SB 260,
as amended, Monning. begin deleteInsurance: reports: electronic submission.end deletebegin insert Medi-Cal: county organized health systems.end insert
Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid Program provisions. One method by which these services are provided is pursuant to contracts with various types of managed care health plans, including through a county organized health system.
end insertbegin insertExisting law, the Knox-Keene Health Care Service Plan Act of 1975 (Knox-Keene), 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.
end insertbegin insertExisting law provides the California Medical Assistance Commission with the authority to negotiate exclusive contracts with county organized health systems to provide health care services under the Medi-Cal program. Under existing law, the contracting counties are exempt from Knox-Keene for purposes of carrying out those contracts.
end insertbegin insertThis bill would repeal that exemption and would deem a county contracting with the department under the provisions described above to be a health care service plan, and would subject contracting counties to the act for purposes of carrying out those contracts, unless the act expressly provides otherwise.
end insertbegin insertBecause a willful violation of Knox-Keene is a crime, this bill would impose a state-mandated local program.
end insertbegin insertThe 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.
end insertbegin insertThis bill would provide that no reimbursement is required by this act for a specified reason.
end insertExisting law provides for the regulation of insurers by the Department of Insurance. Existing law directs the Insurance Commissioner to enforce the execution of laws regulating the business of insurance. The existing Insurance Code requires various entities to submit certain reports to specified committees of the Legislature.
end deleteThis bill would authorize certain reports required to be submitted to a committee of the Legislature pursuant to the Insurance Code to be submitted electronically, as specified. The bill would also require that a report that is required under the Insurance Code to be submitted to a committee of the Legislature also be submitted as an electronic or printed copy to the Legislative Counsel.
end deleteVote: majority.
Appropriation: no.
Fiscal committee: yes.
State-mandated local program: begin deleteno end deletebegin insertyesend insert.
The people of the State of California do enact as follows:
begin insertSection 14087.95 of the end insertbegin insertWelfare and Institutions
2Codeend insertbegin insert is repealed.end insert
Counties contracting with the department pursuant
4to this article shall be exempt from the provisions of Chapter 2.2
5(commencing with Section 1340) of Division 2 of the Health and
6Safety Code for purposes of carrying out the contracts.
begin insertSection 14087.95 is added to the end insertbegin insertWelfare and
8Institutions Codeend insertbegin insert, to read:end insert
A county contracting with the department pursuant
10to this article shall be deemed to be a health care service plan, as
11defined in Section 1345 of the Health and Safety Code, and shall
12be subject to the Knox-Keene Health Care Service Plan Act of
131975 (Chapter 2.2 (commencing with Section 1340) of Division 2
P3 1of the Health and Safety Code) for the purpose of carrying out
2those contracts, unless the act expressly provides otherwise.
No reimbursement is required by this act pursuant to
4Section 6 of Article XIII B of the California Constitution because
5the only costs that may be incurred by a local agency or school
6district will be incurred because this act creates a new crime or
7infraction, eliminates a crime or infraction, or changes the penalty
8for a crime or infraction, within the meaning of Section 17556 of
9the Government Code, or changes the definition of a crime within
10the meaning of Section 6 of Article XIII B of the California
11Constitution.
Section 45.5 is added to the Insurance Code, to
13read:
(a) For purposes of this section, “report” includes any
15study or audit.
16(b) A report required under this code to be submitted to a
17committee of the Legislature shall also be submitted as an
18electronic or printed copy to the Legislative Counsel.
19(c) Reports required under Sections 1872.95, 11629.85, and
2013902 may be submitted electronically to a committee of the
21Legislature. This subdivision is not intended to prohibit the
22submission of a report electronically if authorized by any other
23law or the consent of any legislative committee.
24(d) (1) A report under this code that is submitted electronically
25
to a committee of the Legislature, may be submitted in any of the
26following ways:
27(A) Providing the committee a digital copy of the report
28delivered by electronic means to a person or account designated
29to receive reports.
30(B) Providing the committee a digital copy of the report stored
31on permanent media delivered by first-class mail.
32(C) Placing the report on the reporting entity’s Internet Web
33site so that it is publicly available for a period of no less than three
34years. If a report is submitted electronically in accordance with
35this subparagraph, the committee shall be provided notice that the
36report is available that includes specific instructions on how to
37access the report and how to request a
hardcopy. The notice shall
38be delivered by first-class mail or by electronic means and
39addressed to the person or account designated to receive reports.
P4 1(2) Reports and notices submitted electronically shall be
2provided in a standard format accessible by software or other means
3that is available without charge or obligation and is acceptable to
4the committee.
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