BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Kevin de León, Chair
SB 138 (Hernandez) - Confidentiality of medical information.
Amended: April 8, 2013 Policy Vote: Health 7-2,
Judiciary 5-2
Urgency: No Mandate: Yes
Hearing Date: April 29, 2013
Consultant: Brendan McCarthy
This bill meets the criteria for referral to the Suspense File.
Bill Summary: SB 138 would prohibit a health plan or health
insurer from sending communications to a policy holder regarding
sensitive health care services provided to an individual who is
under 26 years of age and is insured as a dependent on another
person's policy. The bill also prohibits sending communications
regarding sensitive services provided to an individual over 26
years of age, upon that person's request.
Fiscal Impact:
One-time costs between $500,000 and $600,000 for review of
health plan contracts and other documents by the Department
of Managed Health Care to ensure that health plan privacy
policies comply with the bill's requirements (Managed Care
Fund).
Potential ongoing enforcement costs, likely in the tens of
thousands annually, based on complaints for violations of
the bill's requirements by health plans (Managed Care Fund).
One-time costs between $500,000 and $600,000 for review of
insurance plan contracts and other documents by the
Department of Insurance to ensure that health plan privacy
policies comply with the bill's requirements (Insurance
Fund). While the Department indicates that costs under the
bill are absorbable, the initial review of insurance plan
contracts and other documents to ensure compliance with the
bill will likely impose additional workload on the
Department.
Potential ongoing enforcement costs, likely in the tens of
thousands annually, based on complaints for violations of
SB 138 (Hernandez)
Page 1
the bill's requirements by health insurers (Insurance Fund).
Background: Current state law prohibits health care providers or
health plans from sharing medical information without a
patient's consent.
Under current state law, health plans are regulated by the
Department of Managed Health Care and health insurers are
regulated by the Department of Insurance.
Proposed Law: SB 138 would prohibit a health plan or health
insurer from sending communications to a policy holder regarding
sensitive health care services provided to an individual who is
under 26 years of age and is insured as a dependent on another
person's policy.
The bill also prohibits sending communications to a policy
holder regarding sensitive services provided to an individual
over 26 years of age who is insured as a dependent on another
person's policy, upon that person's request.
The bill defines sensitive services as specified health care
services relating to HIV, family planning, drug and alcohol use,
and mental health.
The bill permits a health care provider to make arrangements
with an insured individual for the payment of benefit
cost-sharing and permits the provider to communicate that
information to the appropriate health plan or health insurer.
Staff Comments: The only local mandates imposed by the bill
relate to crimes or infractions and are not reimbursable by the
state under the California Constitution.