BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          SB 494 (Monning) - Health care providers.
          
          Amended: April 3, 2013          Policy Vote: Health 9-0
          Urgency: No                     Mandate: Yes
          Hearing Date: May 6, 2013       Consultant: Brendan McCarthy
          
          This bill meets the criteria for referral to the Suspense File.
          
          
          Bill Summary: SB 494 would authorize a health plan or health  
          insurance plan to assign up to 2,000 patients to a primary care  
          physician. If a primary care physician supervises one or more  
          non-physician medical practitioners, the primary care physician  
          may be assigned an additional 1,750 patients per non-physician  
          medical practitioner

          Fiscal Impact: 
              One-time costs of $600,000 to review plan filings by the  
              Department of Managed Health Care (Managed Care Fund).

              Potential ongoing enforcement cost in the tens of thousands  
              per year by the Department of Managed Health Care (Managed  
              Care Fund).

              One-time costs of $80,000 to update regulations by the  
              Department of Insurance (Insurance Fund).

          Background: Under current law, health plans are licensed and  
          regulated by the Department of Managed Health Care and insurance  
          plans are licensed and regulated by the Department of insurance.

          Under regulation, health plans that assign patients to a primary  
          care physician can assign up to 2,000 patients per full time  
          equivalent primary care physician (often referred to as a  
          physician's "panel").

          The state's Medi-Cal program provides health care coverage for  
          low income children, their families, and certain disabled  
          residents of the state. Of the roughly 8.2 million people  
          enrolled in Medi-Cal, about 70% are served through by Medi-Cal  
          managed care plans.









          SB 494 (Monning)
          Page 1


          Proposed Law: SB 494 would authorize a health plan or health  
          insurance plan to assign up to 2,000 patients to a primary care  
          physician. If a primary care physician supervises one or more  
          non-physician medical practitioners, the primary care physician  
          may be assigned an additional 1,750 patients per non-physician  
          medical practitioner

          The bill specifies that these requirements do not require a  
          physician to accept a number of patients that would exceed the  
          standards of good health care.

          These requirements would apply to both health plans and health  
          insurers.

          The bill specifically extends this authority to Medi-Cal managed  
          care plans.
          
          Staff Comments: The only costs that may be incurred by a local  
          agency under the bill relate to crimes and infractions. Under  
          the California Constitution, those costs are not reimbursable by  
          the state.