SB 677, as introduced, Monning. Health care coverage: agencies: reports.
Existing law requires the Managed Risk Medical Insurance Board to, by January 20, 2004, report to the Legislature specified information with regard to the State Children’s Health Insurance Program. Existing law requires the board to provide, by April 15, 1998, a proposal relating to drug and alcohol treatment programs for children.
This bill would delete those obsolete provisions.
Existing law requires the Department of Managed Health Care and the Department of Insurance to maintain a joint senior level working group to ensure clarity for health care consumers about who enforces their patient rights and consistency in the regulations of these departments. Existing law requires the working group to report its findings for review by the Insurance Commissioner and the Director of the Department of Managed Health Care for review and approval and submission every 5 years to the Legislature.
This bill would delete those reporting requirements.
Vote: majority. Appropriation: no. Fiscal committee: yes. State-mandated local program: no.
The people of the State of California do enact as follows:
Section 12693.925 of the Insurance Code is
2repealed.
(a) The Managed Risk Medical Insurance Board
4shall report to the Legislature on or before January 30, 2004, the
5following information with respect to the State Children’s Health
6Insurance Program:
7(1) A list of the categories of vulnerable children who should
8be the targets of public health initiatives, including, but not limited
9to, immigrant children, homeless children, and other children that
10face health disparities.
11(2) Recommendations on innovative methods available under
12the federal program for addressing health needs and barriers to
13care for the identified groups of vulnerable children. The board
14shall report as many recommendations as possible that are available
15under the federal program and the expected impact of each
16recommendation.
17(3) Recommendations on innovative methods available under
18the federal program for developing in urban areas initiatives similar
19to the rural demonstration projects. The board shall report as many
20recommendations as possible that are available under the federal
21program and the expected impact of each recommendation.
22(b) The board shall seek input, at regularly scheduled meetings
23of the board, from the Healthy Families Advisory Panel and
24stakeholder organizations, including, but not limited to,
25organizations that represent immigrant and homeless populations,
26other communities that experience health disparities, and traditional
27providers of care to low-income populations.
28(c) This section shall be implemented only to the extent that
29federal financial participation is obtained.
Section 12693.95 of the Insurance Code is repealed.
(a) The board in consultation with the Department
32of Alcohol and Drug Programs shall provide the Legislature by
33April 15, 1998, a proposal assessing the viability of providing
34additional drug and alcohol treatment services for children enrolled
35in the program.
36If the board determines that it is feasible to provide additional
37federal funds received pursuant to Title XXI (commencing with
38Section 2101) of the Social Security Act to counties to finance
P3 1drug and alcohol services and required federal approval is obtained,
2the board shall negotiate with participating health plans to establish
3memoranda of understanding between plans and counties to
4facilitate referral of children in need of these services.
5(b) Based on the April 15, 1998, report by the board to the
6Legislature, the Legislature finds and declares that there is a
7statewide gap in publicly funded alcohol and other drug treatment
8for adolescents which is significant and systemic.
9(1) Therefore, the Department of Alcohol and Drug Programs,
10in cooperation with the board, shall do the following:
11(A) Review capacity needs for the Healthy Families Program
12target group after year one data has been collected and an
13assessment of the adequacy of the benefit can be made.
14(B) Request that counties provide data on the number of
15adolescents requesting alcohol and other drug treatment and
16whether they are participating in the Healthy Families Program.
17(2) The board shall do the following:
18(A) Request the participating health plans to voluntarily collect
19data, as prescribed by the board, on the number of children needing
20services that exceed the substance abuse benefit in their plan.
21(B) Upon contract renewal, require participating health plans
22to collect and report the data.
23(C) By September 1, 1999, provide the policy and fiscal
24committees of the Legislature with an analysis of the data obtained
25by the Department of Alcohol and Drug Programs and from the
26participating health plans.
Section 12923.5 of the Insurance Code is amended to
28read:
(a) The Department of Managed Health Care and the
30Department of Insurance shall maintain a joint senior level working
31group to ensure clarity for health care consumers about who
32enforces their patient rights and consistency in the regulations of
33these departments.
34(b) The joint working group shall undertake a review and
35examination of the Health and Safety Code, the Insurance Code,
36and the Welfare and Institutions Code as they apply to the
37Department of Managed Health Care and the Department of
38Insurance to ensure consistency in consumer protection.
39(c) The joint working group shall review and examine all of the
40following processes in each department:
P4 1(1) Grievance and consumer complaint processes, including,
2but not limited to, outreach,
standard complaints, including
3coverage and medical necessity complaints, independent medical
4review, and information developed for consumer use.
5(2) The processes used to ensure enforcement of the law,
6including, but not limited to, the medical survey and audit process
7in the Health and Safety Code and market conduct exams in the
8Insurance Code.
9(3) The processes for regulating the timely payment of claims.
10(d) The joint working group shall report its findings to the
11Insurance Commissioner and the Director of the Department of
12Managed Health Care for review and approval. The commissioner
13and the director shall submit the approved final report under
14signature to the Legislature by January 1 of every year for five
15years.
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