BILL NUMBER: SB 1256 AMENDED
BILL TEXT
AMENDED IN ASSEMBLY JUNE 11, 2014
AMENDED IN SENATE APRIL 29, 2014
INTRODUCED BY Senator Mitchell
FEBRUARY 21, 2014
An act to repeal and add Section 654.4 to
654.3 of the Business and Professions Code,
relating to health care services.
LEGISLATIVE COUNSEL'S DIGEST
SB 1256, as amended, Mitchell. Medical services: credit.
Existing law prohibits a healing arts licensee, including
physicians and surgeons, psychologists, acupuncturists, optometrists,
dentists, podiatrists, and chiropractic practitioners, from
referring a person for certain health care services if the licensee
has a financial interest, as defined, with the person or entity that
receives the referral. Existing law provides specified exemptions
from this prohibition. Under existing law, a violation of the
provisions governing referrals is a crime.
Existing law prohibits a dentist, or an employee or agent of that
dentist, from arranging for or establishing credit extended by a 3rd
party for a patient without first providing a written notice and a
written treatment plan, as specified. Existing law prohibits a
dentist, or employee or agent of a dentist, from charging treatment
not yet rendered or costs not yet incurred to an open-end credit
extended by a 3rd party that is arranged for or established in the
dental office without first providing the patient with specified
information regarding the treatment and services to be rendered and
ensuring the patient's receipt of the treatment plan. A person who
willfully violates these provisions is subject to specified civil
liability.
This bill would similarly delete those
provisions pertaining to a dentist or an employee or agent of a
dentist, and instead would prohibit a healing arts licensee, or
an employee or agent of that licensee, including a dentist,
from arranging for or establishing credit or a loan
extended by a 3rd party for a patient without first providing a
written printed notice or electronic notice, as
specified, and a written treatment plan, and would prohibit
that arrangement or establishment of credit or a loan with
regard to a patient who has been administered or is under the
influence of general anesthesia, conscious sedation, or nitrous
oxide. The bill would prohibit a healing arts licensee, or employee
or agent of a licensee, from charging treatment not yet rendered or
costs not yet incurred to an open-end credit extended by a 3rd party
that is arranged for or established in the licensee's office without
first providing the patient with specified information regarding the
treatment and services to be rendered and ensuring the patient's
receipt of the treatment plan. The bill would require a healing arts
licensee to refund to the lender any payment received for treatment
that has not been rendered or costs that have not been incurred, as
specified, within 15 business days upon the patient's request. The
bill would provide that a person who willfully violates these
provisions is subject to specified civil liability.
Because a violation of these provisions would be a crime, this
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. Section 654.3 of the
Business and Professions Code is repealed.
654.3. (a) A dentist, or an employee or agent of a dentist, shall
not charge treatment or costs to an open-end credit, that is
extended by a third party and that is arranged for or established in
a dental office, before the date upon which the treatment is rendered
or costs are incurred, without first providing the patient a list of
the treatment and services to be rendered, the estimated costs of
the treatment and services, and which treatment and services are
being charged in advance of rendering or incurring of costs, and
ensuring that the patient has received the treatment plan required by
subdivision (d).
(b) A dentist shall, within 15 business days of a patient's
request, refund to the lender any payment received through credit
extended by a third party that is arranged for or established in a
dental office for treatment that has not been rendered or costs that
have not been incurred.
(c) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit extended by a third party for a
patient without first providing the following written notice, on one
page in at least 14-point type, and obtaining a signature from the
patient:
"Credit for Dental Services
The attached application and information is for a credit card/line
of credit or loan to help you finance your dental treatment. You
should know that:
You are applying for a ____ credit card/line of credit or a ____
loan for $____.
You do not have to apply for the credit card/line of credit or
loan. You may pay your dentist for dental treatment in another
manner.
This credit card/line of credit or loan is not a payment plan with
the dental office; it is credit with name of company issuing the
credit card/line of credit or loan]. Your dentist does not work for
this company.
Before applying for this credit card/line of credit or loan, you
have the right to a written treatment plan from your dentist that
includes the anticipated treatment to be provided and the estimated
costs of each service.
If you are approved for a credit card/line of credit, your dentist
can only charge treatment and lab costs to that credit card/line of
credit when you get the treatment or the dentist incurs costs unless
your dentist has first given you a list of treatments that you are
paying for in advance and the cost for each treatment or service.
