BILL ANALYSIS Ó AB 2252 Page 1 CONCURRENCE IN SENATE AMENDMENTS AB 2252 (Gordon) As Amended August 6, 2012 Majority vote ----------------------------------------------------------------- |ASSEMBLY: |77-0 |(May 30, 2012) |SENATE: |37-0 |(August 23, | | | | | | |2012) | ----------------------------------------------------------------- Original Committee Reference: HEALTH SUMMARY : Amends the Health Care Provider's Bill of Rights with respect to a health care service plan or health insurance policy, including specialized health plans and insurance policies, covering dental services, to require notification if a material change is made to the rules, guidelines, policies, or procedures concerning contracting or coverage of or payment for dental services. The Senate amendments : 1)Exclude regulations from the types of documents that require a material change notification. 2)Clarify that the material change notification is provided to contracting dentists. 3)Limit the notification to a change to the system by which the plan adjudicates and pays claims for treatment that would reasonably be expected to cause delays or disruptions or a change to the general coverage or general policies that affect rates and fees paid to providers. 4)Require a plan or insurer to within 60 days (instead of at least 45 days) following a request by the provider, either online, via email, or in paper form, to provide a copy of its current contract and a summary of the changes, as described, in cases of automatic contract renewal. 5)Delete an Assembly approved provision giving the provider a right to terminate the contract within 30 business days of receiving the summary. AS PASSED BY THE ASSEMBLY , this bill required, if a material AB 2252 Page 2 change is made to the rules, regulations, guidelines, policies, or procedures governing contracting, coverage, or payment for dental services to a health care service plan contract, specialized health plan contract covering dental, a health insurance policy or specialized health insurance policy covering dental services, the plan or insurer to provide notice of at least 45 business days and give the dentist an opportunity to negotiate or terminate the contract. FISCAL EFFECT : According to the Senate Appropriations Committee: 1)The Department of Managed Health Care may incur one-time costs up to $70,000 (Managed Care Fund) to review health plan documents. Costs to the California Department of Insurance are likely to be minor. 2)No increase in costs to the state as a provider of dental benefits is likely to occur, as the changes in this bill are not anticipated to significantly increase the costs of providing dental coverage. COMMENTS : This bill is sponsored by the California Dental Association to strengthen the partnership that already exists between providers and plans by ensuring that adequate notification of significant changes in plan polices are communicated in a transparent and timely manner. Analysis Prepared by : Teri Boughton / HEALTH / (916) 319-2097 FN: 0004654