physician, as 
          specified.

           Background
           
           Prevalence of breast cancer  .  According to the American 
          Cancer Society's "Breast Cancer Facts & Figures 2009-2010," 
          excluding cancers of the skin, breast cancer is the most 
          common cancer among women; accounting for more than one in 
          four cancers diagnosed in U.S. women.  It is the second 
          leading cause of death of women in California.  According 
          to the California Breast Cancer Research Program, the 
          breast cancer death rate in California has dropped 20% 
          since 1973, but California women are more likely to get 
          breast cancer today than in 1973.  While the death rate for 
          breast cancer has dropped, the gains have not been shared 
          equally among all women.  Minority and low-income women are 
          less likely than other women to be diagnosed at an early 
          stage, receive effective treatment, and survive the 
          disease.  California Health Benefits Review Program reports 
          that white women are most likely to get the disease, 
          followed closely by African American women, Asian Pacific 
          Islander women, and Hispanic women.  African American women 
          have the highest death rate despite being less likely than 
          white women to get the disease.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  No   
          Local:  No

           SUPPORT  :   (Verified  8/8/12)

          AFSCME, AFL-CIO

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          American Congress of Obstetricians and Gynecologists 
          District IX California
          Association of Northern California Oncologists
          California Commission on the Status of Women
          California Communities United Institute
          California Medical Association
          California Nurse Midwives Association
          Disability Rights Legal Center
          Medical Oncology Association of Southern California
          Planned Parenthood Affiliates of California
          Planned Parenthood Mar Monte
          Susan G. Komen for the Cure - Central Valley Affiliate
          Susan G. Komen for the Cure - Inland Empire Affiliate
          Susan G. Komen for the Cure - Los Angeles County Affiliate
          Susan G. Komen for the Cure - Orange County Affiliate
          Susan G. Komen for the Cure - Sacramento Valley Affiliate
          Susan G. Komen for the Cure - San Diego Affiliate
          Susan G. Komen for the Cure - San Francisco Bay Area 
          Affiliate

          OPPOSITION  :    (Verified  8/8/12)

          America's Health Insurance Plans (prior version)

           ARGUMENTS IN SUPPORT  :    American Federation of State, 
          County and Municipal Employees writes in support that this 
          bill will require insurance companies to cover mammograms 
          for screening purposes for breast cancer.  California Nurse 
          Midwives Association (CNMA) writes in support that 
          certified nurse midwives are often the initial contact for 
          women in providing ongoing health care and provide quality 
          health care to women in a variety of settings.  CNMA 
          contends that this bill will help enhance the quality of 
          health care for many women in our state.  The American 
          Congress of Obstetricians and Gynecologists (ACOG) write in 
          support that this bill corrects an inconsistency in the 
          Insurance Code relative to mammography coverage.  ACOG 
          maintains that it rectifies this discrepancy by mirroring 
          the language for mammography coverage in Knox-Keene. Knox 
          Keene regulations on HMOs provide for mammography, upon 
          referral by a physician subject to medical necessity 
          standards and practice guidelines.

           ARGUMENTS IN OPPOSITION  :    America's Health Insurance 

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          Plans (AHIP) opposes insurance mandate bills, including 
          this bill.  AHIP argues adding additional mandates to 
          California's existing mandates will have a harmful effect 
          on program costs to California's budget.


           ASSEMBLY FLOOR  :  71-0, 1/26/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 
            Brownley, Buchanan, Butler, Campos, Carter, Cedillo, 
            Chesbro, Conway, Cook, Dickinson, Donnelly, Eng, Feuer, 
            Fletcher, Fong, Fuentes, Furutani, Beth Gaines, Garrick, 
            Gatto, Gordon, Grove, Hagman, Hall, Hayashi, Roger 
            Hernández, Hill, Huber, Hueso, Huffman, Jeffries, Jones, 
            Knight, Lara, Logue, Bonnie Lowenthal, Ma, Mansoor, 
            Mendoza, Miller, Mitchell, Morrell, Nestande, Nielsen, 
            Olsen, Pan, Perea, V. Manuel Pérez, Portantino, Silva, 
            Skinner, Solorio, Swanson, Torres, Valadao, Wagner, 
            Wieckowski, Williams, Yamada, John A. Pérez
          NO VOTE RECORDED:  Charles Calderon, Davis, Galgiani, 
            Gorell, Halderman, Harkey, Monning, Norby, Smyth


          CTW:dk  8/8/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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