You have the right to receive a credit to your credit card/line of
credit or loan account refunded for any costs charged to the credit
card/line of credit or loan for treatment that has not been rendered
or costs that your dentist has not incurred. Your dentist must refund
the amount of the charges to the lender within 15 business days of
your request, after which the lender will credit your account.
Please read carefully the terms and conditions of this credit
card/line of credit or loan, including any promotional offers.
You may be required to pay interest on the amount charged to the
credit card/line of credit or the amount of the loan. If you miss a
payment or do not pay on time, you may have to pay a penalty and/or a
higher interest rate.
If you do not pay the money that you owe the company that provides
you with a credit card/line of credit or loan, your missed payments
can appear on your credit report and could hurt your credit rating.
You could also be sued.
Patient's Signature]"
(d) A dentist shall give a patient a written treatment plan prior
to arranging for or establishing credit extended by a third party.
The treatment plan shall include each anticipated service to be
provided and the estimated cost of each service. If a patient is
covered by a private or government dental benefit plan or dental
insurance, from which the dentist takes assignment of benefits, the
treatment plan shall indicate the patient's private or
government-estimated share of cost for each service. If the dentist
does not take assignment of benefits from a patient's dental benefit
plan or insurance, the treatment plan shall indicate that the
treatment may or may not be covered by a patient's dental benefit or
insurance plan, and that the patient has the right to confirm dental
benefit or insurance information from the patient's plan, insurer, or
employer before beginning treatment.
(e) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit extended by a third party for a
patient with whom the dentist, or an employee or agent of that
dentist, communicates primarily in a language other than English that
is one of the Medi-Cal threshold languages, unless the written
notice information required by subdivision (c) is also provided in
that language.
(f) A dentist, or an employee or agent of that dentist, shall not
arrange for or establish credit that is extended by a third party for
a patient who has been administered or is under the influence of
general anesthesia, conscious sedation, or nitrous oxide.
(g) A patient who suffers any damage as a result of the use or
employment by any person of a method, act, or practice that willfully
violates this section may seek the relief provided by Chapter 4
(commencing with Section 1780) of Title 1.5 of Part 4 of Division 3
of the Civil Code.
(h) The rights, remedies, and penalties established by this
article are cumulative, and shall not supersede the rights, remedies,
or penalties established under other laws.
(i) For purposes of this section, the following definitions shall
apply:
(1) "Dentist" includes, but is not limited to, a dental
corporation, as defined in Section 1800.
(2) "Open-end credit" means credit extended by a creditor under a
plan in which the creditor reasonably contemplates repeated
transactions, the creditor may impose a finance charge from time to
time on an outstanding unpaid balance, and the amount of credit that
may be extended to the debtor during the term of the plan (up to any
limit set by the creditor) is generally made available to the extent
that any outstanding balance is repaid.
(3) "Patient" includes, but is not limited to, the patient's
parent or other legal representative.
SEC. 2. Section 654.3 is added to the
Business and Professions Code , to read:
654.3. (a) For purposes of this section, the following
definitions shall apply:
(1) "Licensee" means an individual, firm, partnership,
association, corporation, limited liability company, or cooperative
association licensed under this division or under any initiative act
or division referred to in this division.
(2) "Licensee's office" means either of the following:
(A) An office of a licensee in solo practice.
(B) An office in which services or goods are personally provided
by the licensee or by employees in that office, or personally by
independent contractors in that office, in accordance with law.
Employees and independent contractors shall be licensed or certified
when licensure or certification is required by law.
(3) "Open-end credit" means credit extended by a creditor under a
plan in which the creditor reasonably contemplates repeated
transactions, the creditor may impose a finance charge from time to
time on an outstanding unpaid balance, and the amount of credit that
may be extended to the debtor during the term of the plan, up to any
limit set by the creditor, is generally made available to the extent
that any outstanding balance is repaid.
(4) "Patient" includes, but is not limited to, the patient's
parent or other legal representative.
(b) It is unlawful for a licensee, or employee or agent of that
licensee, to charge treatment or costs to an open-end credit or loan,
that is extended by a third party and that is arranged for, or
established in, that licensee's office, before the date upon which
the treatment is rendered or costs are incurred, without first
providing the patient with a treatment plan, as required by
subdivision (e) and a list of which treatment and services are being
charged in advance of rendering or incurring of costs.
