BILL NUMBER: SB 264	INTRODUCED
	BILL TEXT


INTRODUCED BY   Senator Pavley

                        FEBRUARY 13, 2013

   An act to add Article 11.9 (commencing with Section 1399.850) to
Chapter 2.2 of Division 2 of the Health and Safety Code, relating to
accountable care organizations.


	LEGISLATIVE COUNSEL'S DIGEST


   SB 264, as introduced, Pavley. Accountable care organizations.
   Existing law, the Knox-Keene Health Care Service Plan Act of 1975,
provides for the licensure and regulation of health care service
plans by the Department of Managed Health Care and makes a willful
violation of the act a crime. Existing law, the federal Patient
Protection and Affordable Care Act (PPACA), enacts various health
care coverage market reforms that take effect on January 1, 2014. The
PPACA, among other things, allows for the establishment of
provider-based accountable care organizations to promote
accountability for a patient population and coordinate items and
services, as provided under federal law.
   This bill would require an accountable care organization, as
defined, operating in the state to have a clinical laboratory testing
advisory board, as specified, to recommend testing guidelines that
the accountable care organization may adopt. Because a willful
violation of that requirement by an accountable care organization
would be a crime, the bill would impose a state-mandated local
program.
   The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
   This bill would provide that no reimbursement is required by this
act for a specified reason.
   Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.


THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:

  SECTION 1.  Article 11.9 (commencing with Section 1399.850) is
added to Chapter 2.2 of Division 2 of the Health and Safety Code, to
read:

      Article 11.9.  Accountable Care Organizations


   1399.850.  "Accountable care organization" or "ACO" means the same
as defined in Section 3022 of the federal Patient Protection and
Affordable Care Act (Public Law 111-148).
   1399.858.  (a) An accountable care organization operating in the
state shall have a clinical laboratory testing advisory board that
considers and recommends guidelines for clinical laboratory testing.
   (1) The advisory board may make recommendations to the ACO related
to, but not limited to, diagnostics, disease management, pathology,
and appropriate use of testing.
   (2) The advisory board shall have at least one physician and
surgeon who is legally affiliated with the ACO, and is a director of
a clinical laboratory providing services to the ACO.
   (b) This section does not require an ACO to adopt a recommendation
of the advisory board.
  SEC. 2.  No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.