BILL ANALYSIS Ó
SB 1135
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Date of Hearing: August 3, 2016
ASSEMBLY COMMITTEE ON APPROPRIATIONS
Lorena Gonzalez, Chair
SB 1135
(Monning) - As Amended June 30, 2016
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|Policy |Health |Vote:|13 - 4 |
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Urgency: No State Mandated Local Program: YesReimbursable:
No
SUMMARY:
This bill requires health plans and insurers to provide
enrollees or insureds with information regarding standards for
timely access to care (timely access standards) and interpreter
services pursuant to existing law.
FISCAL EFFECT:
Administrative costs to the California Department of Insurance
of $65,000 in 2016-17 and $79,000 in 2017-18 and (Insurance
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Fund) and minor and absorbable costs to the Department of
Managed Health Care (Managed Care Fund) to verify plans and
insurers comply with this requirement.
COMMENTS:
1)Purpose. According to the author, few California consumers
know that they are entitled to timely access to care and in
their preferred language. The goal of this bill is to help
inform consumers about their timely access rights so consumers
are better able to insure health plan accountability in
meeting timely access standards.
2)Timely Access Standards and Language Services. Current law
requires health plans and insurers to provide timely access to
care. For example, a primary care visit must be available
within 10 days. Health plans and 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. Current law also
requires plans and insurers to provide an interpreter when
requested.
3)Prior Legislation.
a) SB 964 (Hernandez), Chapter 573, Statutes of 2014,
requires a health plan to annually report specified network
adequacy data, including separate Medi-Cal managed care and
individual market product line data, to DMHC as part of its
annual timely access compliance report, and requires DMHC
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to review the network adequacy data.
b) AB 2179 (Cohn), Chapter 797, Statutes of 2002, required
DMHC and CDI to develop and adopt regulations to ensure
that enrollees have access to needed health care services.
Analysis Prepared by:Lisa Murawski / APPR. / (916)
319-2081