(c) A licensee shall, within 15 business days of a patient's
request, refund to the lender any payment received through credit or
a loan extended by a third party that is arranged for, or established
in, that licensee's office for treatment that has not been rendered
or costs that have not been incurred.
(d) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit or a loan extended by a third
party for a patient without first providing the following written or
electronic notice, on one page or screen, respectively, in at least
14-point type, and obtaining a signature from the patient:
"Credit or Loan for Medical Services
The attached application and information is for a credit card/line
of credit or loan to help you finance your medical treatment. You
should know that:
You are applying for a ____credit card/line of credit or a
____loan for $____.
You do not have to apply for the credit card/line of credit or
loan. You may pay your medical provider for treatment in another
manner.
This credit card/line of credit or loan is not a payment plan with
the provider's office; it is credit with, or a loan made by, name of
company issuing the credit card/line of credit or loan]. Your
medical provider does not work for this company.
Before applying for this credit card/line of credit or loan, you
have the right to a written treatment plan from your medical provider
that includes the anticipated treatment to be provided and the
estimated costs of each service.
If you are approved for a credit card/line of credit or loan, your
medical provider can only charge treatment and laboratory costs to
that credit card/line of credit or loan when you get the treatment or
the medical provider incurs costs unless your medical provider has
first given you a list of treatments that you are paying for in
advance and the cost for each treatment or service.
You have the right to receive a credit to your credit card/line of
credit or loan account refunded for any costs charged to the credit
card/line of credit or loan for treatment that has not been rendered
or costs that your medical provider has not incurred. Your medical
provider must refund the amount of the charges to the lender within
15 business days of your request, after which the lender will credit
your account.
Please read carefully the terms and conditions of this credit
card/line of credit or loan, including any promotional offers.
You may be required to pay interest rates on the amount charged to
the credit card/line of credit or the amount of the loan. If you
miss a payment or do not pay on time, you may have to pay a penalty
on the entire cost of your procedure and a higher interest rate.
You may use this credit card/line of credit or loan for payments
toward subsequent medical services.
If you do not pay the money that you owe the company that provides
you with a credit card/line of credit or loan, your missed payments
can appear on your credit report and could hurt your credit rating.
You could also be sued.
______________________Patient's Signature]"
(e) Prior to arranging for or establishing credit or a loan
extended by a third party, a licensee shall give a patient a written
treatment plan. The treatment plan shall include each anticipated
service to be provided and the estimated cost of each service. If a
patient is covered by a private or government medical benefit plan or
medical insurance, from which the licensee takes assignment of
benefits, the treatment plan shall indicate the patient's private or
government-estimated share of cost for each service. If the licensee
does not take assignment of benefits from a patient's medical benefit
plan or insurance, the treatment plan shall indicate that the
treatment may or may not be covered by a patient's medical benefit or
insurance plan, and that the patient has the right to confirm
medical benefit or insurance information from the patient's plan,
insurer, or employer before beginning treatment.
(f) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit or a loan extended by a third
party for a patient with whom the licensee, or an employee or agent
of that licensee, communicates primarily in a language other than
English that is one of the Medi-Cal threshold languages, unless the
written notice information required by subdivision (d) is also
provided in that language.
(g) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit or a loan that is extended by a
third party for a patient who has been administered or is under the
influence of general anesthesia, conscious sedation, or nitrous
oxide.
(h) A patient who suffers any damage as a result of the use or
employment by any person of a method, act, or practice that willfully
violates this section may seek the relief provided by Chapter 4
(commencing with Section 1780) of Title 1.5 of Part 4 of Division 3
of the Civil Code.
(i) The rights, remedies, and penalties established by this
article are cumulative, and shall not supersede the rights, remedies,
or penalties established under other laws.
SEC. 3. 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.
SECTION 1. Section 654.4 is added to the
Business and Professions Code, to read:
654.4. (a) For purposes of this section, the following
definitions shall apply:
(1) "Licensee" means an individual, firm, partnership,
association, corporation, limited liability company, or cooperative
association licensed under this division or under any initiative act
or division referred to in this division.
(2) "Licensee's office" means either of the following:
(A) An office of a licensee in solo practice.
(B) An office in which services or goods are personally provided
by the licensee or by employees in that office, or personally by
independent contractors in that office, in accordance with law.
Employees and independent contractors shall be licensed or certified
when licensure or certification is required by law.
