BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1428
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          CONCURRENCE IN SENATE AMENDMENTS
          AB 1428 (Conway)
          As Amended August 27, 2013
          2/3 vote. Urgency
           
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          |ASSEMBLY:  |77-0 |(August 8,      |SENATE: |37-0 |(September 3,  |
          |           |     |2013)           |        |     |2013)          |
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           Original Committee Reference:    HEALTH  

           SUMMARY  :  Revises provisions that require the California Health  
          Benefit Exchange (Exchange), known as Covered California, to  
          require all employees, prospective employees, contractors,  
          subcontractors, and vendors who facilitate enrollment in the  
          Exchange and have access to the financial or medical information  
          of enrollees or potential enrollees of the Exchange to be  
          fingerprinted for the purpose of obtaining criminal history  
          information by inserting a reference to Minimum Risk Standards  
          for Exchanges (MARS-E), a specific federal document relating to  
          health exchange privacy and security.  Contains an urgency  
          clause in order to become effective immediately upon enactment.

           The Senate amendments  are technical and clarifying. 

           FISCAL EFFECT  :  According to the Senate Appropriations  
          Committee, pursuant to Senate Rule 28.8, negligible state costs.

           COMMENTS  :  This bill is intended as a companion measure to SB  
          509 (DeSaulnier), Chapter 10, Statutes of 2013.  SB 509 was  
          chaptered on June 17, 2013, as an urgency statute in order for  
          Covered California to begin hiring call center employees.  As SB  
          509 moved through the legislative process, its provisions did  
          not mention the MARS-E but instead referenced "federal guidance  
          applicable to state-based exchanges."  Covered California's  
          board determined compliance with the MARS-E was important but  
          because SB 509's proponents did not want to delay call center  
          hiring, SB 509 moved forward with an agreement that clarifying  
          language, including specific reference to the MARS-E, would  
          follow in this bill.

          The author states that the Exchange will hire over 20,000  
          individuals to promote the Exchange and enroll the public.  The  
          author states that it is estimated that the Assisters and  








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          Navigators will guide over four million Californians to enroll  
          in the new state Exchange.  The author further states that these  
          Assisters and Navigators will have access to millions of  
          enrollees' most sensitive personal identifying information (PII)  
          including:  home addresses; Social Security Numbers (SSNs);  
          state and federal tax information (FTI); and personal health  
          information (PHI).  According to the author, federal privacy and  
          security guidelines require state Exchanges to perform  
          fingerprint-based criminal background checks prior to hiring any  
          person whose position will have access to personal information  
          for applicants and enrollees.  The author points out that the  
          guidance also requires periodic rescreening of employees with  
          access to this information.  

          Verification of eligibility will require that many Covered  
          California employees, prospective employees, contractors,  
          subcontractors, volunteers, and vendors have access to applicant  
          or enrollee PII, PHI, and/or FTI.  For example, Covered  
          California will request tax return data regarding Modified  
          Adjusted Gross Income and family size from the federal  
          Department of Health and Human Services (DHHS) through a data  
          hub if they have a SSN or Taxpayer Identification Number and  
          will use it to verify information provided by the applicant.   
          Federal guidance requires that Covered California protect and  
          safeguard customers from unauthorized and illegal access to or  
          disclosure of this information.  

          Based on federal guidance, Covered California has determined the  
          Exchange must meet MARS-E, one of three on Exchange privacy and  
          security standards.  According to documents provided by Covered  
          California, the MARS-E requires all individuals associated with  
          the Exchange who would have access to sensitive information such  
          as PII, PHI, and FTI to be screened before they may be  
          authorized to obtain access to the information system and  
          devices containing such information.  To meet these  
          requirements, Covered California must perform a background check  
          for all persons prior to authorizing access and require  
          appropriate personnel to obtain and hold a moderate-risk  
          security clearance as defined in the federal DHHS Personnel  
          Security/Suitability Handbook.  The MARS-E also requires  
          periodic rescreening of individuals, consistent with the  
          criticality or sensitivity rating of the position.  Furthermore,  
          according to Covered California, the Internal Revenue Service  
          Security Guidelines require screening and consideration of an  
          individual's background and security clearance when designating  








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          personnel who are authorized to access FTI.  

          Covered California is in the process of establishing an  
          Assisters Program that will include assister enrollment entities  
          (AEE) and individual entities.  AEEs are entities and  
          organizations eligible to be trained and registered to provide  
          in-person assistance to consumers and help them apply for  
          Covered California programs, particularly entities that have  
          access to Covered California's targeted population.  Individual  
          AEEs are individuals who are employed, trained, certified, and  
          linked to AEEs to provide in-person assistance to consumers and  
          help them apply for Covered California programs and are  
          individuals who can provide assistance in a culturally and  
          linguistically appropriate manner to consumers.  


           Analysis Prepared by  :    Marjorie Swartz / HEALTH / (916)  
          319-2097 


          FN: 0002261