BILL ANALYSIS Ó SENATE COMMITTEE ON APPROPRIATIONS Senator Ricardo Lara, Chair 2015 - 2016 Regular Session SB 1135 (Monning) - Health care coverage: notice of timely access to care ----------------------------------------------------------------- | | | | | | ----------------------------------------------------------------- |--------------------------------+--------------------------------| | | | |Version: March 30, 2016 |Policy Vote: HEALTH 8 - 1 | | | | |--------------------------------+--------------------------------| | | | |Urgency: No |Mandate: Yes | | | | |--------------------------------+--------------------------------| | | | |Hearing Date: April 25, 2016 |Consultant: Brendan McCarthy | | | | ----------------------------------------------------------------- This bill meets the criteria for referral to the Suspense File. Bill Summary: SB 1135 would require health plans and health insurers (including Medi-Cal managed care plans) to notify enrollees and contracted providers about existing requirements to provide timely access to covered health care services. The bill would require health plans and health insurers (including Medi-Cal managed care plans) to include the appropriate regulatory agency's phone number on an enrollee's proof of coverage card. Fiscal Impact: Likely costs in the tens of millions per year for the Department of Managed Health Care to respond to questions and complaints from health plan enrollees and take enforcement action against health plans, when appropriate (Managed Care Fund). See staff comments below. Likely costs in the low millions for the Department of Insurance to respond to questions and complaints from Health SB 1135 (Monning) Page 1 of ? insurance enrollees and take enforcement action against health insurers, when appropriate (Insurance Fund). See staff comments below. Likely costs in the millions for the Medi-Cal Managed Care Office of the Ombudsman to respond to questions and complaints from enrollees in Medi-Cal managed care plans not regulated by the Department of Managed Health Care (General Fund and federal funds). See staff comments below. No significant increase in Medi-Cal utilization or costs are anticipated under the bill. Medi-Cal managed care plans are required to comply with existing timely access requirements and are already required to notify enrollees of those requirements. It is not anticipated that providing the additional information under the bill will significantly increase enrollee utilization of services. Background: Under current law, health plans and health insurers are required to meet timely access standards - under which they are required to ensure that enrollees have access to covered benefits in specified timeframes. Health plans and health insurers are not required to provide specific notice of those timely access rights to their enrollees, although some health plans or health insurers may do so as part of the information they provide to enrollees on covered benefits and health care networks. Medi-Cal managed care plans are required to provide such information to enrollees upon enrollment and ever year, under the plans' contracts with the Department of Health Care Services. Proposed Law: SB 1135 would require health plans and health insurers (including Medi-Cal managed care plans) to notify enrollees and contracted providers about existing requirements to provide timely access to covered health care services. The bill would require health plans and health insurers (including Medi-Cal managed care plans) to include the appropriate regulatory agency's phone number on an enrollee's proof of coverage card. Specific provisions of the bill would: Require health plan contracts or health insurance contracts to provide information on requirements for timely access to care SB 1135 (Monning) Page 2 of ? for enrollees and enrollee rights to interpretation services; Require such disclosures to include specific information on timely access requirements in law and regulation; Require the information to be provided upon enrollment and annually thereafter; Require the information to be provided in specified ways, including in the enrollee's evidence of coverage, in provider directories, and on the health plan or health insurer's website; Require the same information to be provided annually to providers that contract with a health plan or health insurer; Apply these requirements to Medi-Cal managed care plans; Require health plans and health insurers to provide the toll-free number and website for either the Department of Managed Health Care or the Department of Insurance on the enrollee's proof of coverage card; Require Medi-Cal managed care plans not regulated by the Department of Managed Health Care to provide the toll-free number for the Medi-Cal Managed Care Office of the Ombudsman on the enrollee's proof of coverage card. Staff Comments: Under current law and practice, enrollees in health plans and health insurance have proof of coverage cards which include the health plan or health insurer's toll-free number for enrollee questions or complaints about covered benefits, access to services, and other issues. According to data collected by the Department of Managed Health Care, about 7% of the state's 25 million health plan enrollees contact their health plan each month. On the other hand, the Department gets about 100,000 calls per year from health plan enrollees. This indicates that a relatively small number of enrollees either need to contact the Department or are aware that they can contact the Department if they are unhappy with their health plan's response. By putting the Department of Managed Health Care's toll-free line on the enrollee's proof of coverage card, enrollee awareness of the option to contact the Department will increase dramatically. It is likely that the number of enrollees who contact the Department (either instead of calling their health plan or if they are not satisfied with the health plan's response) will rise dramatically. According to calculations by the Department, if even 3% of the enrollees who contact their plan each year call the Department for assistance, it will SB 1135 (Monning) Page 3 of ? result in over 500,000 additional calls per year. At that call volume, the cost to the Department to respond to calls and take enforcement action when appropriate will be about $50 million per year. Health insurance companies would also be required to provide the toll-free number for the Department of Insurance. Medi-Cal managed care plans not regulated by the Department of Managed Health Care would be required to provide the toll-free number for the Medi-Cal Office of the Ombudsman. It is likely that both of those departments would receive a similar call volume in proportion to their enrollments. The cost estimates above assume that a similar proportion of their enrollees contact those departments each year, at a similar cost per call to operate their call centers. The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state. -- END --