BILL ANALYSIS Ó SB 138 Page 1 Date of Hearing: August 14, 2013 ASSEMBLY COMMITTEE ON APPROPRIATIONS Mike Gatto, Chair SB 138 (Hernández) - As Amended: August 6, 2013 Policy Committee: HealthVote:13-5 Judiciary Vote: 7-3 Urgency: No State Mandated Local Program: Yes Reimbursable: No SUMMARY This bill requires health plans and insurers to accommodate an individual's wishes for confidential communication related to "sensitive services," as defined, for persons insured as dependents on another individuals' policy, as well as an individuals' wishes for non-disclosure of certain insurance communications in cases where an insured individual specifies disclosure will endanger them. FISCAL EFFECT One-time costs for initial review of health plan compliance in the range of $500,000 (Managed Care Fund) to the Department of Managed Health Care (DMHC). Costs to the California Department of Insurance (CDI) should be minor and absorbable, as they appear to rely on insurance plan attestation of compliance rather than reviewing privacy policies and plan contracts for compliance. Potential increase in ongoing enforcement costs to CDI and DMHC, not likely to exceed $100,000 total annually (Insurance Fund/Managed Care Fund). COMMENTS 1)Rationale . This bill intends to protect patient confidentiality for insured dependents accessing services related to sexual and reproductive health, HIV/AIDS, substance use and mental health care or any other health care service when disclosure could cause harm. Studies indicate, for example, minors and young adults delay or forgo needed SB 138 Page 2 reproductive health care because of concerns about confidentiality. This bill mirrors and strengthens existing federal protections related to an individual's wishes for confidentiality of their medical information. Supporters of this bill indicate it will allow individuals to access services without worrying that parents or spouses will be notified. This bill is sponsored by the California Family Health Council. 2)Background . A significant body of federal law and state law protect privacy of an individual's personal health information (PHI). However, PHI related to dependents is often included in insurance communications such as Explanation of Benefits (EOB) forms that are sent to the policyholder as a notification of paid claims. EOB forms, for example, may list specific services that insured individuals may wish to keep confidential from the policyholder. State law allows minors to consent to certain types of medical care, such as care related to the prevention or treatment of pregnancy. Federal law now allows children to remain on their parent's policies until age 26, which supporters indicate is another impetus for strengthening confidentiality protections around certain services. 3)Concerns . Although significant amendments have been taken that addressed some of their concerns, the California Association of Health Plans (CAHP) and the Association of California Life & Health Insurance Companies (ACLHIC) still have significant concerns related to implementation and workability details. They indicate discussions are ongoing with the bill's author to resolve outstanding issues. Analysis Prepared by : Lisa Murawski / APPR. / (916) 319-2081