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: May 23, 2013 Consultant: Brendan McCarthy SUSPENSE FILE. AS PROPOSED TO BE AMENDED. 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 the bill's requirements by health insurers (Insurance Fund). SB 138 (Hernandez) Page 1 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. Proposed author's amendments: would clarify when plan filing reviews would occur.