BILL NUMBER: AB 2436	INTRODUCED
	BILL TEXT


INTRODUCED BY   Assembly Member Roger Hernández

                        FEBRUARY 19, 2016

   An act to add Section 1367.207 to the Health and Safety Code,
immediately following Section 1367.205, and to add Section 10123.202
to the Insurance Code, relating to health care coverage.


	LEGISLATIVE COUNSEL'S DIGEST


   AB 2436, as introduced, Roger Hernández. Health care coverage:
disclosures: drug pricing.
   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 also provides for the
regulation of health insurers by the Department of Insurance.
Existing law imposes various requirements on contracts and policies
that cover prescription drug benefits.
   This bill would require a health care service plan contract or a
policy of health insurance that is issued, amended, or renewed on or
after January 1, 2017, and that provides coverage for prescription
drug benefits to notify the enrollee or insured of specified
information related to the cost of a prescription drug at the time
that the drug is purchased or delivered. Because a willful violation
of the bill's requirements by a health care service plan 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.  Section 1367.207 is added to the Health and Safety
Code, to read:
   1367.207.  A health care service plan contract issued, amended, or
renewed on or after January 1, 2017, that provides coverage for
prescription drug benefits shall require the plan to notify the
enrollee of the following at the time of purchase or time of delivery
of a prescription drug:
   (a) The enrollee's share of the cost for the prescription drug,
including any copayment, coinsurance, or other cost sharing, and the
accumulation of that cost sharing to the enrollee's deductible, if
any, or out-of-pocket maximum.
   (b) The cost of the prescription drug to the plan, after applying
any discounts, rebates, or other reductions in cost to the plan.
   (c) The cost of the prescription drug in United States dollars in
the following countries:
   (1) Canada.
   (2) Germany.
   (3) Mexico.
  SEC. 2.  Section 10123.202 is added to the Insurance Code,
immediately following Section 10123.201, to read:
   10123.202.  A policy of health insurance issued, amended, or
renewed on or after January 1, 2017, that provides coverage for
prescription drug benefits shall require the insurer to notify the
insured of the following at the time of purchase or time of delivery
of a prescription drug:
   (a) The insured's share of the cost for the prescription drug,
including any copayment, coinsurance, or other cost sharing, and the
accumulation of that cost sharing to the insured's deductible, if
any, or out-of-pocket maximum.
   (b) The cost of the prescription drug to the insurer, after
applying any discounts, rebates, or other reductions in cost to the
insurer.
   (c) The cost of the prescription drug in United States dollars in
the following countries:
   (1) Canada.
   (2) Germany.
   (3) Mexico.
  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.