(3) "Open-end credit" means credit extended by a creditor under a
plan in which the creditor reasonably contemplates repeated
transactions, the creditor may impose a finance charge from time to
time on an outstanding unpaid balance, and the amount of credit that
may be extended to the debtor during the term of the plan, up to any
limit set by the creditor, is generally made available to the extent
that any outstanding balance is repaid.
(4) "Patient" includes, but is not limited to, the patient's
parent or other legal representative.
(b) It is unlawful for a licensee to charge treatment or costs to
an open-end credit, that is extended by a third party and that is
arranged for, or established in, that licensee's office, before the
date upon which the treatment is rendered or costs are incurred,
without first providing the patient a list of the treatment and
services to be rendered, the estimated costs of the treatment and
services, and which treatment and services are being charged in
advance of rendering or incurring of costs, and ensuring that the
patient has received the treatment plan required by subdivision (e).
(c) A licensee shall, within 15 business days of a patient's
request, refund to the lender any payment received through credit
extended by a third party that is arranged for, or established in,
that licensee's office for treatment that has not been rendered or
costs that have not been incurred.
(d) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit extended by a third party for a
patient without first providing the following written notice, on one
page in at least 14-point type, and obtaining a signature from the
patient:
"Credit for Medical Services
The attached application and information is for a credit card/line
of credit or loan to help you finance your medical treatment. You
should know that:
You are applying for a ____ credit card/line of credit or a ____
loan for $____.
You do not have to apply for the credit card/line of credit or
loan. You may pay your medical provider for treatment in another
manner.
This credit card/line of credit or loan is not a payment plan with
the provider's office; it is credit with name of company issuing the
credit card/line of credit or loan]. Your medical provider does not
work for this company.
Before applying for this credit card/line of credit or loan, you
have the right to a written treatment plan from your medical provider
that includes the anticipated treatment to be provided and the
estimated costs of each service.
If you are approved for a credit card/line of credit, your medical
provider can only charge treatment and laboratory costs to that
credit card/line of credit when you get the treatment or the medical
provider incurs costs unless your medical provider has first given
you a list of treatments that you are paying for in advance and the
cost for each treatment or service.
You have the right to receive a credit to your credit card/line of
credit or loan account refunded for any costs charged to the credit
card/line of credit or loan for treatment that has not been rendered
or costs that your medical provider has not incurred. Your medical
provider must refund the amount of the charges to the lender within
15 business days of your request, after which the lender will credit
your account.
Please read carefully the terms and conditions of this credit
card/line of credit or loan, including any promotional offers.
You may be required to pay interest rates on the amount charged to
the credit card/line of credit or the amount of the loan. If you
miss a payment or do not pay on time, you may have to pay a penalty
on the entire cost of your procedure and/or a higher interest rate.
You may use this credit card/line of credit for payments toward
subsequent medical services.
If you do not pay the money that you owe the company that provides
you with a credit card/line of credit or loan, your missed payments
can appear on your credit report and could hurt your credit rating.
You could also be sued.
______________________Patient's Signature]"
(e) Prior to arranging for or establishing credit extended by a
third party, a licensee shall give a patient a written treatment
plan. The treatment plan shall include each anticipated service to be
provided and the estimated cost of each service. If a patient is
covered by a private or government medical benefit plan or medical
insurance, from which the licensee takes assignment of benefits, the
treatment plan shall indicate the patient's private or
government-estimated share of cost for each service. If the licensee
does not take assignment of benefits from a patient's medical benefit
plan or insurance, the treatment plan shall indicate that the
treatment may or may not be covered by a patient's medical benefit or
insurance plan, and that the patient has the right to confirm
medical benefit or insurance information from the patient's plan,
insurer, or employer before beginning treatment.
(f) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit extended by a third party for a
patient with whom the licensee, or an employee or agent of that
licensee, communicates primarily in a language other than English
that is one of the Medi-Cal threshold languages, unless the written
notice information required by subdivision (d) is also provided in
that language.
(g) A licensee, or an employee or agent of that licensee, shall
not arrange for or establish credit that is extended by a third party
for a patient who has been administered or is under the influence of
general anesthesia, conscious sedation, or nitrous oxide.
(h) A patient who suffers any damage as a result of the use or
employment by any person of a method, act, or practice that willfully
violates this section may seek the relief provided by Chapter 4
(commencing with Section 1780) of Title 1.5 of Part 4 of Division 3
of the Civil Code.
(i) The rights, remedies, and penalties established by this
article are cumulative, and shall not supersede the rights, remedies,
or penalties established under other laws.
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.