BILL NUMBER: AB 210	AMENDED
	BILL TEXT

	AMENDED IN SENATE  SEPTEMBER 1, 2011
	AMENDED IN SENATE  AUGUST 15, 2011
	AMENDED IN SENATE  JULY 12, 2011
	AMENDED IN SENATE  JUNE 29, 2011
	AMENDED IN ASSEMBLY  JUNE 1, 2011
	AMENDED IN ASSEMBLY  MAY 27, 2011
	AMENDED IN ASSEMBLY  APRIL 4, 2011

INTRODUCED BY   Assembly Member  Solorio   Roger
Hernández 
    (   Coauthors:   Assembly Members 
 Alejo,   Ammiano,   Blumenfield,  
Carter,   Huffman,   Bonnie Lowenthal,  
and Williams   ) 

                        JANUARY 31, 2011

    An act to amend Sections 1797.85, 1797.224, 1797.270,
1797.274, and 1797.276 of, and to repeal and add Section 1797.201 of,
the Health and Safety Code, relating to emergency medical services.
  An act to add Section 10123.866 to the Insurance Code,
relating to maternity services. 


	LEGISLATIVE COUNSEL'S DIGEST


   AB 210, as amended,  Solorio   Roger
Hernández  .  Emergency medical services.  
Maternity services.  
   Existing law provides for the regulation of health insurers by the
Department of Insurance. Under existing law, a health insurer that
provides maternity coverage may not restrict inpatient hospital
benefits, as specified, and is required to provide notice of the
maternity services coverage.  
   This bill, commencing July 1, 2012, would require every group
health insurance policy to provide coverage for maternity services
for all insureds covered under the policy.  
   This bill would become operative only if SB 222 is also enacted.
 
   (1) Existing law establishes the Emergency Medical Services System
and the Prehospital Emergency Medical Care Personnel Act, which
governs local emergency medical service systems and establishes the
Emergency Medical Services Authority, which is responsible for the
coordination and integration of all state activities concerning
emergency medical services. The act requires a county to enter into a
written agreement with a city or fire district that contracted for,
or provided, as of June 1, 1980, prehospital emergency medical
services regarding the provision of these services for the city or
fire district, as specified. The act requires, until an agreement is
reached, prehospital emergency medical services to be continued at
not less than the existing level, unless reduced by the city council
or the governing body of the fire district, as specified. 

   This bill would continue the authorization of a city or fire
district that had continuously contracted for or provided prehospital
emergency medical services (EMS) since June 1, 1980, to contract for
or provide the administration of the same type of prehospital EMS
that it has continuously provided or contracted for during that time,
within the geographical service area that it continuously served
during that time, if the city or fire district makes a formal written
request to the local EMS agency prior to January 1, 2014, and if
specified conditions are met. The bill would authorize a city or fire
district to increase its geographical area if specified conditions
are met. The bill would prohibit a local EMS agency from creating an
exclusive operating area for a type of prehospital EMS provided or
contracted for by a city or fire district that is providing
continuing prehospital EMS.  
   (2) The EMS act authorizes the establishment of an emergency
medical care committee in each county and requires the committee to
annually review ambulance services operating within the county,
emergency medical care offered within the county, and first aid
practices in the county. The act also requires the committee to
report its observations and recommendations relative to this review
to the authority and the local EMS agency.  
   This bill would, instead, require the committee to review the
county's emergency medical care system and to act in an advisory
capacity to the county board or boards of supervisors. The bill would
require the membership of an emergency medical care committee in
each county to be representative of the EMS system participants.
 
   (3) By increasing the duties of local officials, this bill would
impose a state-mandated local program.  
   (4) 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, if the Commission on State Mandates
determines that the bill contains costs mandated by the state,
reimbursement for those costs shall be made pursuant to these
statutory provisions. 
   Vote: majority. Appropriation: no. Fiscal committee:  yes
  no  . State-mandated local program:  yes
  no  .


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

   SECTION 1.    The Legislature finds and declares the
following:  
   (a) In actual practice, health care service plans have been
required by the Knox-Keene Health Care Service Plan Act of 1975
(Chapter 2.2 (commencing with Section 1340) of Division 2 of the
Health and Safety Code) to provide maternity services as a basic
health care benefit.  
   (b) At the same time, existing law does not require health
insurers to provide designated basic health care services and,
therefore, health insurers are not required to provide coverage for
maternity services.  
   (c) Therefore, it is essential to clarify that all health care
coverage made available to California consumers, whether issued by
health care service plans regulated by the Department of Managed
Health Care or by health insurers regulated by the Department of
Insurance, must include maternity services. 
   SEC. 2.    Section 10123.866 is added to the 
 Insurance Code   , to read:  
   10123.866.  (a) Commencing no later than July 1, 2012, every group
health insurance policy shall provide coverage for maternity
services for all insureds covered under the policy.
   (b) For purposes of this section, "maternity services" include
prenatal care, ambulatory care maternity services, involuntary
complications of pregnancy, neonatal care, and inpatient hospital
maternity care, including labor and delivery and postpartum care.
This definition of "maternity services" shall remain in effect until
such time as federal regulations and guidance issued pursuant to the
federal Patient Protection and Affordable Care Act (Public Law
111-148) define the scope of benefits to be provided under the
maternity benefit requirement of that act, after which time the
definition of that term under the federal act and associated
regulations and guidance shall apply for purposes of this section.
   (c) This section shall not apply to specialized health insurance,
Medicare supplement insurance, short-term limited duration health
insurance, CHAMPUS-supplement insurance, or TRI-CARE supplement
insurance, or to hospital indemnity, accident-only, or specified
disease insurance. 
   SEC. 3.    This act shall become operative only if
Senate Bill 222 of the 2011-12 Regular Session is also enacted and
takes effect.  All matter omitted in this version of the bill
appears in the bill as amended in the Senate, August 15, 2011. (JR11)