BILL ANALYSIS Ó
AB 2252
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CONCURRENCE IN SENATE AMENDMENTS
AB 2252 (Gordon)
As Amended August 6, 2012
Majority vote
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|ASSEMBLY: |77-0 |(May 30, 2012) |SENATE: |37-0 |(August 23, |
| | | | | |2012) |
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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
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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